Reconstructive Surgical Strategies in Cranial Nerve Repair

Abstract

Microsurgical reconstruction of damaged cranial nerves at the extracranial level is based on the principles of peripheral nerve repair. Reestablishing the brain–target organ interconnection by restoring afferent and efferent signal transduction represents a prerequisite for an intact central representation of the affected, traumatized body region. Adequate knowledge of microsurgical reconstructive options of peripheral nerves, along with appropriate microsurgical instruments and high-magnification microscopes, allows the well-trained microsurgeon to provide the basis for a functional reconstructive result for traumatized extracranial nerves. Various strategies for extracranial nerve repair exist and should be individually adapted and combined to meet the requirements. Multiple variables, e.g., age of the patient, time passed since the trauma, level and site of the nerve lesion, accompanying lesions, individual expectations of the patient, and local clinical findings, are key factors for establishing an individual reconstructive surgical strategy.

Authors of this chapter: Robert Schmidhammer and Savas Tsolakidis.