Fibrin Glue Anastomosis of the Facial Nerve

Abstract

The facial nerve was repaired by fibrin glue anastomosis in the cerebellopontine angle, the petrous bone and/or the parotid in 70 patients. End-to-end (n = 22) or cable graft (n = 32) anastomosis of the facial nerve or hypoglosso-facial anastomosis (n = 16) was performed for 49 cerebellopontine angle tumors (45 acoustic neuromas and four meningiomas), 13 petrous bone tumors (nine facial neuromas, two cholesteatomas, one papillary epithelial tumor, one hemangioma) five petrous bone fractures, one parotid gland tumor with petrous extension and for two patients with iatrogenic intraparotid section of the nerve trunk. Grade III facial regeneration was observed in 62% of the patients, followed for at least 1 year. End-to-end and cable graft anastomoses in the cerebellopontine angle, in the petrous bone and in the parotid led to 59% and 65% grade III regeneration, respectively. Grade III and grade IV regeneration was observed in 50% of the patients after hypoglosso-facial anastomosis. We include that fibrin glue provides a safe technique for facial nerve repair. The anastomosis should be performed without tension and vascularization of the nerve should be preserved.