Wrapping a facial nerve graft in a superficial temporofascial flap to optimise vascularisation: technical note
Hontanilla B (1), Cabello A (2), Marre D (2), Manrique M (3).
The outcome of grafting the facial nerve can be jeopardised when extensive bone drilling is required for adequate exposure and space for coaptation. Though nerve grafts placed directly over bone (without periosteum) sometimes work, the odds are reduced. To overcome this, the addition of well-vascularised tissue to the bed of the graft can be helpful.
A 34-year-old man with a history of cystic adenocarcinoma of the right parotid gland had a total parotidectomy with transection of the facial nerve at the level of the stylomastoid foramen, ipsilateral neck dissection, and postoperative external beam radiotherapy. Ten months later he consulted us about reanimation of a complete right-sided facial paralysis.