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).
(1) Department of Plastic and Reconstructive Surgery, Clinica Universidad de Navarra, Spain.
(2) Department of Plastic and Reconstructive Surgery, Clinica Universidad de Navarra, Spain.
(3) Department of Ear, Nose and Throat Surgery, Clinica Universidad de Navarra, Spain.
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.
CITATION Br J Oral Maxillofac Surg. 2016 May;54(4):466-8. doi: 10.1016/j.bjoms.2015.09.003. Epub 2015 Oct 1