Falcioni M, Taibah A, Russo A, Piccirillo E, Sanna M
Facial nerve grafting. [Journal Article]
Otol Neurotol 2003 May; 24(3):486-9.
OBJECTIVE: To evaluate the results of facial nerve reconstruction by means of grafting and to determine the influence of different variables on final functional recovery.
STUDY DESIGN: Retrospective case review.
SETTING: Tertiary otologic and skull base referral center.
PATIENTS: Sixty nine patients underwent facial nerve grafting. Facial nerve tumors (24) or vestibular schwannomas (18) affected most of them. Preoperatively, 47 patients had a clinical facial nerve deficit lasting from 1 to 120 months, with a mean of 20.2 months.
MAIN OUTCOME MEASURES: Final facial nerve motor function.
RESULTS: Among the 56 patients with a follow-up time equal to or longer than 1 year, 26 recovered to a Grade III (46.4%), 14 to a Grade IV (25%), while 16 remained at Grade V or Grade VI according to the House-Brackmann scale. Patients with a preoperative facial nerve deficit for more than 1 year showed the lowest rate of recovery, with only 3 cases (19%) reaching Grade III.
CONCLUSIONS: Duration of the preoperative facial nerve deficit emerged as the most important factor influencing final results. According to the authors' data, the 1-year period after the occurrence of the preoperative clinical deficit seemed to be the cutoff point in achieving a high rate of good postoperative recovery. Among the other factors that might have influenced the final outcome, only the underlying cause of the lesion played a significant role.
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