Facial nerve repair: a retrospective review.

Abstract

The purpose of this article is to review a large series of patients evaluated for disorders of the facial nerve in order to assess the indications for surgery, the timing of surgery, the techniques of nerve repair, and to better define those factors associated with a favorable outcome. A retrospective review of patients undergoing facial nerve repair from 1963-1997. One hundred and three patients underwent surgical intervention designed to repair a disrupted facial nerve. All procedures were performed by one of the senior surgeons (M.M.) Seventy-two patients had a complete data set and at least one year of follow-up. Eighty percent of patients attained an outcome considered superb to fair. Twenty percent of patients had a poor outcome. There was a slight worsening of outcome with increased time to repair. Patients with a neoplastic etiology of nerve paralysis tended to have a worse outcome. Facial nerve grafting is most successful if intervention is undertaken at or near the time of initial injury. However, prolonged time (up to two years) to repair does not preclude the potential for some recovery. The limitations of the current systems for grading facial recovery after nerve repair are well known, and the adoption of a new grading scale for assessing recovery after reanimation procedure is recommended.