Facial-accessory nerve neurorrhaphy for treatment of peripheral facial paralysis

Abstract

Objective To investigate the therapeutic effect of facial-accessory nerve anastomosis in the treatment of peripheral facial paralysis.Methods 16 cases of peripheral facial paralysis were treated with neurorrhaphy of sternocleidomastoid muscle branch of accessory nerve and facial nerve from stylomastoid foramen.The facial nerve function was evaluated at the time point of 1 week,1 year and 3 years after the operation respectively.Results The average follow-up period for all patients was 42 months.Within 16 cases,2 cases,8 cases,4 cases,and 1 case were identified as functional recovery to Grade Ⅰ,Ⅱ,Ⅲ and Ⅳ respectively,according to the House-Brackmann evaluation system,and only 1 case did not recover.The standard of function recovery was above Grade Ⅱ,so the overall recovery rate of this group of patients was 63％ (10/16).The statistical analysis showed:preoperative and Ⅰ week,1 year,3 years postoperative H-B degree distribution were different (P ＜ 0.001).The recovery of facial nerve function appeared within 1 week after surgery; the significant improvement was shown within 1 year after surgery ; and further recovery was still possible in some patients during 1-3 years after surgery.Postoperative complications:only one case developed apparent inability to turn the neck.However,it doesn't seriously impact his life quality.Conclusions Facial accessory nerve neurorrhaphy was an effective treatment for peripheral facial paralysis.Strictly choosing the appropriate patients,meticulously operating in the surgery and tension-free neurorrhaphy were important to ensure the therapeutic efficiency. Key words: Facial nerve injuries ; Anastomosis, surgical ; Functional reconstruction ; Therapeutic effect