Movement of the oral commissure was noted at 3 months after combined facial nerve repair with improved facial symmetry and minimal synkinesis. A report by Volk et al 8 demonstrated prevention of synkinesis by combining the hypoglossal nerve for innervation of the lower facial muscles with a cable graft for the upper facial muscles. Inhibition of the oculomotor nerve produces eyelid ptosis, eyelid closure, or both. The combined approach for nerve reconstruction offers several advantages compared with cable grafting alone. Inadequate corneal protection can cause exposure keratitis , corneal ulceration , and blindness. The smile is one of the most important facial expressions, and facial paralysis can debilitate an individual.
However it first has to be investigated if the motor function of the nerve is strong enough to be separated. Nine to twelve months is needed for axonal regeneration in the cross facial nerve graft, because the result of damaged nerve tissue is loss of structure and axonal function. Here the nerve stimulator can be used in identifying the donor motor nerve to the masseter muscle. The procedure of choice for congenital facial paralysis is either CFNG or motor donors, both with a free muscle transfer.
Nederlands Tijdschrift voor de Geneeskunde. These injections may be used to treat synkinesis or to restore symmetry by weakening the non-paralyzed side of the face. In more long standing acquired facial paralysis either a CFNG procedure or "baby-sitter" procedure are the indicated techniques, with or without a free muscle transfer. If the facial nerve is damaged, an attempt to sew the nerve directly together under magnification will be made. Facial nerve paralysis is a relatively common condition with a yearly incidence of 0.
Share Email Print Feedback Close. Recovery of emotional smiling function in free-flap facial reanimation. A thorough history includes onset, initial degree of paralysis, duration, and associated symptoms. J Plast Surg Hand Surg. Denervated facial musculature undergoes atrophy immediately after nerve injury and takes several years to complete. Cable grafting of facial to facial nerve is the most popular option for reconstructing facial nerve defects that result from radical parotidectomy. If the injury is recognized immediately, repair it during the primary procedure.