Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Functional Outcomes of Multiple Sural Nerve Grafts for Facial Nerve Defects after Tumor-Ablative Surgery

  • Lee, Myung Chul (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration) ;
  • Kim, Dae Hee (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration) ;
  • Jeon, Yeo Reum (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration) ;
  • Rah, Dong Kyun (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration) ;
  • Lew, Dae Hyun (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration) ;
  • Choi, Eun Chang (Department of Otorhinolaryngology, Yonsei University College of Medicine) ;
  • Lee, Won Jai (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration)
  • Received : 2015.02.28
  • Accepted : 2015.05.08
  • Published : 2015.07.15
Download PDF
⟨ Previous Next ⟩

Abstract

Background Functional restoration of the facial expression is necessary after facial nerve resection to treat head and neck tumors. This study was conducted to evaluate the functional outcomes of patients who underwent facial nerve cable grafting immediately after tumor resection. Methods Patients who underwent cable grafting from April 2007 to August 2011 were reviewed, in which a harvested branch of the sural nerve was grafted onto each facial nerve division. Twelve patients underwent facial nerve cable grafting after radical parotidectomy, total parotidectomy, or schwannoma resection, and the functional facial expression of each patient was evaluated using the Facial Nerve Grading Scale 2.0. The results were analyzed according to patient age, follow-up duration, and the use of postoperative radiation therapy. Results Among the 12 patients who were evaluated, the mean follow-up duration was 21.8 months, the mean age at the time of surgery was 42.8 years, and the mean facial expression score was 14.6 points, indicating moderate dysfunction. Facial expression scores were not influenced by age at the time of surgery, follow-up duration, or the use of postoperative radiation therapy. Conclusions The results of this study indicate that facial nerve cable grafting using the sural nerve can restore facial expression. Although patients were provided with appropriate treatment, the survival rate for salivary gland cancer was poor. We conclude that immediate facial nerve reconstruction is a worthwhile procedure that improves quality of life by allowing the recovery of facial expression, even in patients who are older or may require radiation therapy.

Keywords

References

  1. Catli T, Bayazit YA, Gokdogan O, et al. Facial reanimation with end-to-end hypoglossofacial anastomosis: 20 years' experience. J Laryngol Otol 2010;124:23-5. https://doi.org/10.1017/S0022215109991344
  2. Flores LP. Surgical results of the hypoglossal-facial nerve jump graft technique. Acta Neurochir (Wien) 2007;149:1205-10. https://doi.org/10.1007/s00701-007-1412-x
  3. Reddy PG, Arden RL, Mathog RH. Facial nerve rehabilitation after radical parotidectomy. Laryngoscope 1999;109: 894-9. https://doi.org/10.1097/00005537-199906000-00010
  4. Kakibuchi M, Tuji K, Fukuda K, et al. End-to-side nerve graft for facial nerve reconstruction. Ann Plast Surg 2004;53:496-500. https://doi.org/10.1097/01.sap.0000116283.76872.de
  5. Volk GF, Pantel M, Streppel M, et al. Reconstruction of complex peripheral facial nerve defects by a combined approach using facial nerve interpositional graft and hypoglossal-facial jump nerve suture. Laryngoscope 2011;121:2402-5. https://doi.org/10.1002/lary.22357
  6. Humphrey CD, Kriet JD. Nerve repair and cable grafting for facial paralysis. Facial Plast Surg 2008;24:170-6. https://doi.org/10.1055/s-2008-1075832
  7. Chuang DC, Wei FC, Noordhoff MS. "Smile" reconstruction in facial paralysis. Ann Plast Surg 1989;23:56-65. https://doi.org/10.1097/00000637-198907000-00010
  8. Wang Z, Zhang Z, Huang Q, et al. Long-term facial nerve function following facial reanimation after translabyrinthine vestibular schwannoma surgery: a comparison between sural grafting and VII-XII anastomosis. Exp Ther Med 2013; 6:101-4. https://doi.org/10.3892/etm.2013.1120
  9. Riedl O, Frey M. Anatomy of the sural nerve: cadaver study and literature review. Plast Reconstr Surg 2013;131:802-10. https://doi.org/10.1097/PRS.0b013e3182818cd4
  10. Osinga R, Buncke HJ, Buncke GM, et al. Subdivision of the sural nerve: step towards individual facial reanimation. J Plast Surg Hand Surg 2011;45:3-7. https://doi.org/10.3109/2000656X.2011.554693
  11. Myckatyn TM, Mackinnon SE. A review of facial nerve anatomy. Semin Plast Surg 2004;18:5-12. https://doi.org/10.1055/s-2004-823118
  12. Vrabec JT, Backous DD, Djalilian HR, et al. Facial Nerve Grading System 2.0. Otolaryngol Head Neck Surg 2009;140: 445-50. https://doi.org/10.1016/j.otohns.2008.12.031
  13. Rubin LR. Re-animation of total unilateral facial paralysis by the contiguous facial muscle technique. In: Rubin LR, editor. The paralyzed face. St. Louis: Mosby Year Book; 1991. p.156-77.
  14. Conley JJ. Facial nerve grafting in treatment of parotid gland tumors; new technique. AMA Arch Surg 1955;70:359-66. https://doi.org/10.1001/archsurg.1955.01270090037008
  15. Captier G, Canovas F, Bonnel F, et al. Organization and microscopic anatomy of the adult human facial nerve: anatomical and histological basis for surgery. Plast Reconstr Surg 2005;115:1457-65. https://doi.org/10.1097/01.PRS.0000160264.42201.F5
  16. Sunderland S. The anatomy and physiology of nerve injury. Muscle Nerve 1990;13:771-84. https://doi.org/10.1002/mus.880130903
  17. Filipo R, Spahiu I, Covelli E, et al. Botulinum toxin in the treatment of facial synkinesis and hyperkinesis. Laryngoscope 2012;122:266-70. https://doi.org/10.1002/lary.22404
  18. Brown PD, Eshleman JS, Foote RL, et al. An analysis of facial nerve function in irradiated and unirradiated facial nerve grafts. Int J Radiat Oncol Biol Phys 2000;48:737-43. https://doi.org/10.1016/S0360-3016(00)00721-5
  19. Hontanilla B, Qiu SS, Marre D. Effect of postoperative brachytherapy and external beam radiotherapy on functional outcomes of immediate facial nerve repair after radical parotidectomy. Head Neck 2014;36:113-9. https://doi.org/10.1002/hed.23276

Cited by

  1. Reconstruction of Soft-Tissue Defects at the Foot and Ankle after Oncological Resection vol.3, pp.None, 2015, https://doi.org/10.3389/fsurg.2016.00015
  2. The injury of marginal mandibular branch unexpectedly promotes the repair of buccal branch of facial nerve in a rat model vol.136, pp.9, 2015, https://doi.org/10.3109/00016489.2016.1169318
  3. Variations in sural nerve formation pattern and distribution on the dorsum of the foot vol.30, pp.4, 2015, https://doi.org/10.1002/ca.22873
  4. Editorial. Outcomes of facial nerve repair using nerve grafts applied immediately following nerve discontinuity in skull base surgery vol.128, pp.2, 2018, https://doi.org/10.3171/2016.10.jns162354
  5. Editorial. Outcomes of facial nerve repair using nerve grafts applied immediately following nerve discontinuity in skull base surgery vol.128, pp.2, 2018, https://doi.org/10.3171/2016.10.jns162354
  6. Surgical technique and results of cable graft interpositioning of the facial nerve in lateral skull base surgeries: experience with 213 consecutive cases vol.128, pp.2, 2015, https://doi.org/10.3171/2016.9.jns16997
  7. Surgical technique and results of cable graft interpositioning of the facial nerve in lateral skull base surgeries: experience with 213 consecutive cases vol.128, pp.2, 2015, https://doi.org/10.3171/2016.9.jns16997
  8. Surgical Management of Intrinsic Tumors of the Facial Nerve vol.83, pp.4, 2015, https://doi.org/10.1093/neuros/nyx489
  9. Controversy in the Surgical Extent of Parotidectomy, Neck Treatment, and Adjuvant Treatment of Parotid Gland Cancer vol.64, pp.11, 2021, https://doi.org/10.3342/kjorl-hns.2021.00864
  10. Efficacy of surgical repair for the functional restoration of injured facial nerve vol.21, pp.1, 2021, https://doi.org/10.1186/s12893-021-01049-x
  11. Repairing whole facial nerve defects with xenogeneic acellular nerve grafts in rhesus monkeys vol.17, pp.5, 2015, https://doi.org/10.4103/1673-5374.324853