FACIAL NEURORRHAPHY WITH AUTOLOGOUS SURAL NERVE GRAFT USING THE CO2-LASER IN A PRIMATE MODEL

CRANIAL NERVES, BEING of fine caliber and having a poorly defined epin eurium, pose problems in intracranial sutural anastomosis. The CO2 las er is a comparatively new prospect that is being evaluated for suturel ess neural anastomosis. Because there are no reports on the laser anas tomosis of a peripheral spinal nerve to a cranial nerve, we designed t his study to explore the possibility of performing a laser anastomosis of the facial nerve, using an autologous sural nerve graft in a prima te model. Six monkeys underwent resection of the right facial nerve in the parotid fossa. In five of them, the CO2 laser was used to anastom ose sural nerve interposition grafts by the use of microsurgical techn iques. In one control animal, the sural nerve graft was interposed bet ween the cut ends of the facial nerve and no anastomosis was performed . Compound muscle action potentials were recorded preoperatively and 2 , 4, and 6 weeks postoperatively. At the end of 6 weeks, the wound was again explored and the grafts were examined. The neurophysiological r esults showed that in the five laser-welded nerves, at 4 weeks and 6 w eeks postoperatively, the proximal latencies showed an improving trend with each successive recording. It was concluded that the CO2 laser c an be used for the anastomosis of interposition grafts to the facial n erve.