REHABILITATION OF THE PARALYZED FACE - RESULTS OF FACIAL-NERVE SURGERY

The case notes of 34 patients undergoing rehabilitative facial nerve s urgery between 1978 and 1994 were retrospectively examined. Thirteen p atients underwent facio-hypoglossal transposition with six achieving a facial nerve grade of IV (House-Brackmann scale) at 24 months post-su rgery. Twelve patients underwent cable grafting of the facial nerve de fect. Of these, 10 achieved a grade III result at 24 months. Nine pati ents underwent end to end anastomosis of the facial nerve, seven achie ving a grade III result at 24 months after the repair. Re-routing of t he facial nerve and the use of tissue glue to effect the anastomosis d id not have an adverse effect on the outcome. Comparison of rerouted e nd to end anastomosis with non-re-routed cable grafting showed no diff erence. Patients presenting pre-operatively with facial weakness and t hose in whom nerve repair surgery was delayed for more than six months were less likely to have a good result.