The disfigurement of irreversible unilateral facial paralysis can be c
orrected by cross-face nerve grafting in conjunction with muscle trans
plantation. A total of 33 patients underwent cross-face nerve grafting
using the sural nerve prior to undergoing the second stage of the pro
cedure. Before a muscle transplant can be successfully connected to th
e distal end of the cross-face nerve graft, the regenerating axons nee
d to have grown from the contralateral facial nerve to the distal end
of the nerve graft. This can be tested by the Tinel sign. A retrospect
ive study was performed to determine the rate of growth of regeneratin
g axons through the cross-face nerve graft. A rate of axon growth of 1
.8 mm/day was found, and also an inverse relationship between the age
of the patient and the regeneration rate. These results can be used as
a guide in planning patients' treatment. (C) 1993 Wiley-Liss, Inc.