EVALUATION OF MUSCLE GRAFT USING FACIAL NERVE ON THE AFFECTED SIDE AS A MOTOR SOURCE IN THE TREATMENT OF FACIAL PARALYSIS

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Abstract
To acquire symmetry of the cheek when smiling, we carried out 39 free vascularised grafts of the muscle, the motor nerve of which was sutured to a stump of the ipsilateral facial nerve, for 39 patients with facial paralysis. We used two methods: an as healthy and fresh as possible facial nerve stump (method 1A, n = 17), or an incompletely affected stump (method 1B, n = 22). The results are classified into grade 1 to 5 indicating increasing efficiency of muscle function. All patients who had method 1A and 14 patients who had method 1B were evaluated grade 4 or better. Both an incompletely affected facial nerve stump and the proximal stump of a facial nerve that had previously been resected have sufficient function to provide contraction in the grafted muscle.