Early Surgical Repair for Temporal Branch of Facial Nerve Injuries: A Retrospective Analysis of Functional Outcomes.

OBJECTIVE

To evaluate surgical techniques and therapeutic outcomes of early nerve coaptation and autologous nerve grafting for the repair of temporal facial nerve injuries.

METHODS

A retrospective analysis was performed on consecutive patients undergoing facial nerve reconstruction for traumatic or iatrogenic temporal branch injuries. Eleven cases received early (within 3 months) surgical exploration and debridement, including one case managed by suture-removal decompression with intact neural continuity. The transected temporal branch was repaired through direct end-to-end neurorrhaphy or autologous grafting using the auriculotemporal nerve, cervical transverse nerve or supraclavicular nerve, according to the length of the nerve defect. Epineurial suture was performed under high-power microscopic visualization.

RESULTS

Recovery of frontal muscle movement was observed in all patients during 6-to-12-month postoperative follow-up, accompanied by visible forehead wrinkles formation. Postoperative measurements demonstrated a significant increase in margin reflex distance (MRD) on the affected side by 2.55 mm (1.99-3.10), reaching comparable measurements to the unaffected side. Eyebrow elevation recovered from complete paralysis to an average 5.36 mm (4.67-6.05), achieving 77% of contralateral functional restoration. Eyebrow and upper eyelid ptosis showed marked improvement.

CONCLUSIONS

Early surgical management of temporal facial nerve injuries achieves favorable functional restoration through precise neural pathway reconstruction.

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