Reconstruction of the facial nerve in acoustic neurinoma surgery. Juxtapontine-intratemporal nerve graft.

Five cases of large acoustic neurinomas (diameter 2.5 cm) with involvement of the facial nerve in the tumour capsule are presented. The preoperative function of the facial nerve was normal. During surgery, in order to achieve a radical tumour removal, the facial nerve was severed juxtapontine. Reconstruction was performed at the same procedure using a 5-6 cm long sural nerve graft. Thus the central juxtapontine stump was joined to the peripheral stump in the facial nerve canal of the petrous bone. After six months, all five patients exhibited a well functioning mimic and a good eyelid function. At the one year control four patients had normal nerve function clinically and one patient still showed asymmetrical mimic.