Interfascicular nerve repair. Is it applicable in facial injuries?

The reapproximation of individual fascicles has been advocated as a microsurgical method of improving neural regeneration following peripheral nerve injuries. To date, this technique has met with limited success, in part owing to an unclear understanding of the anatomic location of fibers in the proximal nerve relative to their distal distribution on the face. Fascicular repair is indicated in clean lacerations of the nerve trunk distal to the stylomastoid foramen. For long defects or injuries proximal to the midmastoid region (where the nerve is monofascicular), simple nerve trunk sutures should be performed until more detailed information on the fascicular anatomy of the intratemporal facial nerve becomes available. A case is reported in which a stab wound of the parotid region was complicated by hemorrhage and infection. A delayed neurorrhaphy was performed using a modified interfascicular grafting technique with sural nerve grafts.