Early postnatal treatment of congenital facial palsy in patients with hemifacial microsomia.

Facial palsy associated with hemifacial microsomia results in a devastating deformity. To date, no attempts on early treatment of the associated facial palsy have been reported. A therapeutic approach may be to provide reinnervation to the affected muscles through a crossed facial nerve graft. The purpose of this paper is to present 8 cases of hemifacial microsomia with associated facial palsy. All these patients were treated before 1 year of age with cross-sural-to-facial nerve grafts. After a 1 year follow-up, clinical and electrodiagnostic results indicate axonal continuity through the graft and evidence of reinnervation activity in all patients. Crossed facial nerve grafting appears to be an adequate procedure in patients with hemifacial microsomia with associated facial palsy.