Facial nerve grafting.

OBJECTIVE

To evaluate the results of facial nerve reconstruction by means of grafting and to determine the influence of different variables on final functional recovery.

STUDY

DESIGN

Retrospective case review.

SETTING

Tertiary otologic and skull base referral center.

PATIENTS: Sixty nine patients underwent facial nerve grafting. Facial nerve tumors (24) or vestibular schwannomas (18) affected most of them. Preoperatively, 47 patients had a clinical facial nerve deficit lasting from 1 to 120 months, with a mean of 20.2 months.

MAIN OUTCOME MEASURES: Final facial nerve motor function.

RESULTS

Among the 56 patients with a follow-up time equal to or longer than 1 year, 26 recovered to a Grade III (46.4%), 14 to a Grade IV (25%), while 16 remained at Grade V or Grade VI according to the House-Brackmann scale. Patients with a preoperative facial nerve deficit for more than 1 year showed the lowest rate of recovery, with only 3 cases (19%) reaching Grade III.

CONCLUSIONS

Duration of the preoperative facial nerve deficit emerged as the most important factor influencing final results. According to the authors' data, the 1-year period after the occurrence of the preoperative clinical deficit seemed to be the cutoff point in achieving a high rate of good postoperative recovery. Among the other factors that might have influenced the final outcome, only the underlying cause of the lesion played a significant role.