[Surgical treatment of transected peripheral facial nerve injury].

Abstract

To evaluate the results of peripheral facial nerve reconstruction by surgical treatment and determine the influence factors for recovery.
From 1999 to 2009, 104 patients underwent surgical rehabilitation for transected peripheral facial nerve injury in the department of oral and maxillofacial surgery, Peking University School and Hospital of Stomatology. The age ranged from 2 to 77 years with a median age of 30 years. Sixty-five of the 72 cases (90.2%) who underwent facial nerve anastomosis and 24 of the 32 patients (75.0%) underwent facial nerve grafting. All these patients were followed for the final results. Facial nerve function was scored by the gross and regional House-Brackmann (HB) facial grading system. Statistical analysis was performed using SPSS 13.0 software package by χ2 test or Fisher exact test.
In the facial nerve anastomosis group, HB I, HB II, HB III and HB IV function were achieved in 37 (56.9%), 11 (16.9%), 15 (23.1%) and 2 (3.1%) patients respectively. The regional grades showed that the recovery rate of HB I and II were 27.3% in forehead, 97.6% in eye region, 97.9% in midface and 78.6% in the mouth region. In the facial nerve grafting group, HB grades I, II, III and IV were achieved in 4 (16.7%), 5 (20.8%), 7 (29.2%) and 8 (33.3%) patients respectively. By regional HB grades, HB I and II rate were 37.5% in forehead, 73.7% in eye region, 72.7% in midface, 44.4% in mouth region. The facial nerve anastomosis group had a higher HB I and II recovery rate than facial nerve grafting group (P=0.002).
Facial nerve anastomosis and facial nerve grafting are effective surgical options for transected peripheral facial nerve injury. The site and range of facial nerve injury, the time post onset until repair, and the age of patient are factors that influence the clinical outcomes.