Strategies to Improve Cross-Face Nerve Grafting in Facial Paralysis

Simeon C Daeschler; Ronald Zuker; Gregory H Borschel

doi:10.1016/j.fsc.2021.03.009

Strategies to Improve Cross-Face Nerve Grafting in Facial Paralysis

Facial Plast Surg Clin North Am. 2021 Aug;29(3):423-430. doi: 10.1016/j.fsc.2021.03.009.

Authors

Simeon C Daeschler¹, Ronald Zuker², Gregory H Borschel³

Affiliations

¹ Neuroscience and Mental Health Program, Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.
² Division of Plastic and Reconstructive Surgery, Hospital for Sick Children (SickKids), University of Toronto, Toronto, Ontario, Canada.
³ Division of Plastic and Reconstructive Surgery, Hospital for Sick Children (SickKids), University of Toronto, Toronto, Ontario, Canada. Electronic address: gregory.borschel@sickkids.ca.

PMID: 34217445
DOI: 10.1016/j.fsc.2021.03.009

Abstract

Cross-face nerve grafting enables the reanimation of the contralateral hemiface in unilateral facial palsy and may recover a spontaneous smile. This chapter discusses various clinically applicable strategies to increase the chances for good functional outcomes by maintaining the viability of the neural pathway and target muscle, increasing the number of reinnervating nerve fibers and selecting functionally compatible donor nerve branches. Adopting those strategies may help to further improve patient outcomes in facial reanimation surgery.

Keywords: Cross-face nerve graft; Electrical stimulation; FK506; Facial palsy; Facial paralysis; Facial reanimation; Supercharge nerve transfer; Tacrolimus.

Publication types

Review

MeSH terms

Face
Facial Nerve / surgery
Facial Paralysis* / surgery
Humans
Nerve Transfer*
Smiling