Facial nerve paralysis leads to functional loss and aesthetic issues. Several techniques are used to restore function and to improve cosmesis. The gold standard is dynamic facial reanimation. Typically, the masseteric, hypoglossal, and contralateral facial nerve branches have been used for cross nerve grafts. This is an excellent review of the advancements in cross facial nerve grafts (CFNG) to improve the neural network. The authors describe the indications for CFNG, the CFNG-to-facial nerve transfers and the CFNG-to-muscle transfers, with their risks and benefits. Combination nerve grafts have been shown to offer increased benefits as they provide stronger facial tone and volitional movement. Duration of paralysis influences the treatment options and there is no consensus about the exact time when nerve grafting should not be recommended and when muscle transfer would be beneficial. The authors recommend that surgeons keep an open mind about offering reanimation surgery to patients who present late, as studies have shown improvement in facial function despite delayed presentations. This offers hope to the countless patients with facial nerve palsy.
Facial reanimation dynamic trends
Reviewed by Gauri Mankekar
Modern cross -facial nerve grafting in facial paralysis.
CONTRIBUTOR
Gauri Mankekar
Department of Otolaryngology-Head Neck Surgery, Louisiana State University Shreveport, Louisiana, USA.
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