Variants of facial nerve neurotization

Abstract

This study presents facial nerve neurotization, a common method of surgical treatment of facial muscle paralysis. In this surgical procedure, a trunk or some portions of individual fibers are sewn to an intact nerve-neurotizator to the injured facial nerve that can act as sublingual, masseteric, phrenic, accessory, glossopharyngeal nerves, as well as the descending branch of the sublingual nerve and anterior branches of the C2–C3 cervical spinal nerves. Often, neurosurgeons combine various donor nerves and autotransplanting inserts for better results. The main stages of neurotization of the facial nerve includes isolation and transection of the facial nerve, isolation and transection of the trunk or separate fibers of the neurotizer, and nerve suturing in an “end-to-end” or “end-to-side” fashion. Facial cross-plasty, the most innovative method of facial nerve neurotization, should be carefully performed, during which an anastomosis is performed between the damaged and intact facial nerves using autotransplantation inserts from the calf nerve or from a free muscle graft, including a tender muscle and an anterior branch of the locking nerve. Recovery of facial nerve function and regression of characteristic symptoms takes time and specialized recovery treatment. Generally, among the lesions of the cranial nerves, injuries and diseases of the facial nerve rank first and are one of the most common pathologies of the peripheral nervous system. The clinical picture of facial nerve injuries in various origins is quite monotonous and manifested by persistent paralysis or paresis of the facial muscles. Various highly effective techniques are aimed at restoring the function of the facial nerve and facial muscles. Many conservative and operative methods of treating facial nerve neuropathy have been presented in the modern medical literature. However, all methods of facial nerve neurotization have several disadvantages, and the leading ones are the inability to achieve 100% efficiency and development of one degree or another neurological deficit.

Keywords

facial nerve / facial nerve neuropathy / neurotization / donor nerve / neurotic nerve / facial nerve crossplasty / facial muscle paralysis / cranial nerve lesions

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Gaivoronsky A.I., Skaliitchouk B.V., Vinogradov V.V., Alekseev D.E., Svistov D.V.