RECENT MICROSURGICAL TECHNIQUES IN MANAGEMENT OF FACIAL NERVE PALSY

Abstract

The present thesis included 20 pa tients with faci al nerve para l ysis whom were treated using microsurgical techniq ues.

Sat isfactory results (good, excellen t and su perb) were achieved in 15 cases ou t of 1 9 (78.9 %), fair results in 3 cases (1 5.8 %) and only one failure (5.3 %). -

1 A ll of the cases in wh ich d irect repa i r of the facia l n erve or its branches was done, satisfactory resul ts were achieved ( I 00%).

Usi ng the hypoglosso-facial techn iq ue, consistent resu lts were ach ieved in the current study (good results in 6 cases "I 00 %").

Fi ve cases of cross face nerve !',Tafts were done as the sol e proced ure to reanimate the face. We had su perb result i n one case, excellent result in 1 one case, good result in one case and 2 fair results.

In the curre nt st ud y 2 cases of free muscle t ra nsfer were done as a single stage procedu re. I n the fi rst case, excellent result (grade V) was achieved after 1 8 m onths a nd com pl ete disappeara nce of the muscle b ulk occurred. In t h e second case, fa i r result (grade II ) i s achieved after I year. However an other I year follow up is recomm ended to assess the fina l result .

The results were d iscussed and i t was concl uded that, m i crosu rgica l techni q ues arc effecti ve in the management of facial nerve pam l ysis of various durations a nd et iologies. However, careful select ion of the appropriate procedure for each case is a m ust.