If you have permanent paralysis of the muscles that allow you to smile, you may be offered a procedure to recreate the smile. This may require two operations to be performed and the cross facial nerve graft procedure is the first of these operations. Alternatively, a cross facial nerve graft can be used to re-power muscles that have very recently been paralysed, but still show evidence that they have the potential to work. This webpage explains more about the procedure and what to expect, including the benefits, risks, any alternatives and what you can expect when you come to hospital. The cross face nerve graft is a procedure that takes the activity of the normal facial nerve without compromising from one side of the face to the other side of the face, typically using a section of nerve taken from the leg to act as a conduit along which nerve fibres can grow from the healthy nerve on the unaffected side. It is important to note that, is used as part of a two-stage reconstruction, this operation does not improve the smile on the affected side of the face, but rather, sets the stage so that the second stage operation can be performed to restore the smile.
The medial canthus is used as a fixed-point reference, and straight lines are drawn to the angles of the mouth. The study dates and dates of analysis were January 1, , to March 31, Intraoperative direct nerve stimulation was performed to assess for the presence of subclinical reinnervation. Patients were followed up for a minimum of 18 months after surgery to evaluate outcomes. Other outcome measures included the duration of paralysis, time to recovery, and evidence of synkinesis. Ten patients underwent nerve grafting by 12 months, 9 patients received grafting after 12 months, and 8 patients had no intervention. Thirty-five patients spontaneously recovered.
Once the healing process is complete, nerve signals will flow from the undamaged facial nerve across the graft into the previously paralyzed facial muscles producing movement. The nerve graft functions much like a telephone line delivering communication signals for the facial muscles. The ability to produce spontaneous, emotionally mediated movement is the greatest benefit of this technique. Before Surgery Video segment: Complete left facial paralysis after excision of facial nerve schwannoma with loss of eye closure and protective blinking.
Return to: Facial Paralysis surgery for facial nerve paralysis weakness. Henstrom's profile page. For appointment please call: Cross-face nerve grafting is indicated if the proximal ipsilateral facial nerve is not available but the distal stumps are available. The surgeon must select appropriate segmental branches of the contralateral facial nerve as donors, with the sural nerve serving as a cable graft.