Facial nerve grafting
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概要
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Facial nerve is injured by trauma of the face and skull, tumor invasion and surgical damages developed extratemporally, intratemporally or intracranially. Facial nerve grafting is performed on a case in which the distance of defect between proximal and distal stumps of injured part of the nerve is too far to suture the both ends directly without excessive tension. Well trained technical skills and pre-check of necessary surgical instruments and materials are indispensable to obtain successful results postoperatively. A nerve graft is usually harvested from the great auricular nerve or the sural nerve. In the surgical field proximal and distal cut-ends of the nerve are identified. The prepared nerve graft is placed between the both cut-ends and adjusted. Under microscopic view the epineurium of the nerve stumps is resected for 2-3mm. Perineuriums of the donor and the graft are sutured with 10-0 thread and both stumps are approximated. Number of the suture depends on the size of nerve bundles. Minimum number of the stiches which keep good approximation will be recommended. Epi- and perineural sutures of the branches also result in fairly good functional recovery. Sutured sites are dripped with fibrin glue to support the sutures. Crossface anastomosis of the facial nerve, though the idea is unique, results in not so good recovery as expected. Combination of the nerve grafting to the upper main branch and the facial-hypoglossal anastomosis to the lower main branch is attempted to obtain better functional recovery and less occurrence of synkinesia. Other clinical applications will follow widely.
- 特定非営利活動法人 日本頭頸部外科学会の論文
特定非営利活動法人 日本頭頸部外科学会 | 論文
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