Enhancement of Facial Nerve Motoneuron Regeneration through CrossFace Nerve Grafts by Adding End-to-Side Sensory Axons EXPERIMENTAL

460 Patients with facial palsy suffer from functional and aesthetic deficits, including impaired speech, difficulty eating, impaired ability to protect the cornea, diminished social interaction, and reduced quality of life.1–3 Facial reanimation surgery is performed in severe cases.4,5 Cross-face nerve grafting, where a sural nerve graft is used to conduct axons of a facial nerve branch from the healthy side of the face to the paralyzed side of the face to innervate the mimetic muscles or a free muscle transplant, is the criterion standard for emotional facial reanimation.6–10 The sural nerve grafts can be over 20 cm long; therefore, it takes several months for axons to regenerate through them.11,12 Histomorphometric studies showed that only 10 to 50 percent of donor axons reach the distal end of the cross-face nerve graft.13,14 With only 100 to 200 motor axons reaching the target muscle,14 the extent of facial movement may be insufficient.

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