Fabienne Carré1,2, Rémi Hervochon3,4,5, Ghizlene Lahlou3,6, Diane Lastennet4,7, Peggy Gatignol3,4, Daniele Bernardeschi3, Georges Lamas3,4, Frédéric Tankéré3,4,5. 1. ENT Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France. Fabienne.carre@aphp.fr. 2. Sorbonne University, Paris, France. Fabienne.carre@aphp.fr. 3. ENT Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France. 4. Sorbonne University, Paris, France. 5. Centre MEG-EEG (UMR 7225/U1127, Sorbonne Université/CNRS/ INSERM), Institut du Cerveau Et de La Moelle Epiniere (ICM), Sorbonne University, Paris, France. 6. Inserm/Pasteur Institute, Hearing Institute, Technology and Gene Therapy for Deafness, Paris, France. 7. Unit of Public Health, Department of Biostatistics, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.
Abstract
PURPOSE: To evaluate functional results of facial nerve repair by direct nerve suture or grafting, compare results between a traumatic and a tumoral group and identify prognostic factors. METHODS: A retrospective monocentric cohort study was studied in a university ENT department. Thirty-one patients who benefited from facial nerve suture or grafting, with at least 12 months postoperative follow-up were included. Patients were divided into two groups according to the lesion type: traumatic (accident of the public road or iatrogenic) and tumoral. Preoperative data studied were sex, side, etiology documented by CT and/or MRI, facial palsy duration and grade according to House Brackmann grading system. Intraoperative data included: surgeon, age of patient, surgical technique, graft type, use of biological glue, facial nerve derivation, lesioned site. Postoperative data included: histological diagnosis, radiotherapy history, time to onset of the first signs of reinnervation, follow-up duration, and final facial function. RESULTS: Success rate, including grade III and IV, was 68% in the whole cohort, 79% in the traumatic group and 59% in the tumoral group. Patients presenting with facial palsy evolving less than 6 months had better recovery results than those evolving longer than 6 months (p = 0.02). No other prognostic factors were identified. CONCLUSIONS: The best outcome that can be achieved by suture or grafting of the facial nerve in traumatic or tumoral lesions is a grade III. Preoperative facial palsy duration is a prognostic factor and must be considered when establishing an operative indication.
PURPOSE: To evaluate functional results of facial nerve repair by direct nerve suture or grafting, compare results between a traumatic and a tumoral group and identify prognostic factors. METHODS: A retrospective monocentric cohort study was studied in a university ENT department. Thirty-one patients who benefited from facial nerve suture or grafting, with at least 12 months postoperative follow-up were included. Patients were divided into two groups according to the lesion type: traumatic (accident of the public road or iatrogenic) and tumoral. Preoperative data studied were sex, side, etiology documented by CT and/or MRI, facial palsy duration and grade according to House Brackmann grading system. Intraoperative data included: surgeon, age of patient, surgical technique, graft type, use of biological glue, facial nerve derivation, lesioned site. Postoperative data included: histological diagnosis, radiotherapy history, time to onset of the first signs of reinnervation, follow-up duration, and final facial function. RESULTS: Success rate, including grade III and IV, was 68% in the whole cohort, 79% in the traumatic group and 59% in the tumoral group. Patients presenting with facial palsy evolving less than 6 months had better recovery results than those evolving longer than 6 months (p = 0.02). No other prognostic factors were identified. CONCLUSIONS: The best outcome that can be achieved by suture or grafting of the facial nerve in traumatic or tumoral lesions is a grade III. Preoperative facial palsy duration is a prognostic factor and must be considered when establishing an operative indication.
Authors: V Darrouzet; J Y Duclos; D Liguoro; Y Truilhe; C De Bonfils; J P Bebear Journal: Otolaryngol Head Neck Surg Date: 2001-07 Impact factor: 3.497