Facial nerve repair with tissue adhesive.

The facial nerve in dogs was exposed, transected, and repaired by either of two methods. Suture and a Silastic sheath was the control method, since a review of the literature suggests it gives the highest rate of success. A tissue adhesive (Histoacryl) was used as the experimental method. In both techniques, the surgical microscope was used. Thirteen nerves were repaired: seven with the adhesive and six with suture and Silastic sheath. Success was judged on two criteria: (1) observation of motion in the muscles that were innervated after electrical stimulation of the nerve proximal to the repair site and (2) evaluation of microanatomical continuity after removal of the repair site and preparation of slides and tissues staining. The two repair methods produced statistically equal results. The "adhesive" method can be performed with greater ease and is less time-consuming. The number of studies required for statistical reliability was determined by means of sequential analysis.