Electrophysiological evaluation of cross-face nerve graft in treatment of facial palsy.

A cross-face autogenous single graft was performed in eight patients with facial palsy. Several electrophysiological techniques have been used in a follow-up study of one to three years' duration. Clinical results are extremely disappointing. The only recovery observed could not be ascribed to the graft. The investigations and the motor unit count in the facial muscles led to the conclusion that the surgical technique employed is a failure. The orbicularis oculi muscle in particular has no chance whatsoever of being satisfactorily reinnervated. Various reasons for this poor recovery are analysed: too small a number of properly grafted axons, syncinesis, muscle degeneration and poor myelination. These observations nevertheless suggest some experimental fields which may lead to improvements in the technique to a point where it may become clinically useful.