European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 12, pp 3301–3308 | Cite as

Facial nerve repair: the impact of technical variations on the final outcome

  • María Sánchez-OcandoEmail author
  • Javier Gavilán
  • Julio Penarrocha
  • Teresa González-Otero
  • Susana Moraleda
  • José María Roda
  • Luis Lassaletta



To analyze the outcome of facial nerve (FN) reconstruction, the impact of technical variations in different conditions and locations, and the importance of additional techniques in case of suboptimal results.

Study design

Retrospective study.


University-based tertiary referral center.


Between 2001 and 2017, reconstruction of the FN was performed on 36 patients with varying underlying diseases.


FN repair was performed by direct coaptation (n = 3) or graft interposition (n = 33). Microsurgical sutures were used in 17 patients (47%) and fibrin glue was used in all cases. Additional reinnervation techniques (hypoglossal–facial or masseter–facial transfers) were performed in five patients with poor results after initial reconstruction.

Main outcome measures

FN function was evaluated using the House–Brackmann (HB) and the electronic clinician-graded facial function (eFACE) grading systems. Minimum follow-up was 12 months.


FN reconstruction yielded improvement in 83% of patients, 21 patients (58.3%) achieving a HB grade III. The eFACE median composite, static, dynamic and synkinesis scores were 69.1, 78, 53.2, and 88.2 respectively. A tendency towards better outcome with the use of sutures was found, the difference not being significant. All patients undergoing an additional reinnervation procedure achieved a HB grade III, eFACE score being 74.8.


FN reconstruction offers acceptable functional results in most cases. No significant differences are expected with technical variations, different locations or conditions. In patients with poor initial results, additional reinnervation techniques should be always considered. The eFACE adds substantial information to the most used HB scale.


Facial nerve repair CPA tumors Nerve graft Suture anastomosis 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • María Sánchez-Ocando
    • 1
    Email author
  • Javier Gavilán
    • 1
  • Julio Penarrocha
    • 1
  • Teresa González-Otero
    • 2
  • Susana Moraleda
    • 3
  • José María Roda
    • 4
  • Luis Lassaletta
    • 1
    • 5
  1. 1.Department of OtorhinolaryngologyLa Paz University Hospital, IdiPAZ Research InstituteMadridSpain
  2. 2.Department of Oral and Maxillofacial SurgeryLa Paz University Hospital, IdiPAZ Research InstituteMadridSpain
  3. 3.Department of Physical Medicine and RehabilitationLa Paz University Hospital, IdiPAZ Research InstituteMadridSpain
  4. 4.Department of NeurosurgeryLa Paz University Hospital, IdiPAZ Research InstituteMadridSpain
  5. 5.Biomedical Research Networking Centre On Rare Diseases (CIBERER)Institute of Health Carlos IIIMadridSpain

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