Axonal regeneration rate through cross‐face nerve grafts

Abstract

The disfigurement of irreversible unilateral facial paralysis can be corrected by cross-face nerve grafting in conjunction with muscle transplantation. A total of 33 patients underwent cross-face nerve grafting using the sural nerve prior to undergoing the second stage of the procedure. Before a muscle transplant can be successfully connected to the distal end of the cross-face nerve graft, the regenerating axons need to have grown from the contralateral facial nerve to the distal end of the nerve graft. This can be tested by the Tinel sign. A retrospective study was performed to determine the rate of growth of regenerating axons through the cross-face nerve graft. A rate of axon growth of 1.8 mm/day was found, and also an inverse relationship between the age of the patient and the regeneration rate. These results can be used as a guide in planning patients' treatment.

Surgical management of facial nerve paralysis in the pediatric population

“…In this situation, branches of the contralateral (intact) facial nerve can be used to transmit facial nerve input to the face with the use of a sural nerve graft. Over the period of 4 to 6 months, the contralateral facial nerve axons will regenerate via the sural nerve graft [53]. To prevent muscle atrophy and preserve tone while the axons regenerate, an ipsilateral branch of the hypoglossal nerve or masseteric branch of the trigeminal nerve may be used to provide motor innervation to the muscles ("babysitter procedure").…”

Threshold of tactile perception in a reconstructed auricle

“…The ears had been reconstructed from 1995-2008. The median age of the patients at the time of reconstruction was 10.5 years (range 6-19); median age 13 years (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) at the time of follow-up, and median time after the reconstruction 20 months (6-60).…”

“…The minimum follow-up time of six months was considered more than enough for restitution of sensitivity. Nerve regeneration is normally about 1 mm/day [18], and the distances to be bridged are only a few cm. There was obviously an initial rapid recovery as we noted no differences between measurements before and after 20 months.…”

Do children with Bell's palsy benefit from steroid treatment? A systematic review

“…Consequently, the benefits of a steroid treatment may appear to be greater in children. It has also been observed that the rate of axonal regeneration of the facial nerve decreases with age [17], another important factor to be considered when evaluating the benefits of steroid therapy for Bell's palsy in children.…”