A case of traumatic facial palsy incurred during the removal of an acoustic neuroma via a sub-occipital craniectomy is presented. The palsy was rehabilitated to a satisfactory degree by anastomosing the normal to the paralyzed facial nerve using an autoplastic peripheral nerve graft of suitable length to join the two.
A case of traumatic peripheral facial palsy incurred during the removal of an acoustic neuroma via a sub‐occipital craniectomy is presented.
The palsy was rehabilitated by using the ingenious method of Dott with a modification. In this, the second anastomosis between the distal end of the peripheral (sural) nerve graft and the distal trunk of the paralyzed facial nerve was performed within the mastoid rather than in the neck. The result obtained is remarkable. The technique is described and illustrated in detail.
We report on our experience with nonsurgical office closure of tympanic membrane pars tensa pelf orations with the little-used but well-established Derlacki method, a procedure that had been in general use bef ore the introduction of tympanoplasty more than a half century ago. We describe our results-including a success rate of 84.2%-in treating 81 pelf orations during the 6-year span fro m 1996 through 2001.
I have enjoyed reading the article, "Facial reanimation by cross-facial nerve grafting: Report of five cases," by Galli , Valauri, and Komisar, which appeared in the January 2002 issue of EAR, NOSE & THROAT JOURNAL. I congratulate the authors for their proficient work and results. The concept of the anastomosis between the two facial nerves , in cases of facial nerve paralysis in which the nerve trunk is not accessible proximal to the site of the injury, remains as sound today as it was when first presented as a preliminary report at the Second International Symposium on Facial Nerve Surgery held in Osaka, Jap an, September 27-30, 1970. (You and I both attended that meeting.) Return of normal function on the paralyzed site of the face cannot be achieved regardless of the surgical technique used, once the facial nerve trunk has been severed. Furthermore, ancillary techniques of plastic surgery to aid in protecting the affected eye and/or in improving a drooping eyebrow, etc., might be needed in some cases. Utilizing the entire lower division of the normal facial nerve as a donor nerve in my cases and experience has not left discernible deficits on the donor site of the face. In fact, the donor site has remained preponderant. The classic paper of Davis and coworkers (Davis RA, et al. Surgical Anatomy of the Facial Nerve and Parotid Gland based on a study of 350 cervico-facial halves. Surgery Gyn-Obstetrics 1956; p. 102-14) showing the relationships among the branches of the pes anserinus was one of the factors in my conceptualizing and performing the anastomosis between the two facial nerves. I again congratulate the authors on their fine presentation and you for your continued genu ine interest in facial nerve problems and study, and for bringing to the fore the above concept once again .
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