Acessibilidade / Reportar erro
• Arq. Neuro-Psiquiatr. 12 (4) • Dec 1954 • https://doi.org/10.1590/S0004-282X1954000400005   copy

Nerve grafting and nerve suture in postoperative facial palsies: A report of 69 cases

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Since 1939, 260 patients with a peripheral facial palsy have been operated on by me according to Ballance and Duel, and in 61 cases nerve grafting, in 8 nerve suture was performed; 66 of the patients have been re-examined by me, 2 have been operated upon lately and one could not be traced. If a complete facial palsy arises in direct conjunction with surgery or accident the repair should, if possible, be undertaken without delay; if it occurs after an interval of freedom and the continuity of the nerve is unbroken the prognosis on the whole is good. The technique is discussed and the importance of the after-treatment is stressed. The results may be divided into two groups according to the conditions for and the proceeding of the repair, illustrated in tables 1 and 2. Among 52 cases, in which no degeneration of the musc'es had taken place and in which the operation was successfully performed a clinically satisfactory result was obtained in 47 patients. If these conditions are not fulfilled the prospect of a satisfactory result is a priori poor. It must be born in mind that not even the most successful operation will be able to restore function completely.

Chief-Surgeon, Frederiksborg County Hospital, Hillerod, Denmark

SUMMARY

Since 1939, 260 patients with a peripheral facial palsy have been operated on by me according to Ballance and Duel, and in 61 cases nerve grafting, in 8 nerve suture was performed; 66 of the patients have been re-examined by me, 2 have been operated upon lately and one could not be traced.

If a complete facial palsy arises in direct conjunction with surgery or accident the repair should, if possible, be undertaken without delay; if it occurs after an interval of freedom and the continuity of the nerve is unbroken the prognosis on the whole is good. The technique is discussed and the importance of the after-treatment is stressed.

The results may be divided into two groups according to the conditions for and the proceeding of the repair, illustrated in tables 1 and 2. Among 52 cases, in which no degeneration of the musc'es had taken place and in which the operation was successfully performed a clinically satisfactory result was obtained in 47 patients. If these conditions are not fulfilled the prospect of a satisfactory result is a priori poor. It must be born in mind that not even the most successful operation will be able to restore function completely.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

BIBLIOGRAPHY

1. Adams, W. M. - The use of the masseter, temporalis and frontalis muscles in the correction of facial paralysis. Plast. a. Reconst. Surg., 1, no. 2 (September) 1946.

2. Ballance, C; Duel, A. B. - The operative treatment of facial palsy. Arch. Otolaryng., 15:1-70 (January) 1932.

3. Bauer, G. - Nerve graft in facial palsy. Acta Chir. Scandinav., 81:130, 1938.

4. Behrman, W. - The surgical treatment of peripheral facial paralysis in fractures of the cranial base. Acta Otolaryng., 37:187-190, 1949.

5. Bergstrom, E. - Good result after operation tor traumatic defect of the facial nerve. Hygiea, 8:2102, 1940.

6. Blair, V. P. - Further observations upon the compensatory use of live tendon strips for facial paralysis. Ann. Surg., 92:694, 1930.

7. Bloch, A.; Bourgeois, R.; Aboulker, P. Lefèvre, J. - Le traitement chirurgical des paralysies faciales otologiques. Congrès de la Société Française d'Oto-Rhino-Laryngologie, 1950.

8. Brooke - A case of facial paralysis treated by facial grafts. Brit. J. Surg., 20:523, 1933.

9. Brown, J. B. - The utilization of the temporal muscle and fascia in facial paralysis. Ann. Surg., 109, no. 6 (June) 1939.

10. Brown, J. B.; McDowell, F.; Fryer, M. P. - Facial paralysis supported with autogenous fascia lata. Ann. Surgery, 127, no. 5 (May) 1948.

11. B runner, H. - Treatment of inveterate facial paralysis. Plast. & Reconstr. Surg., 8:390 (November) 1951.

12. Bunnell, S. - a) Suture of the facial nerve within the temporal bone. Surg., Gynec. a. Obst, pg. 7-12 (July) 1927; b) Surgical repair of the facial nerve. Arch. Otolaryng., 25: 235-259, 1937; c) Summation of papers on management of facial paralysis. Arch. Otolaryng., 55:417 (April) 1952.

13. Bunnell, S.; Boyes, J. H. - Nerve grafts. Am. J. Surg., 44:64, 1939.

14. Cardwell, E. P. - Direct implantation of free nerve grafts between facial musculature and facial trunk. Arch. Otolaryng., 27: 469-472 (April) 1938.

15. Cawthorne, T. - a) Peripheral facial paralysis. Some aspects of its pathology. Laryngoscope, 56:653-664 (November) 1946 ; b) The pathology and surgical treatment of Bell's palsy. Paper read at the Fourth International Congress of Neurology, Paris, 1949; c) Bell's palsy. Lancet, no. 6683, pg. 593 (September 29) 1951; d) The rôle of surgery in the investigation and treatment of peripheral facial palsy. Lancet, pg. 1219 (June 21) 1952.

16. Collier, D. J. - a) Discussion on the limitations of operative treatment in traumatic facial paralysis. Proc. Roy. Soc. Med., 34 (March 7) 1941; b) The present position of facial nerve surgery. Ann. Otol., Rhin. a. Laryng., 58:686 (September) 1949; c) The treatment of facial paralysis. Proc. Roy. Soc. Med., 43:746, 1950.

17. Duel, A. B. - History and development of the surgical treatment of facial palsy. Surg., Gynec. a. Obst, 56:382, 1933.

18. Duel, A. B.; Tickle, T. G. - The surgical repair of facial nerve paralysis. Ann. Otol., Rhin. a. Laryng., 45:3, 1936.

19. Farrior, J. B.; Caldwell, P. C. - Facial nerve paralysis resulting from fracture of the temporal bone; report of a case. New Orleans M. a. S. J., 100:23-26 (July) 1947.

20. Findlay, J. P. - Facial paralysis. Angus & Robertson Ltd., 89 Castle-reagh St., Sydney, 1950.

21. Flodgren, E. - Contribution to the surgery of the facial palsy. Acta Oto-Iaryng., suppl. 74, pg. 188, 1948

22. Fogh-Andersen, P. - Plastikkirurgisk behandling af invetereret facialisparese. Ugeskr. f. Laeger, 113: 828, 1948.

23. Fowler Jr., E. P. - The management and treatment of afflictions of the facial nerve within the fallopian canal. Acta Otolaryng., 27:615, 1939.

24. Kettel, K. - a) Neurinoma of the facial nerve. Arch. Otolaryng., 44:253, 1946; b) Nerve grafting and nerve suture in post-operative facial palsies. Proc. of the Fourth International Congress of Otolaryngology, London, 1949, vol. 1; c) Intratemporal sarcoma of the facial nerve. Arch. Otolaryng., 52:778 (November) 1950;

d) Facial palsy of otitic origin. Arch. Otolaryng., 37:303-348, 1943: e) Prognosen for nervesutur og nervetransplantation ved perifer traumatisk facialisparese. Nord. Med., 43:1066, 1950; f) The prognosis of nerve grafting and nerve suture in peripheral facial palsies. Acta Otolaryng., suppl. 74, pg. 180, 1948.

25. Kisch, H. - Facial paralysis; Ballance-Duel nerve graft; recovery. Proc. Roy. Soc. Med., 29:1679, 1936.

26. Lathrop, F. D. - a) Facial nerve surgery in the European theater of operations. Laryngoscope, 56:665-676 (November) 1946; b) The practical anatomical and surgical considerations for exposure of the facial nerve. Laryngoscope, 58:743-760 (August) 1948; c) Affections of the facial nerve. Bull. New York Acad. Med., 28:796-808, 1952; d) The facial nerve: technique of exposure and repair. S. Clin. North America, 33, no. 3 (June) 1953; e) Affections of the facial nerve. J.A.M.A., 152:19-25 (May 2) 1953.

27. Lindsay, J. R. - Transplantation of facial nerve. Arch. Otolaryng., 27:131 (January) 1938.

28. Love, J. G.; Cannon, B. W. - Nerve anastomosis in the treatment of facial paralysis: special consideration of the etiologic rôle of total removal of tumors of the acoustic nerve. Arch. Surg., 62:379 (March) 1951.

29. Martin, R. C. - a) Infratemporal suture of the facial nerve. Arch. Otolaryng., 13:259 (February) 1931; b) Surgical repair of the facial nerve. Arch. Otolaryng., 23:458 (April) 1936; c) Recent experiences with operation on facial nerve. Arch. Otolaryng., 32:1071 (December) 1940; d) Prognosis in traumatic peripheral facial paralysis. Laryngoscope, 61: 1004 (October) 1951; e) Bell's palsy. Arch. Otolaryng., 55, no. 4 (April) 1952.

30. Maxwell, J. II. - Extratemporal repair of the facial nerve. Case reports. Ann. Otol., Rhin. a. Laryng., 60:1114 (December) 1951.

31. McGillicuddy, O. B. - Facial nerve paralyses of twenty years' duration. Arch. Otolaryng., 58:310, 1953.

32. McArthur, G. A. D. - Repair of facial nerve lesion by nerve graft. M. J. Australia, 2:1123, 1939.

33. Morris, W. M. - a) Surgical treatment of facial paralysis: a review of forty-six cases. Lancet, 2:558, 1939; b) Surgical treatment of Bell's palsy. Lancet, 1:429, 1938; c) Surgical treatment of facial paralysis. Lancet, 2:558, 1939; d) Surgical treatment of facial paralysis. Lancet, 2: 1172, 1936.

34. Ney, K. W. - Facial paralysis and the surgical repair of the facial nerve. Laryngoscope, 32:327, 1922.

35. Owens, N. - a) Implantation of fascial strips through the masseter muscle for surgical correction of facial paralysis. Plast. a. Reconstr. Surgery, 2, no. 1 (January) 1947; b) Reevaluation of the implantation of fascial strips through the masseter muscle for surgical correction of facial paralysis. Ann. Otol., Rhin. a. Laryng., 57:55 (March) 1948.

36. Scott, S. - Nerve-graft in the treatment of facial paralysis: Ballance and Duel method. Proc. Roy. Soc. Med., 28:236, 1935.

37. Sullivan, J. - a) Facial nerveplasma glue. Private communication; b) Modern Practice in Diseases of the Ear, Nose and Throat, vol. 2, section 1: Ear. Chapter 8: Injuries to ear (middle and inner) ; c) Recent advances in the surgical treatment of facial paralysis and Bell's palsy. Laryngoscope, 62:449 (May) 1952.

38. Tickle, T. G. - a) The surgical treatment of facial paralyses. In Kopetzky, S. - Surgery of the Ear. Thomas Nelson & Sons, New York, 1939; b) The surgical treatment of facial paralysis. Loose Leaf Surgery of the Ear. Chapter 14, pages 355-365, 1938; c) Surgery of the facial nerve in 300 operated cases. Laryngoscope, 55:191-195 (May) 1945; d) Surgery of the seventh nerve. J.A.M.A., 136:969-972, 1948.

Relatório apresentado ao XIX Congresso Internacional de Oto-Neuro-Oftalmologia, reunido em São Paulo em 11-17 de junho de 1954, subordinado ao 2º tema oficial: Fisiopatologia do nervo facial.

Postkonto 30279 - Hillerod, Denmark.

  • 1. Adams, W. M. - The use of the masseter, temporalis and frontalis muscles in the correction of facial paralysis. Plast. a. Reconst. Surg., 1, no. 2 (September) 1946.
  • 2. Ballance, C; Duel, A. B. - The operative treatment of facial palsy. Arch. Otolaryng., 15:1-70 (January) 1932.
  • 3. Bauer, G. - Nerve graft in facial palsy. Acta Chir. Scandinav., 81:130, 1938.
  • 4. Behrman, W. - The surgical treatment of peripheral facial paralysis in fractures of the cranial base. Acta Otolaryng., 37:187-190, 1949.
  • 5. Bergstrom, E. - Good result after operation tor traumatic defect of the facial nerve. Hygiea, 8:2102, 1940.
  • 6. Blair, V. P. - Further observations upon the compensatory use of live tendon strips for facial paralysis. Ann. Surg., 92:694, 1930.
  • 7. Bloch, A.; Bourgeois, R.; Aboulker, P. Lefèvre, J. - Le traitement chirurgical des paralysies faciales otologiques. Congrès de la Société Française d'Oto-Rhino-Laryngologie, 1950.
  • 8. Brooke - A case of facial paralysis treated by facial grafts. Brit. J. Surg., 20:523, 1933.
  • 9. Brown, J. B. - The utilization of the temporal muscle and fascia in facial paralysis. Ann. Surg., 109, no. 6 (June) 1939.
  • 10. Brown, J. B.; McDowell, F.; Fryer, M. P. - Facial paralysis supported with autogenous fascia lata. Ann. Surgery, 127, no. 5 (May) 1948.
  • 11. B runner, H. - Treatment of inveterate facial paralysis. Plast. & Reconstr. Surg., 8:390 (November) 1951.
  • 12. Bunnell, S. - a) Suture of the facial nerve within the temporal bone. Surg., Gynec. a. Obst, pg. 7-12 (July) 1927;
  • b) Surgical repair of the facial nerve. Arch. Otolaryng., 25: 235-259, 1937;
  • c) Summation of papers on management of facial paralysis. Arch. Otolaryng., 55:417 (April) 1952.
  • 13. Bunnell, S.; Boyes, J. H. - Nerve grafts. Am. J. Surg., 44:64, 1939.
  • 14. Cardwell, E. P. - Direct implantation of free nerve grafts between facial musculature and facial trunk. Arch. Otolaryng., 27: 469-472 (April) 1938.
  • 15. Cawthorne, T. - a) Peripheral facial paralysis. Some aspects of its pathology. Laryngoscope, 56:653-664 (November) 1946 ;
  • b) The pathology and surgical treatment of Bell's palsy. Paper read at the Fourth International Congress of Neurology, Paris, 1949;
  • c) Bell's palsy. Lancet, no. 6683, pg. 593 (September 29) 1951;
  • d) The rôle of surgery in the investigation and treatment of peripheral facial palsy. Lancet, pg. 1219 (June 21) 1952.
  • 16. Collier, D. J. - a) Discussion on the limitations of operative treatment in traumatic facial paralysis. Proc. Roy. Soc. Med., 34 (March 7) 1941;
  • b) The present position of facial nerve surgery. Ann. Otol., Rhin. a. Laryng., 58:686 (September) 1949;
  • c) The treatment of facial paralysis. Proc. Roy. Soc. Med., 43:746, 1950.
  • 17. Duel, A. B. - History and development of the surgical treatment of facial palsy. Surg., Gynec. a. Obst, 56:382, 1933.
  • 18. Duel, A. B.; Tickle, T. G. - The surgical repair of facial nerve paralysis. Ann. Otol., Rhin. a. Laryng., 45:3, 1936.
  • 19. Farrior, J. B.; Caldwell, P. C. - Facial nerve paralysis resulting from fracture of the temporal bone; report of a case. New Orleans M. a. S. J., 100:23-26 (July) 1947.
  • 20. Findlay, J. P. - Facial paralysis. Angus & Robertson Ltd., 89 Castle-reagh St., Sydney, 1950.
  • 21. Flodgren, E. - Contribution to the surgery of the facial palsy. Acta Oto-Iaryng., suppl. 74, pg. 188, 1948
  • 22. Fogh-Andersen, P. - Plastikkirurgisk behandling af invetereret facialisparese. Ugeskr. f. Laeger, 113: 828, 1948.
  • 23. Fowler Jr., E. P. - The management and treatment of afflictions of the facial nerve within the fallopian canal. Acta Otolaryng., 27:615, 1939.
  • 24. Kettel, K. - a) Neurinoma of the facial nerve. Arch. Otolaryng., 44:253, 1946;
  • b) Nerve grafting and nerve suture in post-operative facial palsies. Proc. of the Fourth International Congress of Otolaryngology, London, 1949, vol. 1;
  • c) Intratemporal sarcoma of the facial nerve. Arch. Otolaryng., 52:778 (November) 1950;
  • d) Facial palsy of otitic origin. Arch. Otolaryng., 37:303-348, 1943: e) Prognosen for nervesutur og nervetransplantation ved perifer traumatisk facialisparese.
  • Nord. Med., 43:1066, 1950;
  • f) The prognosis of nerve grafting and nerve suture in peripheral facial palsies. Acta Otolaryng., suppl. 74, pg. 180, 1948.
  • 25. Kisch, H. - Facial paralysis; Ballance-Duel nerve graft; recovery. Proc. Roy. Soc. Med., 29:1679, 1936.
  • 26. Lathrop, F. D. - a) Facial nerve surgery in the European theater of operations. Laryngoscope, 56:665-676 (November) 1946;
  • b) The practical anatomical and surgical considerations for exposure of the facial nerve. Laryngoscope, 58:743-760 (August) 1948;
  • c) Affections of the facial nerve. Bull. New York Acad. Med., 28:796-808, 1952;
  • d) The facial nerve: technique of exposure and repair. S. Clin. North America, 33, no. 3 (June) 1953;
  • e) Affections of the facial nerve. J.A.M.A., 152:19-25 (May 2) 1953.
  • 27. Lindsay, J. R. - Transplantation of facial nerve. Arch. Otolaryng., 27:131 (January) 1938.
  • 28. Love, J. G.; Cannon, B. W. - Nerve anastomosis in the treatment of facial paralysis: special consideration of the etiologic rôle of total removal of tumors of the acoustic nerve. Arch. Surg., 62:379 (March) 1951.
  • 29. Martin, R. C. - a) Infratemporal suture of the facial nerve. Arch. Otolaryng., 13:259 (February) 1931;
  • b) Surgical repair of the facial nerve. Arch. Otolaryng., 23:458 (April) 1936;
  • c) Recent experiences with operation on facial nerve. Arch. Otolaryng., 32:1071 (December) 1940;
  • d) Prognosis in traumatic peripheral facial paralysis. Laryngoscope, 61: 1004 (October) 1951;
  • e) Bell's palsy. Arch. Otolaryng., 55, no. 4 (April) 1952.
  • 30. Maxwell, J. II. - Extratemporal repair of the facial nerve. Case reports. Ann. Otol., Rhin. a. Laryng., 60:1114 (December) 1951.
  • 31. McGillicuddy, O. B. - Facial nerve paralyses of twenty years' duration. Arch. Otolaryng., 58:310, 1953.
  • 32. McArthur, G. A. D. - Repair of facial nerve lesion by nerve graft. M. J. Australia, 2:1123, 1939.
  • 33. Morris, W. M. - a) Surgical treatment of facial paralysis: a review of forty-six cases. Lancet, 2:558, 1939;
  • b) Surgical treatment of Bell's palsy. Lancet, 1:429, 1938;
  • c) Surgical treatment of facial paralysis. Lancet, 2:558, 1939;
  • d) Surgical treatment of facial paralysis. Lancet, 2: 1172, 1936.
  • 34. Ney, K. W. - Facial paralysis and the surgical repair of the facial nerve. Laryngoscope, 32:327, 1922.
  • 35. Owens, N. - a) Implantation of fascial strips through the masseter muscle for surgical correction of facial paralysis. Plast. a. Reconstr. Surgery, 2, no. 1 (January) 1947;
  • b) Reevaluation of the implantation of fascial strips through the masseter muscle for surgical correction of facial paralysis. Ann. Otol., Rhin. a. Laryng., 57:55 (March) 1948.
  • 36. Scott, S. - Nerve-graft in the treatment of facial paralysis: Ballance and Duel method. Proc. Roy. Soc. Med., 28:236, 1935.
  • 37. Sullivan, J. - a) Facial nerveplasma glue. Private communication;
  • b) Modern Practice in Diseases of the Ear, Nose and Throat, vol. 2, section 1: Ear. Chapter 8: Injuries to ear (middle and inner) ; c) Recent advances in the surgical treatment of facial paralysis and Bell's palsy. Laryngoscope, 62:449 (May) 1952.
  • 38. Tickle, T. G. - a) The surgical treatment of facial paralyses. In Kopetzky, S. - Surgery of the Ear. Thomas Nelson & Sons, New York, 1939;
  • b) The surgical treatment of facial paralysis. Loose Leaf Surgery of the Ear. Chapter 14, pages 355-365, 1938;
  • c) Surgery of the facial nerve in 300 operated cases. Laryngoscope, 55:191-195 (May) 1945;
  • d) Surgery of the seventh nerve. J.A.M.A., 136:969-972, 1948.

  • Nerve grafting and nerve suture in postoperative facial palsies. A report of 69 cases

    Karsten Kettel

    • Publication Dates

    • Publication in this collection
      10 Apr 2014
    • Date of issue
      Dec 1954
    Creative Common - by-nc 4.0
    This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
    Academia Brasileira de Neurologia - ABNEURO R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices Torre Norte, 04101-000 São Paulo SP Brazil, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
    E-mail: revista.arquivos@abneuro.org
    Acompanhe os números deste periódico no seu leitor de RSS