Abstract
Objective: The underlying idea behind this review was to present the
most recent and well-established findings concerning methods of facial
nerve reconstruction in a comprehensive albeit concise fashion. Methods:
The Google scholar, The Medline/Pubmed and Cochrane databases have been
used to select the most relevant and influential experiences on the
reconstruction of the facial nerve. Authors searched for publications
written strictly in English. The authors considered the date of the
publication, the presented cases and the overall significance of the
paper. The references of the publications of interest were also screened
for relevant papers. Conclusions: Facial nerve reconstruction is a
highly formidable challenge, prompting reconstructive surgeons to rely
on a wide spectrum of tools ranging from microsurgery, through
peripheral nerve management to aesthetic procedures. Advances in the
field of reconstructive surgery have resulted in more ambitious goals,
as surgeons strive not only to restore function but also for a highly
aesthetic outcome. The vascularized nerve graft is recommended in cases
with a long nerve gap, inadequate soft-tissue coverage and in patients
with previous irradiation at the wound. Motor nerve grafts seem to be
superior to sensory nerve grafts. A cross-facial nerve graft (CFNG) is
recommended when a proximal nerve stump is unavailable. The gracilis
muscle is effective in the dynamic reconstruction of the oral commissure
movement. Postoperative radiotherapy does not prevent recovery of facial
function after sural nerve grafting. Individual factors and level of
proficiency with a given technique should guide reconstructive surgeons
during the selection of the method.