Abstract

Introduction: Facial paralysis (FP) is a devastating condition causing functional, aesthetic and psychosocial impairments. Following acute traumatic injury to the main trunk of the facial nerve, complete flaccid FP can occur. Ocular protection and smile restoration are top priority goals of the reanimation process. In cases where the proximal facial nerve stump is unavailable or inaccessible, nerve transfer procedures should be considered for reinnervation.

Case Description: We report a case of a 22-year-old male suffered a gunshot wound to the left preauricular area that traversed the external auditory canal and mastoid, causing immediate complete left sided flaccid facial paralysis. Attempts were made to identify the proximal facial nerve stump, however, these attempts were unsuccessful secondary to missile damage and infection. Here, we present a case using four distinct donor nerves to perform four separate nerve transfers to independently reinnervate the upper, middle and lower face following traumatic transection of the intratemporal facial nerve.

Discussion: Acute traumatic FP with an inaccessible proximal facial nerve stump poses a reanimation challenge. Using 4 distinct donor nerves, independent zonal reinnervation was achieved. The described technique in this report provides a systematic method for management of acute traumatic FP with an inaccessible facial nerve stump in order to independently reanimate the upper, middle and lower face.

Keywords: Quadruple Nerve Transfer; Zonal Facial Reanimation; Traumatic Facial Paralysis

References

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Citation

Citation: Celeste Nagy., et al. “Simultaneous Quadruple Nerve Transfer for Independent Zonal Facial Reanimation Following Traumatic Facial Paralysis". Acta Scientific Otolaryngology 2.7 (2020): 16-18.

Copyright

Copyright: © 2020 Celeste Nagy., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.