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Surgical Management of Iatrogenic Facial Nerve Palsy a New Sutureless Grafting Technique
K.L.E Univ., Belgaum, Karnataka
Vijayendra HONNURAPPA, Vijayendra HONNURAPPA
¸ñÀû: Purpose to achieve good Facial nerve functioning from grade VI to grade II . ¹æ¹ý:Method since my centre is a referral centre for facial Nerve surgeries, I have a large series of iatrogenic facial Nerve paralysis. 127 cases operated since 1994 and the end results of improvement mainly depend upon how soon the surgery is performed. With my experience I have seen varieties of injuries, common site being second genu and beginning of the vertical segment. Unusual sites at the Stylomastoid foramen and Internal Auditory meatus. In 38% of cases Lateral semicircular canal has been damaged.Technique at present I get excellent results from grade VI to grade II if operated within 7 days from the day of injury. New technique I decompress the normal facial nerve about 2 cms both proximal and distal to the site of lesion, then incise the Epineurium and then identify the normal healthy perineurium, using Ophthalmic Micro Surgical knife slice the healthy perineurial segment both proximally and distally, retain the epineurium posteriorly for better vascularity and separate the sliced end of perineurium around 360 degree which enables to wrap the Temporalis fascia between the cut end of facial nerve perineurium and greater auricular nerve graft bridge the gap between both healthy cut ends using Greater auricular nerve and ends are wrapped with Temporalis fascia graft (Cable grafting) Monthly follow up is for one year and end results should be accessed at the end of one year. °á°ú:With this technique facial Functioning results are good, we achieve results from grade VI to grade II with proper timing. °á·Ð:The most reliable technique to achieve good results.


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