¸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. |