외상으로 절단된 안면신경의 재건

Reconstruction of traumatically severed facial nerve

Although a major cause of facial nerve lesion is surgical removal of extracranial and intracranial tumors, injuries to the skull or facial tissues may also place this nerve at considerable risk. Extratemporal facial nerve damages result mainly from deep injuries to the lateral face region including the parotid gland. In the past there was much discussion on the question of the best time for neural intervention during treatment of deep injuries in the lateral face region with facial nerve damage. In contrast to immediate primary nerve reconstruction early secondary reconstruction is also successfully carried out 3 to 4 weeks after the accident. A 35 year old woman came to our emergency room after having sustained the deep laceration injury in her left face, and primary closure of the soft tissue injury was done immediately. It was evident that her left upper lip and cheek lost their mimic muscular function 1 month after the accident. She underwent secondary reconstruction of facial nerve using transplantation of the greater auricular nerve to bridge a gap in the buccal branch of this nerve. In 12 months of follow-up the buccal smile muscles of injured side restored their mimic muscular function.