Selective Neurectomy of the Facial Nerve with Cross-Face Nerve Graft for Treating Postparalytic Facial Nerve Syndrome

Although postparalytic facial nerve syndrome (PFS) is a frequent sequela of partial facial palsy, no effective treatment is currently available. Herein, we report a case of a cross-face nerve graft (CFNG) technique with selective neurectomy of the facial nerve in a 52-year-old female with moderate P...

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Main Authors: Ko Nakao, Takako Fujii, Hisashi Sakuma
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc. 2025-05-01
Series:Archives of Plastic Surgery
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/a-2531-3083
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author Ko Nakao
Takako Fujii
Hisashi Sakuma
author_facet Ko Nakao
Takako Fujii
Hisashi Sakuma
author_sort Ko Nakao
collection DOAJ
description Although postparalytic facial nerve syndrome (PFS) is a frequent sequela of partial facial palsy, no effective treatment is currently available. Herein, we report a case of a cross-face nerve graft (CFNG) technique with selective neurectomy of the facial nerve in a 52-year-old female with moderate PFS (especially oral-ocular synkinesis and facial contracture) and a House–Brackmann score grade III. Selective neurectomy resulted in the release of the synkinesis and contractures. Furthermore, we reinnervated the levator muscles of the upper lip and oral commissure by connecting the contralateral facial nerve to the thick zygomatic branch of the facial nerve via a CFNG, which allowed neural signal augmentation of the levator muscles. No obvious PFS recurrence was observed 1 year postoperatively. This procedure is expected to provide a new treatment option for improving PFS because it is effective and less invasive.
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publisher Thieme Medical Publishers, Inc.
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spelling doaj-art-55a71ed0307c4fe6a3d0f0af59e4a2bb2025-08-20T02:31:44ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712025-05-01520312513110.1055/a-2531-3083Selective Neurectomy of the Facial Nerve with Cross-Face Nerve Graft for Treating Postparalytic Facial Nerve SyndromeKo Nakao0https://orcid.org/0009-0001-5407-0819Takako Fujii1https://orcid.org/0000-0003-0608-237XHisashi Sakuma2https://orcid.org/0000-0002-6073-6832Department of Plastic and Reconstructive Surgery, Ichikawa General Hospital, Tokyo Dental College, Ichikawa, JapanDepartment of Plastic and Reconstructive Surgery, Ichikawa General Hospital, Tokyo Dental College, Ichikawa, JapanDepartment of Plastic and Reconstructive Surgery, Ichikawa General Hospital, Tokyo Dental College, Ichikawa, JapanAlthough postparalytic facial nerve syndrome (PFS) is a frequent sequela of partial facial palsy, no effective treatment is currently available. Herein, we report a case of a cross-face nerve graft (CFNG) technique with selective neurectomy of the facial nerve in a 52-year-old female with moderate PFS (especially oral-ocular synkinesis and facial contracture) and a House–Brackmann score grade III. Selective neurectomy resulted in the release of the synkinesis and contractures. Furthermore, we reinnervated the levator muscles of the upper lip and oral commissure by connecting the contralateral facial nerve to the thick zygomatic branch of the facial nerve via a CFNG, which allowed neural signal augmentation of the levator muscles. No obvious PFS recurrence was observed 1 year postoperatively. This procedure is expected to provide a new treatment option for improving PFS because it is effective and less invasive.http://www.thieme-connect.de/DOI/DOI?10.1055/a-2531-3083facial nervecontralateral facial nervefacial palsyneural signal augmentation
spellingShingle Ko Nakao
Takako Fujii
Hisashi Sakuma
Selective Neurectomy of the Facial Nerve with Cross-Face Nerve Graft for Treating Postparalytic Facial Nerve Syndrome
Archives of Plastic Surgery
facial nerve
contralateral facial nerve
facial palsy
neural signal augmentation
title Selective Neurectomy of the Facial Nerve with Cross-Face Nerve Graft for Treating Postparalytic Facial Nerve Syndrome
title_full Selective Neurectomy of the Facial Nerve with Cross-Face Nerve Graft for Treating Postparalytic Facial Nerve Syndrome
title_fullStr Selective Neurectomy of the Facial Nerve with Cross-Face Nerve Graft for Treating Postparalytic Facial Nerve Syndrome
title_full_unstemmed Selective Neurectomy of the Facial Nerve with Cross-Face Nerve Graft for Treating Postparalytic Facial Nerve Syndrome
title_short Selective Neurectomy of the Facial Nerve with Cross-Face Nerve Graft for Treating Postparalytic Facial Nerve Syndrome
title_sort selective neurectomy of the facial nerve with cross face nerve graft for treating postparalytic facial nerve syndrome
topic facial nerve
contralateral facial nerve
facial palsy
neural signal augmentation
url http://www.thieme-connect.de/DOI/DOI?10.1055/a-2531-3083
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AT takakofujii selectiveneurectomyofthefacialnervewithcrossfacenervegraftfortreatingpostparalyticfacialnervesyndrome
AT hisashisakuma selectiveneurectomyofthefacialnervewithcrossfacenervegraftfortreatingpostparalyticfacialnervesyndrome