What is the role of cable grafts in the treatment of congenital facial paralysis?

Updated: Jan 07, 2019
  • Author: Alan D Bruns, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

When a tension-free primary nerve repair is not possible, such as when a segment nerve has been crushed, a cable graft may be indicated. The most common donor nerves are the greater auricular, sural, and the medial and lateral antebrachial cutaneous nerves. The ansa cervicalis has been used as a donor nerve, because some evidence exists that motor nerve grafts are better than sensory nerve grafts. Cable graft anastomosis is accomplished using 8-0 or 9-0 nylon sutures to reapproximate the epineurium. With either primary nerve repair or cable grafting, the best possible outcome is generally with House-Brackmann Grade III facial function. [44]


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