A 4 year old boy had an astrocytoma removed 1 year ago which resulted in a complete flaccid palsy on the left together with bilateral VI palsy. His swallow is safe and other cranial nerves are grossly intact – he is still under surveillance by the oncologists. According to the facial therapists, there is little improvement in his function. My initial thought would be to baby-sit his musculature with a V-VII transfer with a plan to cross face nerve graft at a later date depending on the degree of facial movement recovery. Does anyone have any other ideas?