Healthy 49yo 2 months after fall with temporal bone fracture and complete flaccid paralysis. EMG shows fibrillation potentials and very minimal amplitude without polyphasic waves on that side. Typically I would wait at least 6 mos for spontaneous recovery then consider masseter to facial nerve branch transfer +/- static suspension if no recovery is seen by then. I’m wondering if anyone has had success with a direct CFNG early in the course of paralysis to add spontaneous reanimation in the event natural recovery doesn’t occur? I haven’t seen convincingly good results with direct hook up, but the morbidity is fairly low and it could be used to power a gracilis in the future if needed. Would it provide any benefit in this type of case?
autoimmune Bell Palsy bulbar palsy Cases disscusstion Cranial nerve transfer Cross face nerve graft elderly Electro-stimulation Facial Therapy flaccid paralysis Free muscle transfer Grading systems middle ear multiple cranial nerve palsy myositis nerve graft Objective analysis Pediatric PROMs Reanimation sterno-omohyroid muscle flap Subjective analysis synkinesis Traumatic Facial Palsy tumor vestibular schwannoma viewpoints