Views Read Edit View history. During a one-stage or two-stage CFNG procedure, one or more non-affected facial nerve branches are used for reinnervation of the paralysed side. Selection of the type of nerve transfer is based on the individualised needs and condition of the patient. The distal nerves are dissected in retrograde fashion from distal to proximal through the parotid gland until the lacerated branches are identified. Whether these nerve grafts are immediately attached to the paralysed facial nerve branches or after 9 to 12 months depends on the chosen procedure. Static suspension may be used to augment reinnervation procedures, in order to improve facial symmetry at rest, especially during the period of facial nerve recovery. Good spontaneous smile and sufficient depressor mechanism were achieved by cross-facial nerve grafting and hypoglossal-facial nerve crossover respectively, and these techniques are demonstrated by the authors clinically and electrophysiologically.
In other words, if there is contraction of the mimetic muscle during an electromyogram.
Cross-facial nerve grafting
A free muscle transfer is also used, due to the atrophic muscle. J Plast Reconstr Aesthet Surg. Primary neurorrhaphy provides the best possible outcome, as the anatomy and function of the damaged facial nerve is restored. Reanimation of a spontaneous and synchronous smile, and sufficient depressor mechanism of the lower lip presents a surgical challenge in facial paralysis. Nine to twelve months is needed for axonal regeneration in the cross facial nerve graft, because the result of damaged nerve tissue is loss of structure and axonal function. The elevators of the upper lip and corner of the mouth are innervated by the zygomatic and buccal branches. A disadvantage is that it can only be harvested with the patient in lateral decubitus or prone position.