Evaluation of muscle graft using facial nerve on the affected side as a motor source in the treatment of facial paralysis.

To acquire symmetry of the cheek when smiling, we carried out 39 free vascularised grafts of the muscle, the motor nerve of which was sutured to a stump of the ipsilateral facial nerve, for 39 patients with facial paralysis. We used two methods: an as healthy and fresh as possible facial nerve stump (method 1A, n = 17), or an incompletely affected stump (method 1B, n = 22). The results are classified into grade 1 to 5 indicating increasing efficiency of muscle function. All patients who had method 1A and 14 patients who had method 1B were evaluated grade 4 or better. Both an incompletely affected facial nerve stump and the proximal stump of a facial nerve that had previously been resected have sufficient function to provide contraction in the grafted muscle.