Surgical management of facial nerve injuries.

The comprehensive management of facial nerve injuries requires a surgeon with a number of available methods of reconstruction at his or her disposal. Comprehensive evaluation or documentation of injury is required to determine the most appropriate timing and method of surgical intervention. The majority of nerve injuries are limited, and direct repair or simple nerve grafting are the indicated treatment modalities. These procedures are easily applied to the management of the facial nerve by any well-trained microsurgeon. Accurate diagnosis and timely intervention are critical in achieving acceptable outcomes. Multidisciplinary collaboration is occasionally necessary for extremely proximal injuries wherein the skills of a lateral skull base surgeon are critical. Delayed facial reconstruction by facial reanimation requires subspecialty skills and necessitates referrals to centers experienced in such procedures.