Cross-facial nerve grafts and microneurovascular free muscle transfer for long established facial palsy.

Cross-facial nerve grafts followed in 4 to 12 months by microneurovascular free gracilis transplantation can produce adequate reconstruction in the lower two-thirds of a paralysed face. The mixed sensory and motor deep peroneal nerve and the small muscle bulk of the extensor digitorum brevis limit its usefulness in facial palsy. The gracilis has proved to be a much superior muscle. A feasible method for total reamination of unilateral facial palsy is presented.