Facial Nerve Graft in Malignant Tumors: The Role of Facial Rehabilitation

被引：0

作者：

Mattioli, Francesco ^{[1
]}

Galloni, Costanza ^{[1
]}

Alberti, Chiara ^{[1
]}

Bonali, Marco ^{[1
]}

Lo Manto, Alfredo ^{[2
]}

Baraldi, Stella ^{[1
]}

Tonelli, Roberto ^{[3
,4
,5
]}

Nizzoli, Federica ^{[1
]}

Reggiani, Elena ^{[1
]}

Barbazza, Alice ^{[6
]}

Liberale, Carlotta ^{[7
]}

Ferrari, Marco ^{[8
]}

Fermi, Matteo ^{[6
]}

Alicandri-Ciufelli, Matteo ^{[1
]}

Fernandez, Ignacio Javier ^{[9
]}

Zanoletti, Elisabetta ^{[8
]}

Nicolai, Piero ^{[8
]}

Marchioni, Daniele ^{[1
]}

机构：

[1] Univ Modena & Reggio Emilia, Dept Otorhinolaryngol Head & Neck Surg, Azienda Osped Univ Policlin Modena, I-41125 Modena, Italy

[2] Osped Infermi, Dept Otorhinolaryngol, I-47923 Rimini, Italy

[3] Univ Modena & Reggio Emilia, PhD Program, Clin & Expt Med, I-41125 Modena, Italy

[4] Univ Modena & Reggio Emilia, Dept Surg & Med Sci, Resp Dis Unit, Azienda Osped Univ Policlin Modena, I-41125 Modena, Italy

[5] Univ Modena & Reggio Emilia, Ctr Rare Lung Dis, Dept Surg & Med Sci, Azienda Osped Univ Policlin Modena, I-41125 Modena, Italy

[6] IRCCS Azienda Osped Univ Bologna, Dept Otolaryngol Head & Neck Surg, I-40138 Bologna, Italy

[7] Univ Verona, Dept Otorhinolaryngol, I-37134 Verona, Italy

[8] Univ Padua, Dept Neurosci DNS, Otolaryngol Sect, I-35123 Padua, Italy

[9] Osped Santa Maria Croci, Dept Otorhinolaryngol, I-48121 Ravenna, Italy

来源：

JOURNAL OF CLINICAL MEDICINE | 2025年 / 14卷 / 03期

关键词：

head and neck malignancy; facial nerve sacrifice; facial nerve grafting; post-operative radiotherapy; facial rehabilitation; RADIOTHERAPY; REPAIR; OUTCOMES; IMPACT;

D O I：

10.3390/jcm14030968

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Oncological surgery of the parotid gland or of the temporal bone may require the contemporary sacrifice of the facial nerve (FN). In such cases, the immediate repair of the sacrificed FN is recommended. The aim of this study is to evaluate the impact of facial rehabilitation (FR) and, secondarily, of post-operative radiotherapy (PORT) on the FN outcome after FN sacrifice and reconstruction via cable graft. Methods: This is a multicentric retrospective study including patients affected by malignant tumors whose surgical excision required FN sacrifice and contextual FN reconstruction with a cable graft. Other FN reconstruction techniques were excluded. FN function was assessed using both House-Brackmann and Sunnybrook grading systems. Results: A total of 28 patients were included. Most of the patients underwent a total parotidectomy. The greater auricular nerve was the main donor for cable graft. FR and PORT were performed in 22 and 15 patients, respectively. In particular, 20 patients underwent neuro-muscular retraining (NMR). Patients who underwent FR had better FN outcomes compared to those who did not (p = 0.02 at 12 months and p = 0.0002 at 24 months). In contrast, there was no statistically significant difference between patients who underwent PORT and those who did not (p > 0.05). Pre-operative FN palsy is a risk factor of worse FN function outcomes after cable graft. Conclusions: Our study, even though it was limited to only 28 cases, may demonstrate that cable graft failure is not due to PORT, as widely believed among clinicians, but to the absence of a rehabilitation program. Moreover, we suggest that the key to obtaining the best possible FN function results after FN sacrifice is the association of a technically correct FN reconstruction with a proper and targeted FR.

引用

页数：12

共 22 条

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