The impact of radiotherapy on facial nerve repair

✍ Scribed by Paul W. Gidley; Stephanie J. Herrera; Matthew M. Hanasono; Peirong Yu; Roman Skoracki; Dianna B. Roberts; Randal S. Weber

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 77 KB
• Volume: 120
• Category: Article
• ISSN: 0023-852X
• DOI: 10.1002/lary.21048

✦ Synopsis

Abstract

Objective:

To study the impact of radiotherapy on the success of primary facial nerve repair and cable nerve grafts.

Study Design:

Retrospective review.

Methods:

Pre‐ and postoperative facial nerve function were assessed using the House‐Brackmann (HB) grading system.

Results:

Thirty‐nine patients were identified who had undergone facial nerve repair: 5 patients (13%) underwent primary repair, and 34 patients (87%) underwent nerve grafting. Radiotherapy was administered postoperatively to 34 patients (87%). Preoperative HB scores were I = 18, II = 11, III = 3, IV = 3, V = 3, and VI = 1. Postoperative scores were HB I = 1, II = 4, III = 16, IV = 6, V = 3, and VI = 9. Only patients with single‐branch deficits recovered to HB I or II function. Good facial function (HB I–III) was achieved in 17 of 34 patients (50%) who received postoperative radiotherapy compared to 4 of 5 patients (80%) who did not receive postoperative radiotherapy (P = .349). Among the patients who had either HB I or II function preoperatively, 59% achieved good postoperative function (HB I–III). Four out of 10 patients (40%) with significantly compromised preoperative facial function (HB III–VI) were able to achieve HB III function.

Conclusions:

Postoperative radiotherapy appears not to prevent achieving good facial function after a nerve repair, especially when normal or near‐normal function is present preoperatively. Some patients with fair to little function preoperatively can achieve reasonable postoperative function with facial nerve reconstruction. Laryngoscope, 2010