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Outcomes and prognostic factors of facial nerve repair: a retrospective comparative study of 31 patients and literature review

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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate functional results of facial nerve repair by direct nerve suture or grafting, compare results between a traumatic and a tumoral group and identify prognostic factors.

Methods

A retrospective monocentric cohort study was studied in a university ENT department.

Thirty-one patients who benefited from facial nerve suture or grafting, with at least 12 months postoperative follow-up were included. Patients were divided into two groups according to the lesion type: traumatic (accident of the public road or iatrogenic) and tumoral. Preoperative data studied were sex, side, etiology documented by CT and/or MRI, facial palsy duration and grade according to House Brackmann grading system. Intraoperative data included: surgeon, age of patient, surgical technique, graft type, use of biological glue, facial nerve derivation, lesioned site. Postoperative data included: histological diagnosis, radiotherapy history, time to onset of the first signs of reinnervation, follow-up duration, and final facial function.

Results

Success rate, including grade III and IV, was 68% in the whole cohort, 79% in the traumatic group and 59% in the tumoral group. Patients presenting with facial palsy evolving less than 6 months had better recovery results than those evolving longer than 6 months (p = 0.02). No other prognostic factors were identified.

Conclusions

The best outcome that can be achieved by suture or grafting of the facial nerve in traumatic or tumoral lesions is a grade III. Preoperative facial palsy duration is a prognostic factor and must be considered when establishing an operative indication.

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Data availability

Data available on request from the authors. The data that support the findings of this study are available from the corresponding author upon reasonable request. Corresponding author Fabienne Carré should be requested to access the data.

Code availability

Not applicable.

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Funding

No financial support. No material support.

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Authors and Affiliations

  1. ENT Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France

    Fabienne Carré, Rémi Hervochon, Ghizlene Lahlou, Peggy Gatignol, Daniele Bernardeschi, Georges Lamas & Frédéric Tankéré

  2. Sorbonne University, Paris, France

    Fabienne Carré, Rémi Hervochon, Diane Lastennet, Peggy Gatignol, Georges Lamas & Frédéric Tankéré

  3. Centre MEG‐EEG (UMR 7225/U1127, Sorbonne Université/CNRS/ INSERM), Institut du Cerveau Et de La Moelle Epiniere (ICM), Sorbonne University, Paris, France

    Rémi Hervochon & Frédéric Tankéré

  4. Inserm/Pasteur Institute, Hearing Institute, Technology and Gene Therapy for Deafness, Paris, France

    Ghizlene Lahlou

  5. Unit of Public Health, Department of Biostatistics, Pitié-Salpêtrière Hospital, AP-HP, Paris, France

    Diane Lastennet

Authors
  1. Fabienne Carré
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  2. Rémi Hervochon
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  3. Ghizlene Lahlou
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  4. Diane Lastennet
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  5. Peggy Gatignol
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  6. Daniele Bernardeschi
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  7. Georges Lamas
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  8. Frédéric Tankéré
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Contributions

All authors contributed to the study conception and design.

Corresponding author

Correspondence to Fabienne Carré.

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Conflict of interest

The authors declare no conflict of interest.

Ethical approval

Local ethics committee approval was not required, as the French law on clinical research (Law No. 2012-300 dated 5 March 2012) does not apply to this retrospective observational study.

Consent to participate

All patients gave their written informed consent.

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Patients signed informed consent regarding publishing their data.

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Carré, F., Hervochon, R., Lahlou, G. et al. Outcomes and prognostic factors of facial nerve repair: a retrospective comparative study of 31 patients and literature review. Eur Arch Otorhinolaryngol 279, 1091–1097 (2022). https://doi.org/10.1007/s00405-021-07043-6

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  • DOI: https://doi.org/10.1007/s00405-021-07043-6

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