The paper shows the result of a study comparing recovery after complete facial nerve transection and immediate repair by direct neurorrhaphy or nerve grafting in an animal model. The authors cut the buccal and mandibular trunk of the left facial nerve at the pes anserinus performing direct suture of proximal and distal ends in 50% of the animals. In the other 50% an additional cut was made two centimetres further, at the distal convergence of the buccal and mandibular branches, creating a complete nerve loop that was inverted. This inverted nerve loop was sutured to the proximal and distal stumps acting as an autograft with a proximal and a distal neurorrhaphies. Quantitative measurement of the whisking movements was used as a parameter of function recovery for comparison of the two groups. Results only showed a small delay on function recovery in the nerve graft group that did not reach statistical difference. As the authors state, this is the first study where primary nerve suture and cable nerve grafting are compared in a controlled fashion. The results are extremely valuable, not just for understanding the process of facial recovery after complete transection of the nerve, but also for decision taking. The experimental model opens a wide range of possibilities for further research in the different techniques for facial nerve repair after severe injury. 

Functional recovery after facial nerve cable grafting in a rodent model.
Hohman MH, Kleiss IJ, Knox CJ, et al.
Nov 2013; Epub ahead of print.
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Eduardo Morera Serna

Hospital Universitario Son Espases, Palma de Mallorca, Spain.

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