Clinical Application of Fat Tissue Wraparound Splint after Facial Nerve Repair

ABSTRACT

Facial deformity after nerve injury changes ones' social life. We experienced a few patients with healthy early recovery of muscle contraction after the operation with soft tissue wraparound splint. Under general anesthesia, exploration to find as many injured nerve stumps with x 2.5 loopes was undertaken at first. Interfascicular repair was done with minimal tension by 10-0 nylon under a microscope, and the suture site was sealed by approximating the surrounding fat flaps. This conjoined adipose tissue flap was a splint as a wraparound environment to reduce the tension in the coaptation site, and to increase the relative concentration of releasing neurotrophic factors by surrounding it. A 45-year-old man fell down in a drunken state and had deep laceration by broken flowerpot fragments with facial muscle weakness on the right cheek. His injured mandibular branches of the facial nerve were found. A 31-year-old female suffered from motionlessnesss of frontalis muscle after a traffic accident. She had four frontal branches injured. The man had his cheek with motion after seven days, and the woman two months after the operation. The nerve conduction test of the woman showed normalized values. Facial nerve repair surrounded by adipose tissue wraparound splint can make the recovery time relatively short.