A comparison of methods of extra temporal facial nerve repair

The development during the past 100 years of methods of repair of the divided facial nerve is discussed, from the early attempts to bring the nerve ends together inside a tube of vein. The success of the repair is enhanced by the care of the blood supply to the nerve and by measures to avoid scar developing between the ends of the nerve. Rest of the suture line is aided by the support of some form of tube, but unless this latter is kept below I cm. in length interference with the radial blood vessels to the nerve occurs. Intubation also encourages parallel growth of the nerve fibres and discourages fibroblast proliferation. Animal experimentation shows that the results when a soft silicone tube of special shape is used are superior to those obtained if the nerve is left free in the tissues, buried in muscle, or placed inside a vein.