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Updated: Jun 9, 2026
Facial Nerve Surgery in the Rat Model to Study Axonal Inhibition and Regeneration
Published on: May 5, 2020
The impact of radiotherapy on facial nerve repair
Paul W Gidley1, Stephanie J Herrera, Matthew M Hanasono
1Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. pwgidley@mdanderson.org
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.
