Comparison of results utilizing one-step and two-step triple innervation techniques

A retrospective comparison between two groups of patients who underwent one-step or two-step triple innervation was performed to reveal the role of scar tissue in axonal regeneration. The surgical technique used was the same in all cases, but the first group underwent a one-time triple innervation procedure, while patients in the second group underwent delayed performance of neurorrhaphies between the distal ends of the cross-face grafts and the terminal branches of the injured facial nerve. The Wilcoxon signed-rank test for paired groups showed a statistically significant improvement in both facial symmetry and voluntary movements in both groups of patients. Separately, the Mann-Whitney test confirmed no statistically significant difference between the two groups regarding the restoration of facial symmetry and voluntary movements, and the development of postoperative synkinesis. A comparison of median values for each spontaneous parameter between the groups revealed greater effectiveness of the two-step surgery, with both blinking and laughing demonstrating better results. The greater effectiveness of the double-step technique in restoring spontaneous movements strongly supports the use of a two-stage triple innervation technique in patients with facial palsy.