Nerve suture and grafting to restore the extratemporal facial nerve

A concept for dealing with extratemporal lesions of the facial nerve is based on cadaver studies performed by Meissl. In spite of plexiform arrangement and fiber exchange, areas and fascicle groups can be differentiated within the cross section of the facial nerve which contain a great percentage of the fibers supplying a certain muscle group. An attempt should be made to unite the corresponding parts by direct coaptation, or, if nerve defect exists, by nerve grafts.