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National Utilization of Dynamic Facial Nerve Reconstruction Procedures in Pediatric Patients
Allen Green1, Eric X Wei2, Sarah R Akkina3
1Stanford University School of Medicine, Stanford, CA.
The Journal of Craniofacial Surgery
|November 25, 2025
Summary
Pediatric patients with facial nerve disorders (FND) are significantly more likely to receive advanced dynamic facial nerve reconstruction than adults. This trend shows a consistent preference for dynamic procedures in younger patients over time.
Area of Science:
- Neurosurgery
- Otolaryngology
- Plastic Surgery
Background:
- Facial nerve disorders (FND) often require advanced surgical interventions like dynamic facial nerve reconstruction, especially for long-standing paralysis.
- Limited national data exists comparing the utilization of these advanced procedures between pediatric and adult populations.
Purpose of the Study:
- To compare the utilization trends of static versus dynamic facial nerve reconstruction procedures in pediatric and adult patients with FND.
- To identify factors associated with the choice of dynamic reconstruction in pediatric patients.
Main Methods:
- Retrospective cohort study utilizing the Merative MarketScan Research Databases (2007-2023).
- Patients were stratified into pediatric (≤17 years) and adult (≥18 years) groups.
- Surgical approaches (static vs. dynamic reconstruction) were analyzed using chi-squared and multivariable logistic regression.
Main Results:
- Pediatric patients constituted 5.7% of the 4422 reconstructions, with 82.9% receiving dynamic procedures versus 33.6% for adults (P<0.001).
- Pediatric patients had over 9-fold increased odds of receiving dynamic reconstruction, with younger age and more recent surgery associated with higher utilization.
- Both age groups showed increasing trends in dynamic reconstruction use from 2007-2011 to 2017-2023.
Conclusions:
- Pediatric patients with FND demonstrate a significantly higher likelihood of undergoing dynamic facial reconstruction compared to adults.
- Dynamic reconstruction utilization remains consistently high in the pediatric population throughout the study period.
- These findings underscore significant age-related disparities in the surgical management of facial paralysis.
