Facial nerve grafting in acoustic neurinoma

The introduction of the operating microscope has strongly influenced our surgical possibilities for preserving and reconstructing the facial nerve in tumor surgery in the cerebellopontine angle as well as in the internal auditory canal. In 1975, we introduced a new method for facial nerve reconstruction in the cerebellopontine angle. Since then, we have operated upon 20 patients using this technique of intracranial-intratemporal nerve graft; 15 of these have been done directly after the removal of the acoustic neurinoma. Of these patients, 12 have been followed over a period of 9 to 87 months. A sural nerve graft 4 to 5 cm in length was placed between the central stump of facial nerve at the brain stem and the distal end of facial nerve in tympanal or mastoidal course after total removal of the acoustic neurinoma. The results, demonstrated in this paper, are highly encouraging. It is recommended that this operative technique be included in the entire concept of microsurgery in the cerebellopontine angle.