• Tass H Malik, Gerard Kelly, Aftab Ahmed, Shakeel R Saeed, and Richard T Ramsden.
• University Department of Otorhinolaryngology-Head and Neck Surgery, Manchester Royal Infirmary, Oxford Road, Manchester, England, UK.
• Otol. Neurotol. 2005 Mar 1; 26 (2): 284-91.

ObjectivesTo compare the outcomes of three surgical techniques used in the rehabilitation of the paralyzed face.Study DesignRetrospective study.SettingUniversity-based tertiary referral center.PatientsBetween 1976 and 2000, rehabilitative facial nerve surgery was performed on 70 adult patients with varying underlying diseases.InterventionThree methods of facial nerve rehabilitative surgery were performed: end-to-end anastomosis, cable nerve graft interposition, and classic faciohypoglossal transposition.Main Outcome MeasuresThe House-Brackmann grade was scored at 6, 12, 24, and 36 months by the two senior authors. A favorable outcome was defined as House-Brackmann Grade ResultsData were available on 66 patients (94%), of whom 13 had an end-to-end anastomosis, 25 a cable nerve graft interposition, and 28 a classic faciohypoglossal transposition. At 24 months, a House-Brackmann Grade ConclusionEnd-to-end anastomosis confers the best facial function, followed by cable nerve graft interposition and then classic faciohypoglossal transposition. Contrary to some previous opinions, improvement in facial function can still occur 2 years after surgical repair, particularly with classic faciohypoglossal transposition.

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