Guidelines for Complications of Cancer Treatment Vol VIII Part B

2. Interposition or cable graft (to be used if a section of thenerve has been excised and primary suturing not possiblebecause of nerve loss): Greater auricular nerve - most commonly used. Sural nerve – up to 35cms available. Ansa hypoglossi. Medial antebrachial cutaneous nerve.3. If proximal stump is unavailable: Hypoglossal – facial nerve anastomosis: Technically easy Anastomosis lies far peripherally, thusleading to an early reinnervation. (3-4months) Can be done as end to end or an interpositiongraft. (jump anastomosis) Cross facial nerve grafts – It is helpful when theproximal nerve segment is unavailable for use butthere is always the potential risk of disruption ofinnervation to the donor site, hence notrecommended.4. Muscle transfer: If proximal nerve is not available and particularlyif the hypoglossal nerve is sacrificed. Masseter or temporalis muscle are most commonlyused.5. Delayed:-Success depends upon the time elapsed andthe functional status of the facial muscles. Up to 2yrs – Recovery expected 2-3yrs – Recovery possible 3-5yrs – recovery questionable 5yrs – Recovery not expected229