Observation Of Clinical Curative Effect Of Facial Nerve Injury Repair In Acute Stage

Objective:To analyze the facial nerve recovery of patients with traumatic facial nerve rupture who underwent tension-free end-to-end epineurial anastomosis in our hospital during the acute period（0-72 hours）retrospectively,in order to provide reference for the treatment of traumatic facial nerve injury.Methods:A total of 11 patients who attended our department and underwent surgery for facial nerve rupture due to trauma from November 2016 to January 2022 were retrospectively analyzed.All patients suffered from facial nerve branch rupture due to trauma,and received facial nerve anastomosis in our department within 72 hours after injury.Regular follow-up after operation was performed to observe the recovery of facial nerve function of the patients.The follow-up time was 7 months（minimum）to 57 months（maximum）.The recovery of facial nerve function of patients in different periods after operation was observed and evaluated by telephone follow-up and the imaging data retained when the patients came to the hospital for re-examination.Photographs of intraoperative facial nerve rupture and anastomosis were taken Photos and dynamic imaging data of expressive muscle functions such as resting,eyebrow raising,eyes closed,cheek bulging,teeth baring,whistling,etc.were taken during the re-examination.The international House-Brackman facial nerve evaluation system and the regional House-Brackman facial nerve evaluation system were used to evaluate the recovery of the patient’s facial nerve function.The higher the facial nerve grade,the worse the facial nerve function.Results:The HB grade of 11 patients recovered from preoperative HB grade Ⅵ in 1case（9.1%）,HB grade Ⅴ in 3 cases（27.3%）,HB grade Ⅳ in 4 cases（36.3%）,HB grade Ⅲ in 3 cases（27.3%）,to HB grade Ⅲ in 1 case.cases（9.1%）,7cases（63.6%）of HB grade Ⅱ,and 3 cases（27.3%）of HB grade I.There were90.9% of patients recovered to grade Ⅱ and below,and their daily life was almost no longer affected.There are some differences in the recovery of facial nerve in different divisions.The proportion of postoperative recovery to HB grade Ⅰ and grade Ⅱ（hardly affecting daily life）is zygomatic branch 100%（grade I 80%）,buccal branch 100%（grade Ⅰ 44.4%）,mandibular border 88.9%,temporal branch66.7%.Conclusion:1.After the facial nerve is ruptured due to external trauma,timely surgical anastomosis can effectively promote the recovery of the facial nerve,improve the patient’s facial nerve function,reduce the incidence of facial paralysis,improve the patient’s quality of life,and have a high patient satisfaction rate.2.We believe that after the first-stage repair of the facial nerve,it will start to recover slowly in 1-3 months,and the facial nerve function of most patients will be greatly recovered after 8 months.Subsequently,the recovery of the injured facial nerve of the patient will gradually slow down and become stable.3.The functional recovery of different branches of the facial nerve is different after the repair.The buccal and zygomatic branches have the best recovery effect,followed by the marginal mandibular branch,and the worst is the temporal branch.4.Young patients are significantly better than old patients in terms of recovery degree and recovery time.