Facial Nerve Reconstruction Using Acellular Nerve Allograft

When repaired with interposition nerve grafts, segmental facial nerve defects are traditionally treated with nerve autograft. The authors present a patient who presented after partial resection of a basal cell carcinoma over the left zygomatic region with positive deep and peripheral margins and complete loss of frontal and zygomatic facial nerve function. She was subsequently treated with wide resection, superficial parotidectomy, and cervicofacial flap. The parotidectomy was performed for deep margin control and the facial nerve was dissected distally demonstrating the prior resection of a segment of frontal and zygomatic branches consistent with clinical exam. For acute segmental facial nerve defects, nerve autograft has been the gold standard. in our patient, segmental repair using processed nerve allograft demonstrated rapid and complete recovery. This is a viable option for facial nerve reconstruction with various benefits of avoiding donor site morbidity, ease of allograft nerve handling and decreased operative time.