A sural nerve “loop” graft for total facial nerve reconstruction: a clinical case

In this article we present our experience in the reconstruction of multiple branches of the facial nerve by a loop of sural nerve graft on a patient with gigantic recurrent parotid adenoma. In the original technique of Kikabuchi et al., one end of the grafted nerve is sutured with the stumps of the facial nerve branches in an end-to-side manner through epineural windows made on the nerve graft. In contrast with this approach, we sutured the graft branches with the stumps of the facial nerve branches in an end-to-end manner. Functional recovery of all branches and satisfactory facial expression (House–Brackmann Grade I–II) were obtained within 2 years postoperatively. This technique is a useful option for facial nerve reconstruction managing multiple branches.