Nerve grafting repairs a damaged facial or other cranial nerve by bridging a gap with a donor nerve segment. The goal is to re‑establish nerve continuity so regenerating fibres can reach target muscles.
Technique
A sensory nerve such as the sural nerve in the leg is commonly harvested and sutured microscopically between healthy proximal and distal nerve ends. Over months, axons grow through the graft towards facial muscles.
- Best results occur when performed within months of injury
- Graft length and tension influence recovery potential
- May be combined with direct repair or nerve transfers
- Donor site numbness is a typical trade‑off
Outcomes
Recovery is slow and variable; some patients regain useful movement, while others require additional reanimation strategies. Intensive physiotherapy aids re‑education of muscles.
- Complications include neuroma formation, graft failure, or incomplete reinnervation
- Patients must understand the long time frame for signs of recovery
- EMG and clinical follow‑up assess progress
- Adjunct eyelid and eye‑protection procedures often remain necessary during regeneration
