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Questions and Answers
What is one of the main reasons the sural nerve is commonly chosen for the cross-facial nerve graft procedure?
What is one of the main reasons the sural nerve is commonly chosen for the cross-facial nerve graft procedure?
- It produces stronger motor function.
- It prevents axonal escape effectively.
- It innervates the facial muscles directly.
- It has sufficient length for interposition grafting. (correct)
Which of the following statements about the cross-facial nerve graft procedure is incorrect?
Which of the following statements about the cross-facial nerve graft procedure is incorrect?
- It allows for improved resting tone.
- Total denervation time can exceed 6 months. (correct)
- It is often combined with gracilis free muscle transfer.
- It can produce a spontaneous emotional smile.
What is a significant risk associated with the selection of the donor facial nerve branch in the CFNG procedure?
What is a significant risk associated with the selection of the donor facial nerve branch in the CFNG procedure?
- Functional deficits after nerve cutting. (correct)
- Spontaneous emotional smile is not achieved.
- Increased axonal escape at the coaptation site.
- Facial nerve weakness on the involved side.
Why might the cross-facial nerve graft procedure result in limited commissure excursion, particularly in elderly patients?
Why might the cross-facial nerve graft procedure result in limited commissure excursion, particularly in elderly patients?
What is the average axonal regeneration rate mentioned for the cross-facial nerve graft?
What is the average axonal regeneration rate mentioned for the cross-facial nerve graft?
Flashcards
Cross-Facial Nerve Graft (CFNG)
Cross-Facial Nerve Graft (CFNG)
A surgical procedure where a nerve graft is used to connect a branch of the facial nerve on one side of the face to corresponding branches on the other side.
Contralateral Facial Nerve
Contralateral Facial Nerve
The nerve that provides the axonal input for reanimation in the CFNG procedure.
Sural Nerve
Sural Nerve
A common type of nerve graft used in CFNG due to its length.
6 Months
6 Months
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Synkinesis
Synkinesis
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Study Notes
Cross-Facial Nerve Graft (CFNG) Procedure
- Input Source: The contralateral facial nerve provides axonal input for reanimation. Neural impulses are routed through a nerve graft.
- Graft Material: Commonly, the sural nerve is used as an interpositional graft due to its length.
- Donor Nerve Source: CFNG is a standard donor source because it potentially produces spontaneous emotional smiles and improved resting tone.
- Time Limitation: The total denervation time must be less than 6 months for successful stand-alone CFNG. This is significantly limited by the rate of axonal regeneration, which is 1-2mm/day.
- Regeneration Time: It takes 6 - 9 months for axons to regrow across a typical 15- to 20-cm graft.
- Combined Procedure: Commonly used with gracilis free muscle transfer.
- Disadvantages:
- Relatively weak motor function
- Limited commissure excursion, especially in the elderly. This is thought to be due to two coaptation sights.
- Risk of facial nerve weakness and synkinesis on the unaffected side (if the donor branch isn't carefully selected).
- Donor Selection: The best donor branch is the largest possible branch that does not cause a deficit when cut. Using a nerve stimulator during surgery can aid in identifying redundant branches
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Description
This quiz provides an overview of the Cross-Facial Nerve Graft (CFNG) procedure, detailing key aspects such as graft material, donor nerve source, and regeneration time. Learn about the advantages and limitations of CFNG in facial reanimation and its common use with gracilis muscle transfer.
