Methods of surgical reinnervation of the facial nerve at different levels of traumatic injury: A prospective cohort study

Objective. To evaluate the effectiveness of various surgical strategies for reinnervating the facial nerve in patients who have sustained post-traumatic paralysis of the facial muscles. Material and methods. The cohort included six male patients with a mean age of 29±7 years. Depending on the level of nerve lesion—whether intra- or extratemporal—patients underwent either triple selective reinnervation or reinnervation via the hyoid nerve (XII), accompanied by intraoperative neurophysiological monitoring. Results. Evaluations using the House-Brackmann scale, needle electromyography, and eFACE scores indicated statistically significant improvements (p<0.05) by 12 months of follow-up for all patients. These findings underscore the effectiveness of a tailored approach and the importance of neuromonitoring. Conclusions. The findings from this prospective study demonstrate the clinical efficacy of a differentiated surgical approach to facial nerve reinnervation in patients with post-traumatic paralysis of the facial muscles.