# Selective Neurectomy of the Facial Nerve with Cross-Face Nerve Graft for Treating Postparalytic Facial Nerve Syndrome

## TL;DR

A new surgical technique using selective nerve removal and grafting improves symptoms in a patient with facial nerve syndrome.

## Contribution

A novel surgical approach combining selective neurectomy and cross-face nerve grafting is proposed for postparalytic facial nerve syndrome.

## Key findings

- Selective neurectomy reduced synkinesis and facial contracture in a patient with moderate PFS.
- Cross-face nerve grafting successfully reinnervated facial muscles, improving function.
- No recurrence of PFS symptoms was observed one year after the procedure.

## Abstract

Although postparalytic facial nerve syndrome (PFS) is a frequent sequela of partial facial palsy, no effective treatment is currently available. Herein, we report a case of a cross-face nerve graft (CFNG) technique with selective neurectomy of the facial nerve in a 52-year-old female with moderate PFS (especially oral-ocular synkinesis and facial contracture) and a House–Brackmann score grade III. Selective neurectomy resulted in the release of the synkinesis and contractures. Furthermore, we reinnervated the levator muscles of the upper lip and oral commissure by connecting the contralateral facial nerve to the thick zygomatic branch of the facial nerve via a CFNG, which allowed neural signal augmentation of the levator muscles. No obvious PFS recurrence was observed 1 year postoperatively. This procedure is expected to provide a new treatment option for improving PFS because it is effective and less invasive.