Facial Nerve Grafting Efficacy With Medial Antebrachial Cutaneous Nerve Cable Grafts in the Setting of Radiation Therapy

INTRODUCTION: This study investigates the facial nerve cable graft reconstruction functional outcomes using the medial antebrachial cutaneous (MABC) nerve within previously irradiated surgical fields compared with facial nerve reconstruction receiving adjuvant radiotherapy. MATERIALS AND METHODS: A retrospective review of patients requiring a radical parotidectomy between 1998 and 2020 with immediate facial nerve reconstruction using the MABC nerve. Patients were divided in 2 groups, the previously irradiated salvage radical parotidectomy group (group 1) and the radical parotidectomy requiring adjuvant radiotherapy (group 2). The House-Brackmann (HB) system was used to assess facial functional results, with a minimum of 18 months of follow-up. A postoperative HB score of I-III was considered a successful outcome. RESULTS: Thirty-two patients were included, with 8 patients in group 1 and 24 patients in group 2. Overall, 25/32 (78.1%) of patients achieved a HB score III, with 7/8 (85%) in group 1 and 18/24 (75%) in group 2. There was no difference in functional outcomes (HB score). There were no donor site complications reported. CONCLUSIONS: The MABC nerve is a reliable nerve for facial nerve cable graft reconstruction, and a good functional result (HB III) was achieved in most patients with previously irradiated surgical fields and/or requiring radiotherapy.