Surgical Repair of the Facial Nerve

Surgical procedure on the mastoid is beset by the possibility of unpleasant sequelae, one of which, facial paralysis, I shall discuss. It is the most distressing nonfatal surgical catastrophe, because it is evident to the patient's associates as well as to the sufferer himself. Various procedures aimed at anatomic and functional restoration have been suggested. They are: direct anastomosis (Bunnell1and Martin2), apposition of the ends without suturing (Graham3), interposition of a homogenous nerve graft (Ballance and Duel4) and simple decompression of depressed fractures of the canal (Smith5). My associates and I have employed the first three of the aforementioned methods successfully in three cases. Other patients are under observation, but insufficient time has elapsed to determine the result or to justify predictions. The use of a homogenous graft, which has been allowed to degenerate in situ before it is removed, to bridge