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W. Fredrick McGuirt, MD, Winston-Salem, NC, and coworkers, at the Annual Meeting of the American Triological Society in Palm Beach, Fla, recently reported the efficacy of facial nerve cable grafting before anticipated postoperative radiation therapy. The authors described 12 patients who underwent cable graft of the facial nerve following resection for malignant tumors of the parotid gland. All 12 patients underwent postoperative radiation therapy of 50 Gy to the graft bed. Surviving patients were followed up with photographic and videotape recordings of facial nerve function and were graded on a system comparable with the Brundy modification of the House system.
Three patients died before any return of facial nerve function could be seen, but the nine patients who did survive experienced return of function within two to nine months. Although no patient had totally normal facial nerve function, all nine demonstrated some return of function and seven experienced moderate-to-excellent return