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January 1991

Rapid Neurorrhaphy Technique: A Useful Adjunct to Cranial Base Surgery Exposure

Arch Otolaryngol Head Neck Surg. 1991;117(1):19. doi:10.1001/archotol.1991.01870130025005

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At the September 1990 meeting of the American Academy of Otolaryngology—Head and Neck Surgery, San Diego, Calif, Daniel W. Nuss, MD, and Ivo P. Janecka, MD, Pittsburgh, Pa, reported their initial results using a simple and rapid technique for facial neurorrhaphy. In resecting cranial base neoplasms, the facial translocation procedure provides wide exposure to such areas as the infratemporal fossa, nasopharynx, clivus, cavernous sinus, and sphenoid. Unfortunately, frontal branches of the facial nerve must be sacrificed.

The authors described a technique that begins by splitting small Silastic tubes longitudinally and securing them around each frontal branch. The branches are then divided by cutting the tubes in half. At the end of the case, neurorrhaphy is accomplished by telescoping the tubes back together and securing them with a stitch through the overlapping walls of the tubes. Suturing of the nerves is not done. The tubes provide conduits for the regrowth of

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