make three grafts out of one sural nerve

1. Diagnosis?

3. Chronic
Unilateral
facial
palsy
Facial
reanima7on
One
stage
Two
stage
Three
stage

5. Two/three
stage
nerve
gra=
muscle
gra=
hypoglossal
(ipsi)
pectoralis
minor
accessory
(ipsi)
la7ssimus
dorsi
masseter
(ipsi)
gracilis
sural
(cross
face)
serratus
anterior

6. Problem
of
mass
movement
Possible
solu7on:
3
independent
neuronal
inputs
combined
with
3
neurovascular
pedicles
of
one
single
muscle
Can
1
sural
nerve
provide
3
gra=s?

7. Yes
it
can!
But
with
how
many
fascicles?

8. Some
contain
more...
25cm
12
11
7
30,5cm
9
6
31,5cm
10

9. ...some
less
fascicles

10. 3
22cm
4
4
23cm
3
5
23,5cm
6

11. Mean
number
of
fascicles
was
6,3
at
the
proximal
end
(min.
1,
max.
20)
and
6,7
distal
(min.
2,
max.
16)
in
the
generated
nerve
gra=s.
The
average
number
of
interfascicular
bridges
(some
of
them
being
very
7ny),
that
had
to
be
cut
in
one
nerve
in
order
to
generate
these
three
nerve
transplants,
was
15
(min.
6,
max.
26).
The
measurable
length
of
each
gra=
was
32
cm
in
average
(min.
19
cm,
max.
42
cm).

12. Thank
you!