The use of various thigh tissue grafts, including the lateral femoral cutaneous nerve, vastus lateralis branch of the femoral nerve, perifascial areolar tissue, and anterolateral thigh flap and fascia, for the immediate reconstruction of facial nerve defects

Surgical resection for parotid cancer often results in the loss of the facial nerve as well as creating both skin and soft tissue defects. An anterolateral thigh (ALT) flap with the vastus lateralis branch of the femoral nerve (VLFN) and the lateral femoral cutaneous nerve (LFCN) can be used for the immediate reconstruction of a defect associated with parotid cancer resection. From October 2003 to December 2008, 10 parotid cancer patients underwent VLFN and/or LFCN grafting for immediate reconstruction after cancer ablation. Five cases received non-vascularized nerve grafts and 5 cases received vascularized and non-vascularized nerve grafts. In 9 cases, an ALT flap was combined with a nerve graft to treat skin defects, and perifascial areolar tissue (PAT) was used in one case to treat a soft tissue defect. The results were satisfactory, and facial animation returned in all but 2 patients. Various tissues, such as nerves, muscle flaps, PAT, and fascia can therefore be used for facial nerve reconstruction after parotid cancer ablation.