Name of the Procedure:

Nerve Graft (includes obtaining graft), Head or Neck; More than 4 cm Length

Summary

A nerve graft procedure involves taking a healthy nerve from one part of the body and transplanting it to the head or neck to replace a damaged nerve longer than 4 centimeters. This helps restore function and sensation in the affected area.

Purpose

The main goal of a nerve graft is to repair damaged nerves to improve function, reduce pain, and restore sensation. It is often used when the nerve damage is too extensive to heal on its own or with simpler treatments.

Indications

• Severe nerve damage in the head or neck due to trauma, surgery, or disease.
• Persistent numbness, tingling, or weakness not improving with other treatments.
• Loss of motor or sensory function in the affected area.
• Candidates should be in good general health and have realistic expectations about the outcomes.

Preparation

• Fasting for several hours prior to surgery.
• Stopping certain medications, as instructed by the healthcare provider.
• Undergoing preoperative assessments including blood tests, imaging studies (like MRI or CT scans), and possibly a nerve conduction study.

Procedure Description

1. Anesthesia: The patient is given general anesthesia to ensure comfort and eliminate pain during surgery.
2. Harvesting Graft: A healthy nerve is typically taken from a less critical area, such as the leg.
3. Preparing the Graft Site: The damaged nerve in the head or neck is exposed and prepared.
4. Graft Insertion: The harvested nerve is carefully transplanted to bridge the gap in the damaged nerve.
5. Suturing: Fine sutures and microsurgical techniques are used to attach the nerves precisely.
6. Closure: Both the donor and recipient sites are meticulously closed and bandaged.

Tools include microscopes for precision, microsurgical instruments, and sutures.

Duration

The procedure generally takes 2-4 hours, depending on the complexity and length of the graft.

Setting

Performed in a hospital or an advanced surgical center under sterile conditions.

Personnel

• Surgeons (often a neurosurgeon or plastic surgeon specialized in microsurgery)
• Anesthesiologists
• Surgical nurses and technicians

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma
• Scar formation
• Poor or delayed healing of the graft
• Loss of function or sensation in the donor area
• Potential for incomplete recovery or need for further surgery

Benefits

• Restoration of motor and sensory function in the affected area.
• Reduction or elimination of pain and discomfort.
• Improvement in quality of life and daily functioning.
• Benefits are often noticed gradually over several months as the nerve heals.

Recovery

• Hospital stay of 1-2 days may be required.
• Pain management via medications.
• Instructions to keep the surgical sites clean and dry.
• Avoiding strenuous activities for several weeks.
• Regular follow-up appointments to monitor healing and nerve function.

Alternatives

• Physical therapy and rehabilitation.
• Medications for pain and inflammation.
• Nerve decompression surgeries.
• Electrical nerve stimulation.
• Pros: Less invasive, shorter recovery periods.
• Cons: May not be as effective for severe nerve damage.

Patient Experience

• Patient will be under general anesthesia during the procedure, ensuring a pain-free experience.
• Postoperatively, there could be soreness and swelling at both the donor and recipient sites, managed with pain relief medications.
• Detailed care instructions and supportive resources will be provided.
• Some temporary discomfort, but improvement in nerve function is expected over the following months.