A case of congenital facial palsy is presented in this report. A 4-year-old female with right facial palsy was introduced to our institution. When she was 1 year and half, surgery was performed to decompress and resect an acoustic tumor, but palsy remained. Intraoperatively, the facial nerve was compressed by the tumor, which was 1 cm in diameter. The pathological diagnosis was not inflammatory granulation. At 3 years old, she exhibited incomplete paralysis of her right mimetic muscle on ENoG. Network-like reconstruction by cross-linking of her right facial nerve trunk and hypoglossal nerve using a great auricular nerve graft was performed when she was 4 years old at our institute. Nine years later, there was no improvement in her clinical status or ENoG. When she was 15 years old, free latissimus dorsi muscle transfer was performed at our institute, and facial movement of the right cheek stimulated by the hypoglossal nerve-thoracodorsal nerve system was confirmed. Network-like reconstruction may be contraindicated even if ENoG suggests incomplete paralysis.
