When the facial nerve has been sacrificed and intracranial reconstruction is performed in surgery of acoustic neurinoma, placement and tying of sutures present a difficult technical problem. In order to solve this technical difficulty, we have tried a reconstructive procedure which, by using fiblin glue, required no placement of suture in 3 cases. In one case we performed direct end-to-end anastomosis and in two cases we carried out nerve-grafting. In one case of nerve-grafting which has been followed for 21 months after surgery, facial function began to return 6 months postoperatively and a satisfactory recovery has been obtained. In one case, of end-to-end anastomosis, facial function began to return 8 months after surgery and is still improving 14 months postoperatively. In the remaining one case of nerve-grafting, of which the follow-up period is as short as 7 months, motor unit potentials are recognized electromyographically despite no recovery of the facial function clinically. These results seem to be as good as or better than those obtained after reconstruction by the conventional suture technique. Although more analysis is needed, we have had the impression that this technique using fibrin glue is advantageous over the suture in simplicity as well so that the former can be a substitute to the latter in reconstructing the facial nerve intracranially.
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