Preparation of distal ipsilateral nerves
On the ipsilateral (paralyzed) side the distal branches of the facial nerve are exposed as they exit the parotid.
Intraoperative direct nerve stimulation may be possible up to 7 days from time of injury.
If not successful, the distal nerves are identified as they exit the parotid.
The distal nerves are dissected in retrograde fashion (from distal to proximal) through the parotid gland until the lacerated branches are identified.