Great Auricular Nerve Arborization for Multi-Branch Facial Nerve Reconstruction After Parotidectomy: A Surgical Innovation.

Reconstruction of multibranch facial nerve defects following parotidectomy presents a significant challenge. To our knowledge, this article first introduces the concept of great auricular nerve (GAN) arborization, a term that refers to the natural branching pattern of the GAN. The GAN often exhibits an intrinsic branching structure resembling a tree, with a main trunk and several terminal branches. The main trunk can be coapted to a suitable proximal facial nerve stump, while each natural branch can be connected to a corresponding distal facial nerve branch. We describe the surgical procedure and present a single illustrative case as preliminary evidence of technical feasibility. GAN arborization provides an additional option for immediate reconstruction of multi-branch facial nerve defects when suitable proximal and distal nerve stumps are available. Further comparative studies with standardized assessment and long-term follow-up are required.