AIM OF THE STUDY: To evaluate the results of facial nerve (FN) grafting using 
great auricular cable graft and fibrin glue without suturing to palliate FN 
disruption after removal of large cerebellopontine angle (CPA) vestibular 
schwannoma (VS) or facial nerve schwannoma (FNS). To assess whether tumor size 
and origin influenced the results.
STUDY DESIGN AND SETTING: Retrospective review of all patients having undergone 
removal of FNS/VS and needing intraoperative FN repair between 2001 and 2011.
INTERVENTION: FN was rehabilitated using great auricular nerve cable graft and 
fibrin glue (Tisseal) without stitching suture.
MAIN OUTCOME MEASURES: All data recorded were reviewed to access age, sex, tumor 
type, and tumor size according to the Koos classification and presenting 
symptoms. FN function was evaluated preoperatively and at 18 months using the 
House-Brackmann (HB) grading system.
RESULTS: Among the 595 patients operated for CPA schwannomas in this period, 15 
patients (2.5%) underwent FN repair, including 7 cases of FNS and 8 cases of VS. 
Tumor removal was total in all cases. FN recovery was HB3 in 13 cases (86.7%) 
and HB4 in 2. The mean time to the first clinical signs of facial reinnervation 
was 10 months (6-12 mo). No significant relation was found between postoperative 
facial function and tumor size or type, even if all cases of preoperative FP 
were noted in FNS.
CONCLUSION: Immediate FN reconstruction with fibrin glue-aided greater auricular 
nerve graft can effectively restore FN function with excellent outcomes. The 
results seem better than those observed by other authors using sutured grafts or 
delayed hypoglossal-facial nerve anastomosis.