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The study aimed to assess the outcomes of facial nerve grafting using an artificial intelligence-based facial asymmetry measurement system. The data of 23 patients who underwent facial nerve grafting between 2011 and 2020 were retrospectively reviewed. The study found that oral movement recovered at 12-18 months postoperatively, and postoperative radiotherapy and a larger number of anastomosed distal stumps were significantly associated with poor and good final oral symmetry, respectively. The severity of synkinesis was weakly correlated with the degree of oral movement recovery, and caution should be exercised in facial nerve grafting for cases with postoperative radiotherapy.
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