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In three cases, small amounts of bone from the piriform aperture were mixed with the BMP-2/DBM. After 3-7 months, all patients had generated bone in the clefts and did not require bone grafting. While we continue to prefer a "like with like" reconstruction, bone grafting has a high likelihood of failure in patients with suboptimal soft tissues or tight closures. We suggest that combining BMP-2 and DBM in higher risk patients is an excellent option to avoid bone graft loss and reoperation.In general, facial nerve palsy is treated by rec
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