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Facial reanimation with end-to-end hypoglossofacial anastomosis: 20 years’ experience

Published online by Cambridge University Press:  29 September 2009

T Catli*
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
Y A Bayazit
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
O Gokdogan
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
N Goksu
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
*
Address for correspondence: Dr Tolgahan Catli, Gazi Universitesi Tıp Fakültesi, Kulak Burun Boğaz AD, Besevler, Ankara, Turkey. E-mail: [email protected]

Abstract

Objective:

This study aimed to evaluate retrospectively the results of experience with end-to-end anastomosis of cranial nerves VII and XII, performed due to transection of the facial nerve during acoustic neuroma removal.

Methods:

We assessed the facial reanimation results of 33 patients whose facial nerves had been transected during acoustic neuroma excision via a retrosigmoid approach, between 1985 and 2006, and who underwent end-to-end hypoglossofacial anastomosis. We compared the facial nerve functions of patients receiving short term (two to three years) and long term (more than three years) follow up, and we assessed any complications of the anastomosis.

Results:

A House–Brackmann grade III facial function was achieved in 46.2 and 86.4 per cent of the patients in the short and long term, respectively. House–Brackmann grade IV facial function was achieved in 53.8 and 13.6 per cent of the patients in the short and long term, respectively. There was a statistically significant difference between the facial recovery results, comparing the short and long term follow-up periods (p = 0.03). Disarticulation was the most common complication, seen in 19 (57.6 per cent) patients; numbness of the tongue was the next commonest (10 (30.3 per cent) patients). None of the patients developed dysphagia.

Conclusion:

Despite such morbidities as disarticulation and tongue numbness, end-to-end hypoglossofacial anastomosis is still an effective procedure for the surgical rehabilitation of static and dynamic facial nerve functions. Significant improvement in facial nerve function can occur more than three years post-operatively.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2009

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References

1 Harner, SG, Daube, JR, Beatty, CW, Ebersold, MJ. Intraoperative monitoring of the facial nerve. Laryngoscope 1988;98:209–12CrossRefGoogle ScholarPubMed
2 Prass, RL, Kinney, SE, Hardy, RW Jr, Hahn, JF, Lüders, H. Acoustic (loudspeaker) facial EMG monitoring: II. Use of evoked EMG activity during acoustic neuroma resection. Otolaryngol Head Neck Surg 1987;97:541–51CrossRefGoogle ScholarPubMed
3 House, JW, Brackmann, DE. Facial nerve grading system. Otolaryngol Head Neck Surg 1985;93:146–7CrossRefGoogle ScholarPubMed
4 Linnet, J, Madsen, FF. Hypoglosso-facial nerve anastomosis. Acta Neurochir (Wien) 1995;133:112–15CrossRefGoogle ScholarPubMed
5 Pellat, JL, Bonnefille, E, Zanaret, M, Cannoni, M. Hypoglossal-facial anastomosis. A report of 60 cases. Ann Chir Plast Esthet 1997;42:3743Google ScholarPubMed
6 Pitty, LF, Tator, CH. Hypoglossal-facial nerve anastomosis for facial nerve palsy following surgery for cerebellopontine angle tumors. J Neurosurg 1992;77:724–31CrossRefGoogle ScholarPubMed
7 Rosenwasser, RH, Liebman, E, Jiménez, DF, Buchheit, WA, Andrews, DW. Facial reanimation after facial nerve injury. Neurosurgery 1991;29:568–74CrossRefGoogle ScholarPubMed
8 Samii, M, Matthies, C. Indication, technique and results of facial nerve reconstruction. Acta Neurochir (Wien) 1994;130:125–39CrossRefGoogle ScholarPubMed
9 Shah, SB, Jackler, RK. Facial nerve surgery in the 19th and early 20th centuries: the evolution from crossover anastomosis to direct nerve repair. Am J Otol 1998;19:236–45Google ScholarPubMed
10 Spector, JG. Neural repair in facial paralysis: clinical and experimental studies. Eur Arch Otorhinolaryngol 1997;254(suppl 1):6875CrossRefGoogle ScholarPubMed
11 Papel, ID. Rehabilitation of the paralyzed face. Otolaryngol Clin North Am 1991;24:727–38CrossRefGoogle ScholarPubMed
12 Darrouzet, V, Dutkiewicz, J, Chambrin, A, Stoll, D, Bébéar, JP. Hypoglosso-facial anastomosis: results and technical development towards end-to-side anastomosis with rerouting of the intra-temporal facial nerve (modified May technique) (in French). Rev Laryngol Otol Rhinol (Bord) 1997;118:203–10Google ScholarPubMed
13 Malik, TH, Kelly, G, Ahmed, A, Saeed, SR, Ramsden, RT. A comparison of surgical techniques used in dynamic reanimation of the paralyzed face. Otol Neurotol 2005;26:284–91CrossRefGoogle ScholarPubMed
14 Kunihiro, T, Higashino, K, Kanzaki, J. Classic hypoglossal-facial nerve anastomosis after acoustic neuroma resection. J Otorhinolaryngol Relat Spec 2003;65:16CrossRefGoogle ScholarPubMed
15 Rochkind, S, Shafi, M, Alon, M, Salame, K, Fliss, DM. Facial nerve reconstruction using a split hypoglossal nerve with preservation of tongue function. J Reconstr Microsurg 2008;24:469–74CrossRefGoogle ScholarPubMed
16 Yetiser, S, Karapinar, U. Hypoglossal-facial nerve anastomosis: a meta-analytic study. Ann Otol Rhinol Laryngol 2007;116:542–9CrossRefGoogle ScholarPubMed