Facio-hypoglossal anastomosis for the treatment of facial palsy after acoustic neuroma resection.
Despite current micro-neurosurgical techniques the facial nerve may be irrecoverably damaged in up to 40% of operations for large acoustic neuromas. The results of 121 facio-hypoglossal anastomoses performed since 1960 for post-operative facial palsy are reported. Patients began to recover facial function after an average of 2.5 months and at final follow-up 91% had good function (grade 2 or 3 according to Lye3). The functional result was dependent on the age of the patient, those over 50 years having a poorer, but still acceptable result. The result was not critically dependent on the delay in performing the procedure; in 10 patients with non-functioning but nevertheless intact nerves, the procedure was delayed for 12-15 months to allow for spontaneous recovery, with little detriment to outcome. There was no operative mortality and only minimal morbidity from hypoglossal loss.
Sabin
H I
HI
Gough-Cooper Department of Neurological Surgery, National Hospital, London, United Kingdom.
Bordi
L T
LT
Symon
L
L
Compton
J S
JS
D000328:Adult; D000367:Age Factors; D000714:Anastomosis, Surgical / Q000379:methods; D005069:Evaluation Studies as Topic; D005154:Facial Nerve / Q000601:surgery*; D005158:Facial Paralysis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007002:Hypoglossal Nerve / Q000601:surgery*; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D012189:Retrospective Studies