Hypoglossal-facial nerve anastomosis: assessment of clinical results and patient benefit for facial nerve palsy following acoustic neuroma excision.
Despite advances in neuro-otological techniques permanent complete facial palsy may still occur in up to 10% of patients undergoing removal of cerebellopontine angle tumours. Hypoglossal-facial nerve anastomosis is the procedure of choice in our unit for facial reanimation in such patients and below we report the results of hypoglossal-facial nerve anastomosis performed on 29 patients. Assessment of patient benefit from hypoglossal-facial nerve anastomosis was obtained using a questionnaire based on the Glasgow Benefit Inventory. The results showed all patients to have an improvement in their House Brackmann grade following hypoglossal-facial anastomosis with 65% achieving grade III or better. Of the 20 patients who completed the questionnaire, 18 showed a positive benefit (median score 59.5, range 40-77). There was a significant correlation (P < 0.045) between the Glasgow benefit inventory score and House Brackmann grade. Outcome was not affected by the time interval between the acoustic neuroma surgery and performing the hypoglossal-facial nerve anastomosis, sex or length of follow-up. However the Glasgow benefit score was significantly influenced by age (P = 0.023) with younger patients showing more benefit independent of improvement in facial nerve function.
Sood
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S
Department of Otolaryngology, Leeds General Infirmary, United Leeds Teaching Hospitals, UK. SANJSOOD@aol.com
Anthony
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Homer
J J
JJ
Van Hille
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Fenwick
J D
JD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D005154:Facial Nerve / Q000601:surgery*; D005158:Facial Paralysis / Q000601:surgery*; D005260:Female; D006801:Humans; D007002:Hypoglossal Nerve / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D011788:Quality of Life; D018570:Risk Assessment; D011795:Surveys and Questionnaires