Reanimation of the paralyzed face by indirect hypoglossal-facial nerve anastomosis.
BACKGROUND
The results of indirect hypoglossal facial nerve anastomosis with interposition of a free nerve graft, end-to-end to the periferal facial nerve stump, and end-to-side to the hypoglossal nerve are prospectively evaluated. This technique is supposed to overcome loss of hypoglossal function.


METHODS
Tongue function in 39 consecutive patients and facial reanimation in 29 patients who completed 24 months follow-up were assessed. Facial nerve function was judged using the House-Brackmann (HB) grading system.


RESULTS
Tongue movements were normal in all operated on patients. Initial facial movements occurred on average 7.5 months postoperatively. The results were graded HB II in 6 (20.9%), HB III in 13 (44.6%), HB IV in 7 (24.1%), HB V in 2 (6.8%) patients, and HB VI in 1 (3.4%) patient. The results were significantly better in young patients and when a short time interval between paralysis and surgery existed.


CONCLUSIONS
Indirect hypoglossal-facial anastomosis is the preferred technique in most patients for whom the classical direct hypoglossofacial anastomosis is indicated.
Manni
J J
JJ
Department of Otorhinolaryngology, Head and Neck Surgery, University of Maastricht, P.O. Box 5800, 6202 AZ, The, Maastricht, Netherlands. J.J.MANNI@KNO.AZM.NL
Beurskens
C H
CH
van de Velde
C
C
Stokroos
R J
RJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D005154:Facial Nerve / Q000601:surgery*; D005158:Facial Paralysis / Q000601:surgery*; D006801:Humans; D007002:Hypoglossal Nerve / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D014059:Tongue / Q000502:physiology; D016896:Treatment Outcome