[Side-to-end hypoglossal-facial nerve anastomosis with intratemporal facial nerve translocation. Long-term results and indications in 15 cases over 10 years].
OBJECTIVE
To describe functional results concerning facial and lingual mobility after side-to end hypoglossal facial nerve anastomosis.


METHODS
15 patients were operated on between 1993 and 2002 (11 cases of facial nerve injury during vestibular schwannoma surgery, and 4 cases of brainstem stroke). Were assessed at a minimum of 18 months postop tonus and facial voluntary movements recovery (modified House Brackmann (HB) grading), lingual mobility (amyotrophy and self-evaluation questionnaire), and patients' overall satisfaction (questionnaire).


RESULTS
The mean delay to evaluation was 57.5 months. The tonus recovery appeared within 6 to 8 months (mean 28.5 weeks, SD 4.6 weeks). All patients recovered a normal tonus. The facial function was evaluated HB grade III in II cases (73.3%), grade IV in 3 cases (20%) and grade V in one (6.6%). Eye occlusion was obtained within 13.6 months on average (SD 2.6 months) in all cases except one. The blepharorraphy was maintained in 2 patients. No facial spasm was noted. The lingual motricity troubles were absent in 93.3% of cases. Patients were satisfied in 93.3% of cases. The less satisfactory results were observed when patients were managed late (>2 years after nerve section) and in case of brainstem stroke.


CONCLUSIONS
This technique seems to be very efficient. It presents the advantage to preserve lingual motricity and to decrease postoperative problems of midface spasticity.
Franco-Vidal
V
V
CHU de Bordeaux, Hôpital Pellegrin, Clinique ORL, Place A. Raba Léon, 33076 Bordeaux, France.
Blanchet
H
H
Liguoro
D
D
Darrouzet
V
V
D000328:Adult; D000714:Anastomosis, Surgical; D005154:Facial Nerve / Q000601:surgery*; D005158:Facial Paralysis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007002:Hypoglossal Nerve / Q000601:surgery*; D008297:Male; D009464:Neuroma, Acoustic / Q000601:surgery*; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications; D016896:Treatment Outcome