title: Split hypoglossal-facial nerve neurorrhaphy for treatment of the paralyzed face.
abstract: BACKGROUND
  Several methods of neural rehabilitation for facial paralysis using 12-7 transfers have been described. The purpose of this study is to report on a series for dynamic reinnervation of the paralyzed face by using a split 12-7 nerve transposition. The goals of this procedure are to minimize tongue morbidity and to provide good facial reinnervation.
  
  
  METHODS
  Prospective case series. Melolabial crease discursion, overall facial movement, and degree of tongue atrophy and mobility were recorded.
  
  
  RESULTS
  Thirteen patients underwent facial reanimation using a split hypoglossal-facial nerve transfer with postoperative follow-up to 58 months (range, 6-58 months). All patients achieved excellent rest symmetry and facial tone. Of 13 patients, 10 had measurable coordinated movement and discursion of their melolabial crease. Of 13 patients, 12 had mild to moderate ipsilateral tongue atrophy. The mean time to onset of visible reinnervation was 3 months.
  
  
  CONCLUSIONS
  Split hypoglossal-facial nerve transposition provides good rehabilitation of facial nerve paralysis with reduced lingual morbidity. Long-term rest symmetry and potential learned movement can be achieved. This technique may provide a favorable alternative to the traditional method of complete hypoglossal sacrifice or jump grafting.
authors.affiliation: Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Indiana University Health, Indianapolis, USA.
authors.forename: Taha Z
authors.initials: TZ
authors.lastname: Shipchandler
authors.forename: Rahul
authors.initials: R
authors.lastname: Seth
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Alam
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004576:Electromyography / Q000379:methods; D004954:Esthetics; D005154:Facial Nerve / Q000601:surgery* / Q000637:transplantation; D005158:Facial Paralysis / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007002:Hypoglossal Nerve / Q000601:surgery* / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome