title: Hypoglossal-facial-jump-anastomosis without an interposition nerve graft.
abstract: OBJECTIVE
  The hypoglossal-facial-anastomosis is the most often applied procedure for the reanimation of a long lasting peripheral facial nerve paralysis. The use of an interposition graft and its end-to-side anastomosis to the hypoglossal nerve allows the preservation of the tongue function and also requires two anastomosis sites and a free second donor nerve. We describe the modified technique of the hypoglossal-facial-jump-anastomosis without an interposition and present the first results.
  
  
  METHODS
  Retrospective case study.
  
  
  METHODS
  We performed the facial nerve reconstruction in five patients. The indication for the surgery was a long-standing facial paralysis with preserved portion distal to geniculate ganglion, absent voluntary activity in the needle facial electromyography, and an intact bilateral hypoglossal nerve. Following mastoidectomy, the facial nerve was mobilized in the fallopian canal down to its bifurcation in the parotid gland and cut in its tympanic portion distal to the lesion. Then, a tensionless end-to-side suture to the hypoglossal nerve was performed. The facial function was monitored up to 16 months postoperatively.
  
  
  RESULTS
  The reconstruction technique succeeded in all patients: The facial function improved within the average time period of 10 months to the House-Brackmann score 3.
  
  
  CONCLUSIONS
  This modified technique of the hypoglossal-facial reanimation is a valid method with good clinical results, especially in cases of a preserved intramastoidal facial nerve.
  
  
  METHODS
  Level 4.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Beutner
authors.forename: Jan C
authors.initials: JC
authors.lastname: Luers
authors.forename: Maria
authors.initials: M
authors.lastname: Grosheva
mesh_terms: D000714:Anastomosis, Surgical; D005154:Facial Nerve / Q000637:transplantation*; D005158:Facial Paralysis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007002:Hypoglossal Nerve / Q000601:surgery*; D008297:Male; D016067:Nerve Transfer / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D013536:Suture Techniques
keywords: Facial palsy; facial nerve; hypoglossal nerve; interposition graft