title: Hemi-hypoglossal nerve transfer for obstetric brachial plexus palsy: report of 3 cases.
abstract: Use of the entire hypoglossal nerve for nerve transfer in obstetric palsy is not recommended because of major donor nerve morbidity in terms of feeding and speech problems. We used a hemi-hypoglossal nerve transfer for biceps reinnervation in obstetric palsy in 3 infants with multiple root avulsions. Two of the 3 infants recovered normal or near-normal elbow flexion. There was no donor nerve morbidity in terms of feeding. Speech was assessed at age 20 to 27 months and was appropriate for age, which indicates that early speech development (speech intelligibility and articulation) were not affected. However, phonological development (expected to develop by age 3 y) and full consonant development (expected to be complete by age 5 y) could not be assessed because all children were younger than age 3 years at final follow-up. Our results confirm the relative safety of using a hemi-hypoglossal nerve transfer in infants. The transfer deserves study in a larger series and with longer follow-up, particularly regarding speech development.
authors.affiliation: Division of Plastic Surgery, National Guard Hospital, Riyadh, Saudi Arabia; Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al-Thunyan
authors.affiliation: Division of Plastic Surgery, National Guard Hospital, Riyadh, Saudi Arabia; Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia. Electronic address: moqattan@hotmail.com.
authors.forename: Mohammad M
authors.initials: MM
authors.lastname: Al-Qattan
authors.affiliation: Division of Plastic Surgery, National Guard Hospital, Riyadh, Saudi Arabia; Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Obaid
authors.initials: O
authors.lastname: Al-Meshal
authors.affiliation: Division of Plastic Surgery, National Guard Hospital, Riyadh, Saudi Arabia; Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Hanan
authors.initials: H
authors.lastname: Al-Husainan
authors.affiliation: Division of Plastic Surgery, National Guard Hospital, Riyadh, Saudi Arabia; Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Assaf
authors.initials: A
authors.lastname: Al-Assaf
mesh_terms: D020516:Brachial Plexus Neuropathies / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007002:Hypoglossal Nerve / Q000601:surgery / Q000637:transplantation*; D007223:Infant; D008297:Male; D009416:Nerve Regeneration / Q000502:physiology*; D016067:Nerve Transfer / Q000379:methods*; D010246:Paralysis, Obstetric / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D020127:Recovery of Function; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D060053:Transplant Donor Site / Q000503:physiopathology; D016896:Treatment Outcome
keywords: Obstetric palsy; brachial plexus; hypoglossal nerve