title: Outcome of different facial nerve reconstruction techniques.
abstract: BACKGROUND
  There is no technique of facial nerve reconstruction that guarantees facial function recovery up to grade III.
  
  
  OBJECTIVE
  To evaluate the efficacy and safety of different facial nerve reconstruction techniques.
  
  
  METHODS
  Facial nerve reconstruction was performed in 22 patients (facial nerve interpositional graft in 11 patients and hypoglossal-facial nerve transfer in another 11 patients). All patients had facial function House-Brackmann (HB) grade VI, either caused by trauma or after resection of a tumor. All patients were submitted to a primary nerve reconstruction except 7 patients, where late reconstruction was performed two weeks to four months after the initial surgery. The follow-up period was at least two years.
  
  
  RESULTS
  For facial nerve interpositional graft technique, we achieved facial function HB grade III in eight patients and grade IV in three patients. Synkinesis was found in eight patients, and facial contracture with synkinesis was found in two patients. In regards to hypoglossal-facial nerve transfer using different modifications, we achieved facial function HB grade III in nine patients and grade IV in two patients. Facial contracture, synkinesis and tongue atrophy were found in three patients, and synkinesis was found in five patients. However, those who had primary direct facial-hypoglossal end-to-side anastomosis showed the best result without any neurological deficit.
  
  
  CONCLUSIONS
  Among various reanimation techniques, when indicated, direct end-to-side facial-hypoglossal anastomosis through epineural suturing is the most effective technique with excellent outcomes for facial reanimation and preservation of tongue movement, particularly when performed as a primary technique.
authors.affiliation: Akita Graduate School of Medicine, Head and Neck Surgery, Department of Otorhinolaryngology, Akita, Japan.
authors.forename: Aboshanif
authors.initials: A
authors.lastname: Mohamed
authors.affiliation: Akita Graduate School of Medicine, Head and Neck Surgery, Department of Otorhinolaryngology, Akita, Japan.
authors.forename: Eigo
authors.initials: E
authors.lastname: Omi
authors.affiliation: Akita Graduate School of Medicine, Head and Neck Surgery, Department of Otorhinolaryngology, Akita, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Honda
authors.affiliation: Akita Graduate School of Medicine, Head and Neck Surgery, Department of Otorhinolaryngology, Akita, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Akita Graduate School of Medicine, Head and Neck Surgery, Department of Otorhinolaryngology, Akita, Japan. Electronic address: ishioto@med.akita-u.ac.jp.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Ishikawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005154:Facial Nerve / Q000601:surgery*; D005158:Facial Paralysis / Q000601:surgery*; D005260:Female; D006801:Humans; D007002:Hypoglossal Nerve / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
keywords: Acoustic neuroma; Anastomose término-lateral; End-to-side anastomosis; Facial nerve; Hypoglossal nerve; Nerve reconstruction; Nervo facial; Nervo hipoglosso; Neuroma acústico; Reconstrução de nervos