Facial reanimation using hypoglossal-facial nerve anastomosis after schwannoma removal.
CONCLUSIONS
In this series, the split type hypoglossal-facial nerve anastomosis resulted in more favorable outcomes in terms of both facial function and tongue atrophy.


OBJECTIVE
This study compared surgical techniques for hypoglossal-facial nerve anastomosis after schwannoma removal and evaluated which technique achieves better facial outcomes and less tongue morbidity.


METHODS
This study included 14 patients who underwent hypoglossal-facial nerve anastomosis after schwannoma removal and were followed for more than 1 year. Three surgical techniques were performed: end-to-end, end-to-side, and split anastomoses. Facial palsy and tongue atrophy after anastomosis were evaluated using the scales suggested by House-Brackmann and Martins, respectively. Tumor volume and the time to surgery were also evaluated, and the effects on facial outcomes were analyzed.


RESULTS
Overall, nine of 14 (64.3%) patients had favorable facial outcomes, and eight of 14 (57.1%) had favorable tongue outcomes. Regarding facial palsy, five of seven (71.4%) end-to-end, three of four (75%) split, and only one of three (33.3%) end-to-side patients had favorable facial function. Regarding tongue atrophy, all three (100%) end-to-side, three of four (75%) split, and two of seven (28.6%) end-to-end patients had favorable tongue outcomes. The effects of tumor volume and time to surgery on facial outcome were not significant.
a Department of Otorhinolaryngology , Yonsei University College of Medicine , Seoul , Korea.
Ji Hyuk
JH
Han
a Department of Otorhinolaryngology , Yonsei University College of Medicine , Seoul , Korea.
Mischelle J
MJ
Suh
a Department of Otorhinolaryngology , Yonsei University College of Medicine , Seoul , Korea.
Jin Won
JW
Kim
b Department of Otorhinolaryngology-Head and Neck Surgery , Seoul Veterans Hospital , Seoul , Korea.
Hyun Sang
HS
Cho
a Department of Otorhinolaryngology , Yonsei University College of Medicine , Seoul , Korea.
In Seok
IS
Moon
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D005154:Facial Nerve / Q000601:surgery*; D020220:Facial Nerve Injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D007002:Hypoglossal Nerve / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D055815:Young Adult
Facial palsy; hypoglossal-facial nerve anastomosis; schwannoma; tongue atrophy