Issue N# 2 - 2006
Side-to-end hypoglossal-facial nerve anastomosis with intratemporal facial nerve translocation. Long-term results and indications in 15 cases over 12 years
Authors : V. Franco-Vidal, H. Blanchet, D. Liguoro, V. Darrouzet (Bordeaux)
Ref. : Rev Laryngol Otol Rhinol. 2006;127,2:97-102.
Article published in french
Downloadable PDF document french
Objectives: To describe functional results concerning facial and lingual mobility after side-to end hypoglossal facial nerve anastomosis. Material and methods: 15 patients were operated on between 1993 and 2002 (11 cases of facial nerve injury during vestibular schwannoma surgery, and 4 cases of brainstem stroke). Were assessed at a minimum of 18 months postop tonus and facial voluntary movements recovery (modified House Brackmann (HB) grading), lingual mobility (amyotrophy and self-evaluation questionnaire), and patients’ overall satisfaction (questionnaire). Results: The mean delay to evaluation was 57.5 months. The tonus recovery appeared within 6 to 8 months (mean 28.5 weeks, SD 4.6 weeks). All patients recovered a normal tonus. The facial function was evaluated HB grade III in 11 cases (73.3%), grade IV in 3 cases (20%) and grade V in one (6.6%). Eye occlusion was obtained within 13.6 months on average (SD 2.6 months) in all cases except one. The blepharorraphy was maintained in 2 patients. No facial spasm was noted. The lingual motricity troubles were absent in 93.3% of cases. Patients were satisfied in 93.3% of cases. The less satisfactory results were observed when patients were managed late (> 2years after nerve section) and in case of brainstem stroke. Conclusion: This technique seems to be very efficient. It presents the advantage to preserve lingual motricity and to decrease postoperative problems of midface spasticity.
Price : 10.50 €