Classic Hypoglossal-Facial Nerve Anastomosis after Acoustic Neuroma Resection

Abstract

To clarify the factors contributing to patient satisfaction with facial movement after the classic hypoglossal-facial nerve anastomosis, we examined 46 such patients who consented to an interview and video-recording. No correlation was seen between the physician’s evaluation of returned function (according to Yanagihara’s 40-point scale and the grading system of House-Brackmann) and the scores (full marks: 100 points) the patients assigned to their own facial movements. Instead the scores that the patients assigned were closely related to subjective oral dysfunction, such as difficulty in masticating, articulating, and swallowing. Those scores did not correlate with eye-related functional deficits. These findings indicate that modified techniques to minimize the hypoglossal nerve deficit may enhance patient satisfaction without sacrificing recovery of facial movements.

Facial reanimation with end-to-end hypoglossofacial anastomosis: 20 years’ experience

“…Sectioning of the hypoglossal nerve can result in atrophy of the ipsilateral tongue and problems with swallowing and speech articulation. In a previous study of hypoglossofacial anastomosis after acoustic neuroma resection, difficulties in articulation and swallowing were noted in 69.6 and 58.7 per cent of patients, respectively 14 . In our study, 57 per cent of patients had speech articulation problems and 29 per cent had numbness of the ipsilateral tongue, although none had swallowing problems.…”

Quality of life before and after different treatment modalities in peripheral facial palsy: A systematic review

“…One study had a patient population consisting of only central facial palsies . Finally, the studies by Lassaletta et al, Kunihiro et al, and Kleiss et al did not include postoperative records. The study by Ryzenman et al did not include any treatment for patients with a PFP, and the study of Leong and Lesser was a survey among PFP patients.…”

Combination of hypoglossal-facial nerve surgical reconstruction and neurotrophin-3 gene therapy for facial palsy

“…7,36 However, complete transection of the hypoglossal nerve for such an anastomosis may lead to paralysis and atrophy of the ipsilateral hemitongue, which would likely interfere with mastication, speech, and swallowing. 17,25 To overcome this drawback, some modifications of the hypoglossal-facial anastomosis were proposed and subsequently developed. 3,30 One method involves cutting 30%-50% of the hypoglossal nerve in a transverse direction and then interposing a nerve graft at its two extremities with an end-to-side anastomosis to the hypoglossal nerve and another end-to-end anastomosis to the facial nerve.…”