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[Paralyzed face. Ansa-cervicalis-nervi-hypoglossi]
1Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde und Poliklinik, Universitätsklinikum Freiburg. schipper@hno.ukl.uni-freiburg.de
Summary
Ansa cervicalis nervi hypoglossi-facial nerve anastomosis (ACHFA) offers an alternative to hypoglossal-facial nerve anastomosis (HFA) for facial reanimation. ACHFA shows comparable results to HFA without adverse effects on speech or swallowing.
Area of Science:
- Neurosurgery
- Facial Nerve Surgery
- Reconstructive Surgery
Background:
- Hypoglossal-facial nerve anastomosis (HFA) is a long-established procedure for facial paralysis.
- HFA can lead to unfavorable outcomes in speech and swallowing due to denervation and scarring of target muscles.
- Ansa cervicalis nervi hypoglossi-facial nerve anastomosis (ACHFA) presents an alternative to mitigate these late effects.
Purpose of the Study:
- To evaluate the efficacy and safety of delayed ACHFA as an alternative to HFA.
- To compare clinical outcomes of ACHFA with established HFA results.
Main Methods:
- Retrospective analysis of eight cases undergoing delayed ACHFA.
- Comparison of clinical results with historical HFA data from literature and own experience.
Main Results:
- ACHFA demonstrated good reanimation in facial muscles, comparable to HFA, except for the forehead region.
- A potential reduction in neuronal plasticity of the ansa cervicalis may explain the forehead result.
- No late-onset side effects on speech or swallowing were observed following ACHFA.
Conclusions:
- ACHFA is a viable alternative to HFA for facial reanimation, preserving speech and swallowing functions.
- While forehead reanimation may be less effective, overall functional outcomes are favorable.
- ACHFA avoids the specific late complications associated with HFA.