Hypoglossal Facial Nerve Anastomosis for Post-Operative and Post-Traumatic Complete Facial Nerve Paralysis

Area of Science:

• Neurosurgery
• Otolaryngology
• Facial Nerve Surgery

Background:

• Complete facial paralysis can result from cerebellopontine angle tumor resection or traumatic petrous bone fractures.
• Facial reanimation is crucial for restoring function and improving quality of life.

Purpose of the Study:

• To evaluate the clinical outcomes and complications of hypoglossal-facial anastomosis for facial reanimation.
• To assess improvements in facial asymmetry and muscle contractility post-procedure.

Main Methods:

• A prospective study of 15 patients with unilateral complete lower motor neuron facial paralysis.
• Patients underwent end-to-end hypoglossal-facial nerve anastomosis following tumor resection or trauma.
• Data collected from June 2015 to January 2017 at Cairo University Hospitals.

Main Results:

• At one-year follow-up, 20% of patients improved to House Brackmann grade II.
• 73.33% improved to grade III, and 6.66% improved to grade IV.
• The study assessed clinical improvement and associated complications.

Conclusions:

• End-to-end hypoglossal-facial nerve anastomosis is a gold standard for facial reanimation when distal facial nerve stump is viable.
• Early anastomotic repair after acute facial nerve injury leads to superior long-term facial function.
• This procedure should be considered in the management of facial nerve paralysis.