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Updated: Dec 17, 2025

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Results of End-To-Side Hypoglossal-Facial Nerve Anastomosis in Facial Paralysis after Skull Base Surgery
Sasan Dabiri1, Mohammadtaghi Khorsandi Ashtiani1, Melorina Moharreri1
1Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Introduction:
The primary aim of facial reanimation surgery is to restore tone, symmetry, and movement to the paralyzed face. Hypoglossal-facial end-to-side anastomosis provides satisfactory facial reanimation in the irreversible proximal injury of the facial nerve. This study discussed the facial function results of end-to-side anastomosing of hypoglossal nerve to facial nerve when the injury occurred during skull base surgery.
Materials And Methods:
The present study enrolled a total of 10 patients who underwent end-to-side hypoglossal-facial nerve anastomosis after facial nerve paralysis due to skull base surgery. The data of the patients were gathered from hospital records, pictures, and movies during the 18 months of follow-up.
Results:
At the 18 months of follow-up, seven (70%) and three (30%) patients were reported with grades III and IV of the House-Brackmann scoring system, respectively. In total, out of the seven grade III patients, six subjects underwent early anastomosis (within the first year of the paralysis). On the other hand, among patients with grade IV, two subjects had late anastomosis.
Conclusion:
It seems that early end-to-side hypoglossal-facial anastomosis can be a favorable surgical option with good facial function results for reanimating the facial function of patients with facial paralysis following skull base surgery.

