Hypoglossal-Facial Anastomosis for Facial Nerve Reconstruction: Outcomes using the Side-to-End Surgical Technique
Arq. bras. neurocir
;
40(3): 222-228, 15/09/2021.
Article
in English
| LILACS
| ID: biblio-1362108
ABSTRACT
Introduction The side-to-end hypoglossal-facial anastomosis (HFA) technique is an excellent alternative technique to the classic end-terminal anastomosis, because itmay decrease the symptoms resulting from hypoglossal-nerve transection. Methods Patients with facial nerve palsy (House-Brackmann [HB] grade VI) requiring facial reconstruction from 2014 to 2017were retrospectively included in the study. Results In total, 12 cases were identified, with a mean follow-up of 3 years. The causes of facial paralysis were due to resection of posterior-fossa tumors and trauma. There was improvement in 91.6% of the patients (11/12) after the HFA. The rate of improvement according to the HB grade was as follows HB III - 58.3%; HB IV - 16.6%; and HB II - 16.6%. The first signs of improvement were observed in the patients with the shortest time between the paralysis and the anastomosis surgery (3.5months versus 8.5 months; p » 0.011). The patients with HB II and III had a shorter time between the diagnosis and the anastomosis surgery (mean 5.22 months), while the patients with HB IV and VI had a longer time of paresis (mean 9.5 months; p » 0.099). We did not observe lingual atrophy or changes in swallowing. Discussion and Conclusion Hypoglossal-facial anastomosis with the terminolateral technique has good results and low morbidity in relation to tongue motility and swallowing problems. The HB grade and recovery appear to be better in patients operated on with a shorter paralysis time.
Full text:
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Index:
LILACS (Americas)
Main subject:
Anastomosis, Surgical
/
Facial Nerve
/
Facial Paralysis
/
Hypoglossal Nerve
Type of study:
Etiology study
/
Prognostic study
Language:
English
Journal:
Arq. bras. neurocir
Journal subject:
Cirurgia
/
Neurosurgery
Year:
2021
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
DFV Neuro Neurology and Neurosurgery Service/BR
/
Instituto de Neurologia de Curitiba/BR
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