with complete facial palsy due to facial nerve transection during surgery for acoustic neuroma removal followed by a hypoglossal-facial nerve anastomosis. This report describes a new surgical technique to improve the results of conventional hypoglossal-facial nerve anastomosis that does not necessitate the use of. This procedure allows a straight end-to-side hypoglossal–facial anastomosis without interruption of the 12th cranial nerve or the need for graft interposition.

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Hypoglossal-facial nerve anastomosis: a meta-analytic study.

Journal List Funct Neurol v. Statistical significance was set at a p level of less than. Larger randomized clinical trials should be considered in order to provide more conclusive evidence. Enhancing facial appearance with cosmetic camouflage.

Hypoglossal-facial nerve anastomosis: a meta-analytic study.

The average age of the patients was All of our patients were sent to us by different centers, so there is also a potential recruitment bias linked to both the selection of patients with fewer signs of recovery and the geographical origins of the patients.

The meta-analysis conducted by Yetiser and Karapinarbased on data of patients derived from 23 studies, reported a median improvement of two levels on the HB grading system in patients who underwent surgery alone.

Our study included patients who underwent XII-VII anastomosis using different surgical techniques as it has been reported that they give similar results Lin et al.

The results are unquestionably dependent on the precision of the suture, and therefore microsurgical skill in nerve repair is obviously welcome. This use of the new motor circuit is accompanied by a reorganization of brain activation patterns: Preliminary studies suggest a cacial effect of electromyographic biofeedback rehabilitation Brudny et al.


An accurate evaluation of the results is hindered by two important factors. A limitation of the jump graft technique is the necessity of a graft together with its obvious double line of suture to be crossed by the regenerating axons as well as the resultant scarring and morbidity at the donor site usually the sural nerve or, more rarely, the great auricular nerve.

A reduced rate of anastomosus after a true end-to-side faial has also been confirmed by the observations of Yoleri, et al.

Anastomossi, regardless of the scale used, data somehow depend on the personal evaluation of the surgeon or the team. Argomenti di Terapia Occupazionale. Finally, the Spearman test was used to identify variables associated with the HB grade at 36 months.

Our study is the first to hypogolssal results obtained by combining XII-VII anastomosis with a prolonged systematic rehabilitation program hypoglosswl a large clinical series. Treating facial nerve palsy by true termino-lateral hypoglossal-facial nerve anastomosis.

At only 3 months muscle tone is excellent at rest, and at 6 months facial muscle function is very good during controlled speaking or laughing. Twenty patients had an acoustic neuroma average size 3. Articles were identified by means of a PubMed search using the key words “facial-hypoglossal anastomosis,” which yielded articles.

Introduction Hypoglossal-facial nerve XII-VII anastomosis is a surgical procedure that has long been used to restore movement to the facial muscles in cases of paralysis anasotmosis the seventh cranial nerve Ozsoy et al. The facial nerve is extracted from the fallopian canal, rerouted, and neurotized end to side to the hypoglossal nerve distal to the descending ansa. Independent of us and on a different basis, the same technique was described by Donzelli, et al.

Use of this procedure gains an additional length of 3.


The hypoglossal nerve is prepared in the retromandibular space distal to the origin of the descending ansa, to enhance the anastomoeis of recruiting powerful motor axons Fig. Depending on its condition, a ruptured proximal stump might not always be considered the best choice for reinnervation.

Finally, anastomoais scarring or morbidity due to graft harvesting is part of the process. Only one patient did not show signs of reinnervation after surgery. The recovery continues for at least three years after the anastomosis, meaning that prolonged follow-up of these patients is advisable.

End-to-side intrapetrous hypoglossal–facial anastomosis for reanimation of the face

Once patients have mastered static symmetry, they need to improve dynamic symmetry. Articles that reported facial nerve function after surgery and timing of repair were included.

Results An accurate evaluation of the results is hindered by two important factors. In light of the results obtained and the absolute lack of any morbidity associated with our procedure, one wonders whether the technique may be even better than a direct intracranial repair of the seventh cranial nerve when a wear-and-tear interruption of the proximal facial nerve occurs, as might happen in the course of removing large acoustic tumors.

All post-hoc comparisons showed a significant reduction in scores test for trend: A very important issue is still to be ascertained: In a meta-analysis, Yetiser and Karapinar reported a median improvement of two levels on the House-Brackmann HB grading system in patients who underwent surgery alone.