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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Acoustic Neuroma and Skull Base Surgery. Many surgical series show a significant correlation between early surgery and outcome Yetiser and Karapinar, ; Celis-Aguilar et al.

To prevent eye complications related to incomplete eyelid closure, eight patients had gold weight implants and six patients had undergone tarsorrhaphy. The 22 cases of complete facial palsy were gleaned from a series of cases of cerebellopontine angle tumors treated surgically by one of the authors. Only one patient did not show signs of reinnervation after surgery. In order to reduce muscle atrophy and to improve musculocutaneous vascularization during this phase, they are trained to carefully massage their face.

Facial nerve function had to be reported according to the House-Brackmann scale.

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

Open in a separate window. Clinical assessment The HB grading system House and Brackmann, was used to evaluate the severity of paralysis before the anastomosis, at the first rehabilitation assessment and at follow-up sessions 12, 18 and 36 months after surgery. The disadvantage is that it was difficult to quantify patient compliance with the rehabilitation. This procedure involves the use of only a portion of the hypoglossal nerve and has the enormous advantage of avoiding aanastomosis tongue dysfunction that results from resection of the entire hypoglossal nerve.

Once patients have mastered static symmetry, they need to improve dynamic symmetry. The results are unquestionably dependent on the precision of the suture, and therefore microsurgical skill in nerve repair is obviously welcome. Surgical results of the hypoglossal-facial nerve jump graft technique.


Ann Chir Plast Esthet.

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

The hypoglossal-facial nerve repair as Method to improve recovery of motor function after facial nerve injury. Patients who met the following inclusion criteria were included in the present study: To do this they must learn how to produce a voluntary smile; again they need to use a mirror, dosing the strength of their tongue thrust and repeating the movement several anastomozis a day.

The first rehabilitation assessment took place on average 5. Hypoglossal-facial nerve anastomosis is one xnastomosis the procedures frequently performed to abastomosis function after facial palsy secondary to surgery for removal of cerebellopontine angle tumors.

A very important issue is still to be ascertained: Elena Dalla Toffola, E-mail: Other authors identify age as a prognostic factor for outcome Malik et al.

Our study, confirming the findings of Catli et al. We thank Charlotte Buckmaster for her linguistic expertise. Closure of the eye generally requires separate treatment involving the insertion of either a gold weight or a fascial sling in the upper eyelid.

In the two patients treated, the gold weight in the upper eyelid was removed without consequence. At 1 year postresection, electromyography and clinical examination results showed evidence of irreversible damage and surgery was undertaken. Eur J Phys Rehabil Med. In contrast, the true end-to-side technique that we describe anqstomosis two main advantages: Two young women 31 anasromosis 34 years old each underwent removal of a large 4-cm vestibular schwannoma via the suboccipital retrosigmoid approach.

Patients who have undergone XIIVII anastomosis are not considered to be capable of regaining control of their emotive facial expressions, the smile in particular, since this control is regulated by the extrapyramidal system Rinn et hypoglossla. Long-term facial nerve function following facial reanimation after translabyrinthine vestibular achwannoma surgery: The median HB score at different time points was compared using the Friedman test.


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. Discussion Our study demonstrates that patients treated with XII-VII anastomosis followed by a rehabilitation ansatomosis show a progressive improvement of facial function: Argomenti di Terapia Occupazionale.

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

Three years after the anastomosis, For the first four to five months after surgery, before the first signs of reinnervation appear, patients who have undergone this procedure have complete facial paralysis. The main trunk of the nerve is progressively gently pulled using multiple epineurial stay sutures and is anchored to the surrounding connective tissue in an upward and lateral position Fig.

After surgery, the facial muscles are reinnervated by the twelfth cranial nerve, therefore patients have to learn how to control facial motility through the use of voluntary tongue movements Rinn, A report of 60 cases. A comparison of surgical techniques used in dynamic reanimation of the paralyzed face. Use of this procedure gains an additional length of 3.

Treating facial nerve palsy by true termino-lateral hypoglossal-facial nerve anastomosis. 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.

When the patient is emotionally upset sudden burst of crying or laughingthe responses are uncoordinated and the sequelae of the palsy are clearly visible.

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