Hypoglossal-Facial Anastomosis for Facial Nerve Reconstruction: Outcomes using the Side-to-End Surgical Technique
Introduction The side-to-end hypoglossal-facial anastomosis (HFA) technique is an excellent alternative technique to the classic end-terminal anastomosis, because it may decrease the symptoms resulting from hypoglossal-nerve transection. Methods Patients with facial nerve palsy (House-Bra...
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| Format: | Article |
| Language: | English |
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Thieme Revinter Publicações Ltda.
2021-09-01
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| Series: | Brazilian Neurosurgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1718431 |
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| author | Leonardo Gilmone Ruschel Joel Sanabria Duarte Jonathan De La Cruz Kristel Back Merida Gustavo Fabiano Nogueira Matheus Fernandes de Oliveira Ricardo Ramina |
| author_facet | Leonardo Gilmone Ruschel Joel Sanabria Duarte Jonathan De La Cruz Kristel Back Merida Gustavo Fabiano Nogueira Matheus Fernandes de Oliveira Ricardo Ramina |
| author_sort | Leonardo Gilmone Ruschel |
| collection | DOAJ |
| description | Introduction The side-to-end hypoglossal-facial anastomosis (HFA) technique is an excellent alternative technique to the classic end-terminal anastomosis, because it may 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 (3.5 months 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. |
| first_indexed | 2024-12-14T15:02:21Z |
| format | Article |
| id | doaj.art-0aa32d1cb6ff49829feee1cd752fa810 |
| institution | Directory Open Access Journal |
| issn | 0103-5355 2359-5922 |
| language | English |
| last_indexed | 2024-12-14T15:02:21Z |
| publishDate | 2021-09-01 |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Brazilian Neurosurgery |
| spelling | doaj.art-0aa32d1cb6ff49829feee1cd752fa8102022-12-21T22:56:46ZengThieme Revinter Publicações Ltda.Brazilian Neurosurgery0103-53552359-59222021-09-014003e222e22810.1055/s-0040-1718431Hypoglossal-Facial Anastomosis for Facial Nerve Reconstruction: Outcomes using the Side-to-End Surgical TechniqueLeonardo Gilmone Ruschel0Joel Sanabria Duarte1Jonathan De La Cruz2Kristel Back Merida3Gustavo Fabiano Nogueira4Matheus Fernandes de Oliveira5Ricardo Ramina6DFV Neuro Neurology and Neurosurgery Service, São Paulo, BrazilNeurosurgery Department, Instituto de Neurologia de Curitiba (INC), Curitiba, Paraná, BrazilNeurosurgery Department, Instituto de Neurologia de Curitiba (INC), Curitiba, Paraná, BrazilNeurology Department, Instituto de Neurologia de Curitiba (INC), Curitiba, Paraná, BrazilOtorhinolaryngology Department, Instituto de Neurologia de Curitiba (INC), Curitiba, Paraná, BrazilDFV Neuro Neurology and Neurosurgery Service, São Paulo, BrazilNeurosurgery Department, Instituto de Neurologia de Curitiba (INC), Curitiba, Paraná, BrazilIntroduction The side-to-end hypoglossal-facial anastomosis (HFA) technique is an excellent alternative technique to the classic end-terminal anastomosis, because it may 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 (3.5 months 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.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1718431facial-nerve traumafacial nervehypoglossal nervefacial paralysissurgical anastomosis |
| spellingShingle | Leonardo Gilmone Ruschel Joel Sanabria Duarte Jonathan De La Cruz Kristel Back Merida Gustavo Fabiano Nogueira Matheus Fernandes de Oliveira Ricardo Ramina Hypoglossal-Facial Anastomosis for Facial Nerve Reconstruction: Outcomes using the Side-to-End Surgical Technique Brazilian Neurosurgery facial-nerve trauma facial nerve hypoglossal nerve facial paralysis surgical anastomosis |
| title | Hypoglossal-Facial Anastomosis for Facial Nerve Reconstruction: Outcomes using the Side-to-End Surgical Technique |
| title_full | Hypoglossal-Facial Anastomosis for Facial Nerve Reconstruction: Outcomes using the Side-to-End Surgical Technique |
| title_fullStr | Hypoglossal-Facial Anastomosis for Facial Nerve Reconstruction: Outcomes using the Side-to-End Surgical Technique |
| title_full_unstemmed | Hypoglossal-Facial Anastomosis for Facial Nerve Reconstruction: Outcomes using the Side-to-End Surgical Technique |
| title_short | Hypoglossal-Facial Anastomosis for Facial Nerve Reconstruction: Outcomes using the Side-to-End Surgical Technique |
| title_sort | hypoglossal facial anastomosis for facial nerve reconstruction outcomes using the side to end surgical technique |
| topic | facial-nerve trauma facial nerve hypoglossal nerve facial paralysis surgical anastomosis |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1718431 |
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