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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Autores principales:	Leonardo Gilmone Ruschel, Joel Sanabria Duarte, Jonathan De La Cruz, Kristel Back Merida, Gustavo Fabiano Nogueira, Matheus Fernandes de Oliveira, Ricardo Ramina
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Revinter Publicações Ltda. 2021
Materias:	facial-nerve trauma facial nerve hypoglossal nerve facial paralysis surgical anastomosis Medicine R Surgery RD1-811
Acceso en línea:	https://doaj.org/article/0aa32d1cb6ff49829feee1cd752fa810
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spelling	oai:doaj.org-article:0aa32d1cb6ff49829feee1cd752fa8102021-11-03T23:45:46ZHypoglossal-Facial Anastomosis for Facial Nerve Reconstruction: Outcomes using the Side-to-End Surgical Technique0103-53552359-592210.1055/s-0040-1718431https://doaj.org/article/0aa32d1cb6ff49829feee1cd752fa8102021-09-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1718431https://doaj.org/toc/0103-5355https://doaj.org/toc/2359-5922Introduction 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.Leonardo Gilmone RuschelJoel Sanabria DuarteJonathan De La CruzKristel Back MeridaGustavo Fabiano NogueiraMatheus Fernandes de OliveiraRicardo RaminaThieme Revinter Publicações Ltda.articlefacial-nerve traumafacial nervehypoglossal nervefacial paralysissurgical anastomosisMedicineRSurgeryRD1-811ENBrazilian Neurosurgery, Vol 40, Iss 03, Pp e222-e228 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	facial-nerve trauma facial nerve hypoglossal nerve facial paralysis surgical anastomosis Medicine R Surgery RD1-811
spellingShingle	facial-nerve trauma facial nerve hypoglossal nerve facial paralysis surgical anastomosis Medicine R Surgery RD1-811 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
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.
format	article
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
title	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_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_sort	hypoglossal-facial anastomosis for facial nerve reconstruction: outcomes using the side-to-end surgical technique
publisher	Thieme Revinter Publicações Ltda.
publishDate	2021
url	https://doaj.org/article/0aa32d1cb6ff49829feee1cd752fa810
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Hypoglossal-Facial Anastomosis for Facial Nerve Reconstruction: Outcomes using the Side-to-End Surgical Technique

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