Hypoglossal-facial nerve anastomosis: assessment of clinical results and patient benefit for facial nerve palsy following acoustic neuroma excision

Despite advances in neuro-otological techniques permanent complete facial p alsy may still occur in up to 10% of patients undergoing removal of cerebel lopontine angle tumours. Hypoglossal-facial nerve anastomosis is the proced ure of choice in our unit for facial reanimation in such patients and below we report the results of hypoglossal-facial nerve anastomosis performed on 29 patients. Assessment of patient benefit from hypoglossal-facial nerve a nastomosis was obtained using a questionnaire based on the Glasgow Benefit Inventory. The results showed all patients to have. an improvement in their House Brackmann grade following hypoglossal-facial anastomosis with 65% ac hieving grade III or better. Of the 20 patients who completed the questionn aire, 18 showed a positive benefit (median score 59.5, range 40-77). There was a significant correlation (P < 0.045) between the Glasgow benefit inven tory score and House Brackmann grade. Outcome was not affected by the time Interval between the acoustic neuroma surgery and performing the hypoglossa l-facial nerve anastomosis, sex or length of follow-up. However the Glasgow benefit score was significantly influenced by age (P = 0.023) with younger patients showing more benefit independent of improvement in facial nerve f unction.