Reanimation of the paralyzed face by indirect hypoglossal-facial nerve anastomosis

Background: The results of indirect hypoglossal facial nerve anastomosis wi th interposition of a free nerve graft, end-to-end to the periferal facial nerve stump, and end-to-side to the hypoglossal nerve are prospectively eva luated. This technique is supposed to overcome loss of hypoglossal function . Methods: Tongue function in 39 consecutive patients and facial reanimation in 29 patients who completed 24 months follow-up were assessed. Facial nerv e function was judged using the House-Brackmann (HB) grading system. Results: Tongue movements were normal in all operated on patients. Initial facial movements occurred on average 7.5 months postoperatively. The result s were graded HB II in 6 (20.9%), HB III in 13 (44.6%), HB IV in 7 (24.1%), HB V in 2 (6.8%) patients, and HB VI in 1 (3.4%) patient. The results were significantly better in young patients and when a short time interval betw een paralysis and surgery existed. Conclusions: Indirect hypoglossal-facial anastomosis is the preferred techn ique in most patients for whom the classical direct hypoglossofacial anasto mosis is indicated. (C) 2001 Excerpta. Medica, Inc. All rights reserved.