Hypoglossal-Facial Anastomosis for Facial Nerve Reconstruction: Outcomes using the Side-to-End Surgical Technique
| Autor: | Leonardo Gilmone Ruschel, Matheus Fernandes de Oliveira, Gustavo Nogueira, Jonathan De La Cruz, Kristel Back Merida, Joel Sanabria Duarte, Ricardo Ramina |
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| Rok vydání: | 2020 |
| Předmět: |
hypoglossal nerve
medicine.medical_specialty RD1-811 facial paralysis facial-nerve trauma surgical anastomosis Anastomosis 03 medical and health sciences Surgical anastomosis 0302 clinical medicine Swallowing Paralysis Medicine 030223 otorhinolaryngology Paresis business.industry medicine.disease Facial nerve Facial paralysis Surgery facial nerve Neurology (clinical) medicine.symptom business Hypoglossal nerve 030217 neurology & neurosurgery |
| Zdroj: | Brazilian Neurosurgery, Vol 40, Iss 03, Pp e222-e228 (2021) |
| ISSN: | 2359-5922 0103-5355 |
| DOI: | 10.1055/s-0040-1718431 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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