Results of 13 hypoglosso-facial anastomoses
Facial nerve paralysis significantly decreases the quality of life in patients after skull base tumors surgery. There are different options for surgical repair of the nerve. One of the most effective methods is the anastomosis of the distal trunk of the facial nerve with the proximal trunk of the hypoglossal nerve or with hypoglossal loop. Thirteen hypoglosso-facial anastomoses had been performed in our department between 1999 and 2003. In all patients the facial nerve paralysis was due to the surgery in its proximity. In one case the patient suffered from petroclival chordoma, in one case ameloblastoma, one was with petroclival meningioma and the rest of cases were after vestibular schwannoma. The follow-up period lasted from 6 months to three years. The final result was expressed in House-Brackmann scale (HB) describing facial muscle strength. In two cases there was no improvement (HB 6), in two cases barely perceptible motion (HB 5), in five obvious weekness with disfiguring assymetry (HB 4) and in four obvious but not disfiguring dysfunction (HB 3). There was only one postoperative complication haematoma at the place of anastomosis requiring evacuation. Hypoglosso-facial anastomosis remains one of the most important techniques of the reanimation of the paralysed face. Its efficacy is limited, but it is a relatively safe procedure.