[Hypoglossofacial anastomosis for facial palsy treatment: Indications and results]

Abstract

Hypoglossofacial anastomosis is a classical surgical procedure for the treatment of facial paralysis when the trunk of the facial nerve cannot be repaired and its peripheral branches are normal.

Patients and methods: Between 2004 and 2015, 77 patients were able to benefit from an hypoglossofacial anastomosis. The etiology of the paralysis was mainly the surgery of vestibular schwannoma, tumors of the facial nerve and diseases of the brainstem. A specific and premature speech therapy remediation was realized for all patients in order to preserve the tongue function and to upgrade the facial motricity.

Results: Sixty-nine patients could be studied. The House Brackmann grading scale was used to appreciate the result. Thirty-one patients are grade III, 34 grade IV and in only one case the result is a grade V despite the anastomosis works. The main predictive factor for a good result is a small delay between the onset of the paralysis and the surgery for the rehabilitation. The specific physiotherapy upgrades the result with less side effects of the anastomosis.

Conclusion: Hypoglossofacial anastomosis is a simple and reliable surgical procedure for rehabilitation of paralysed face. The quality of the result is linked with an early surgery and a specific physiotherapy.

Keywords: Anastomose hypoglosso-faciale; Facial palsy; Facial schwanomma; Hypoglossofacial anastomosis; Paralysie faciale; Remediation of facial palsy; Rééducation des paralysies faciales; Schwanomme nerf facial; Schwanomme vestibulaire; Vestibular schwanomma.