Functional Outcome and Quality of Life After Hypoglossal-Facial Jump Nerve Suture

Abstract

Background: To evaluate the face-specific quality of life after hypoglossal-facial jump nerve suture for patients with long-term facial paralysis. Methods: A single-center retrospective cohort study was performed. Forty-one adults (46% women; median age: 55 years) received a hypoglossal-facial jump nerve suture. Sunnybrook and eFACE grading was performed before surgery and at a median time of 42 months after surgery. The Facial Clinimetric Evaluation (FaCE) survey and the Facial Disability Index (FDI) were used to quantify face-specific quality of life after surgery. Results: Hypoglossal-facial jump nerve suture was successful in all cases without tongue dysfunction. After surgery, the median FaCE Total score was 60 and the median FDI Total score was 76.3. Most Sunnybrook and eFACE grading subscores improved significantly after surgery. Younger age was the only consistent independent predictor for better FaCE outcome. Additional upper eyelid weight loading further improved the FaCE Eye comfort subscore. Sunnybrook grading showed a better correlation to FaCE assessment than the eFACE. Neither Sunnybrook nor eFACE grading correlated to the FDI assessment. Conclusion: The hypoglossal-facial jump nerve suture is a good option for nerve transfer to reanimate the facial muscles to improve facial motor function and face-specific quality of life.

Selective Surface Electrostimulation of the Denervated Zygomaticus Muscle

“…While, in the majority of the cases, idiopathic facial palsy tends to show a complete recovery within 3–9 weeks, this feature is not shared by iatrogenic or traumatic forms. If facial palsy persists for longer than three months, it is known as chronic facial palsy and often requires surgical treatment for effective symptom mitigation, such as surgical reinnervation [ 8 , 9 , 10 , 11 , 12 , 13 , 14 ], even if surgical approaches are almost never able to ensure a complete recovery [ 15 ]. For instance, surgical reinnervation effectiveness is often reduced by the occurrence of misdirected axon regeneration causing synkinesis and the consequent so called post-paralytic facial syndrome [ 16 ], or delayed by the low rate of nerve grow (1 mm/d) in case of extended injuries [ 17 , 18 ].…”

Clinical Studies and Pre-clinical Animal Models on Facial Nerve Preservation, Reconstruction, and Regeneration Following Cerebellopontine Angle Tumor Surgery–A Systematic Review and Future Perspectives

“…The resultant paresis of tongue movements on the affected side is easily compensated (May et al, 1991;Flores, 2007;Volk et al, 2020). There is no difference in facial outcome results between direct end to side anastomosis or interposition nerve graft.…”

“…The XII/VII-HFA technique has therefore gained widespread acceptance as the preferred method of VII/XII coaptation (Liu et al, 2018 ). In case of anticipated tension at the site of anastomosis, several studies report on the use of an interposition sural or greater auricular nerve graft between the distal segment of the facial and partial thickness of the hypoglossal nerve ( Figure 2E ; May et al, 1991 ; Flores, 2007 ; Volk et al, 2020 ). This combination of previously described techniques produced good facial movements without causing loss of tongue function.…”

“…This combination of previously described techniques produced good facial movements without causing loss of tongue function. The resultant paresis of tongue movements on the affected side is easily compensated (May et al, 1991 ; Flores, 2007 ; Volk et al, 2020 ). There is no difference in facial outcome results between direct end to side anastomosis or interposition nerve graft.…”

Preservation, reconstruction, and rehabilitation of the facial nerve

“…Zur Kreuznervennaht werden der ipsilaterale N. hypoglossus, der ipsilaterale N. massetericus oder Anteile des kontralateralen N. facialis am meisten verwendet [ 18 – 20 ]. Jede Schädigung des Nervs im Bereich der Bifurkation oder einer Trifurkation führt zu einem komplexen Defizit.…”