Motor Relearning After Hypoglossal-Facial Nerve Anastomosis

Abstract

Facial paralysis is a clinical condition associated with significant functional and psychosocial morbidity (Facial Plast Surg FPS. 2011;27(4):346–57). The management paradigm for this condition continues to evolve with the use of both surgical and nonsurgical strategies (Facial Plast Surg FPS. 2011;27(4):346–57). Hypoglossal-facial nerve anastomosis is a surgical technique whereby the hypoglossal nerve acts as a donor motor nerve to restore facial muscle reinnervation via movements of the tongue (Plast Reconstr Surg. 1979;63(1):63–72). This case describes a 33-yr-old woman with unilateral facial paralysis who underwent hypoglossal-facial nerve anastomosis and 14 wks of postoperative rehabilitation. This report highlights the details of her rehabilitation regimen including the specific techniques used to enhance motor relearning of facial expression through movement of the tongue.

Sternocleidomastoid Muscle Transfer for Treatment of Longstanding Facial Paralysis: Long-term Outcomes and Complications

“…Either direct anastomosis of the severed facial nerve or nerve transfer of branches of other cranial nerves (V, XI, or XII) can be applied to reactivate the paralyzed mimetic muscles when they are still viable (5)(6)(7)(8)(9). However, in case of longstanding facial palsy, in which the mimetic muscles have already gone through fibrosis and have therefore lost their ability to be reinnervated, local or free muscle flap transfer are needed to achieve a dynamic reconstruction (10)(11)(12)(13).…”