Treatment of complete facial palsy in adults: comparative study between direct hemihypoglossal-facial neurorrhaphy, hemihipoglossal-facial neurorrhaphy with grafts, and masseter to facial nerve transfer

Socolovsky, Mariano; Martins, Roberto S.; Masi, Gilda Di; Bonilla, Gonzalo; Siqueira, Mário G.

doi:10.1007/s00701-016-2767-7

Cited by 39 publications

(19 citation statements)

References 62 publications

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“…In contrast, good results (House-Brackmann Grade III 28 ) can be expected after a hypoglossal nerve-facial nerve transfer. 24,26,49,57 One possible explanation for this discrepancy is that no connection between elbow flexion and the tongue cortical area exists (Fig. 4), whereas good horizontal connections between the tongue and the face area do exist (Fig.…”

Section: Hypoglossal Nerve As Donor To the Mcn Or Facial Nervementioning

confidence: 99%

Current concepts in plasticity and nerve transfers: relationship between surgical techniques and outcomes

Socolovsky

Malessy

Lopez

et al. 2017

FOC

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OBJECTIVE Neuroplasticity is analyzed in this article as the capacity of the CNS to adapt to external and internal stimuli. It is being increasingly recognized as an important factor for the successful outcome of nerve transfers. Better-known factors are the number of axons that cross the coaptation site, the time interval between trauma and repair, and age. Neuroplasticity is mediated initially by synaptic and neurotransmitter changes. Over time, the activation of previously existing but lowly active connections in the brain cortex contributes further. Dendritic sprouting and axonal elongation might also take place but are less likely to be prominent. METHODS The authors reviewed different factors that play roles in neuroplasticity and functional regeneration after specific nerve transfers. RESULTS The authors found that these different factors include, among others, the distance between cortical areas of the donor and receptor neurons, the presence versus absence of preexisting lowly active interneuronal connections, gross versus fine movement restoration, rehabilitation, brain trauma, and age. CONCLUSIONS The potential for plasticity should be taken into consideration by surgeons when planning surgical strategy and postoperative rehabilitation, because its influence on results cannot be denied.

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Section: Hypoglossal Nerve As Donor To the Mcn Or Facial Nervementioning

confidence: 99%

Current concepts in plasticity and nerve transfers: relationship between surgical techniques and outcomes

Socolovsky

Malessy

Lopez

et al. 2017

FOC

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“…Hemihypoglossal-facial and masseteric-facial anastomosis are also options to improve facialnerve function with lesser complications. [27][28][29][30][31] Both techniques present decreased morbidity and average outcomes compared with classic HFA. [27][28][29][30][31] In many studies in the literature, [27][28][29][30][31] there is wide evidence to support their application.…”

Section: Discussionmentioning

confidence: 99%

“…[27][28][29][30][31] Both techniques present decreased morbidity and average outcomes compared with classic HFA. [27][28][29][30][31] In many studies in the literature, [27][28][29][30][31] there is wide evidence to support their application. Although the masseteric-facial anastomosis technique seems to be technically easier, the outcomes tend to be equal or worse than those of the HFA.…”

Section: Discussionmentioning

confidence: 99%

“…Although the masseteric-facial anastomosis technique seems to be technically easier, the outcomes tend to be equal or worse than those of the HFA. [27][28][29][30][31][32] Regarding the complications of side-to-end HFA, few articles with a low number of patients have been published. In a study conducted by Samii et al, 10 1 out of 17 patients developed lingual hypotrophy.…”

Section: Discussionmentioning

confidence: 99%

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Hypoglossal-Facial Anastomosis for Facial Nerve Reconstruction: Outcomes using the Side-to-End Surgical Technique

Ruschel¹,

Duarte

Cruz

et al. 2020

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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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.

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“…The α angle was that intersected by line A and line B, while the β angle was defined as the angle between line C and line D. We calculated the value of the angle at the preoperative assessment minus that at the various postoperative time points. Additionally, we assessed the differences between the two groups in terms of facial symmetry, palpebral occlusion, and synkinetic movement during eye closure, opening of the mouth, and chewing (Socolovsky et al, 2016).…”

Section: Facial Symmetrymentioning

confidence: 99%

Repairing whole facial nerve defects with xenogeneic acellular nerve grafts in rhesus monkeys

et al. 2022

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Treatment of complete facial palsy in adults: comparative study between direct hemihypoglossal-facial neurorrhaphy, hemihipoglossal-facial neurorrhaphy with grafts, and masseter to facial nerve transfer

Abstract: HFD appears to produce the most satisfactory facial reanimation results, with MF providing lesser but still satisfactory outcomes. Using interposed grafts while performing hemihypoglossal-to-facial nerve transfers should likely be avoided, whenever possible.

Cited by 39 publications

References 62 publications

Current concepts in plasticity and nerve transfers: relationship between surgical techniques and outcomes

Current concepts in plasticity and nerve transfers: relationship between surgical techniques and outcomes

Hypoglossal-Facial Anastomosis for Facial Nerve Reconstruction: Outcomes using the Side-to-End Surgical Technique

Repairing whole facial nerve defects with xenogeneic acellular nerve grafts in rhesus monkeys

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