Vol.97 No.6 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 97 No. 6 June 2004
Hypoglossal-facial Nerve Side-to-End Anastomosis:
A Case Report
Katsura Kawata
(Shizuoka City Hospital)
Hideyuki Fukushima, Hajime Nakamura, Hiroo Umeda,
Yoshiharu Kitani and Harumi Hamaguchi
(Kitano Hospital)
Hypoglossal-facial nerve anastomosis is a procedure for restoring facial nerve function after facial palsy caused by surgery for removal of cerebellopontine angle tumors. Classical hypoglossal-facial nerve anastomosis, however, sacrifices the hypoglossal nerve, inevitably causing hemitongue atrophy. To preserve hypoglossal nerve function, we tried hypoglossal-facial nerve side-to-end anastomosis for a 67-year-old woman who suffered from complete facial nerve palsy due to the removal of an acoustic neuroma. In this technique, the facial nerve in the mastoid cavity is exposed to the level of the external genu and then transected. The hypoglossal nerve is also exposed at the level of the axis and dissected as proximally as possible. One-third of the hypoglossal nerve is transected and the distal stump of the facial nerve is anastomosed without tension. In the postoperative stage, this technique provided facial reanimation without hypoglossal nerve dysfunction within one year. In conclusion, hypoglossal-facial nerve side-to-end anastomosis is a useful treatment for patients with long-standing facial palsy who do not want to have tongue dysfunction.
Key words : nerve anastomosis, preserving hypoglossal nerve function, facial nerve palsy, facial reanimation