HYPOGLOSSAL-FACIAL NERVE ANASTOMOSIS FOR MANAGEMENT OF FACIAL PALSY
Abstract
Facial nerve dysfunction is a frequent complication (rate of 3 to 35%) in the surgery of cerebellopontine angle (CPA) tumours, which significantly affects patient’s quality of life. In this study, we report our experience with hypoglossal to facial nerve anastomosis (HFA) for facial reanimation. Retrospective data were collected from 26 patients who underwent HFA. The efficiency of reinnervation was assessed by the May scale, the quality of life was assessed by the Facial Disability Index (FDI). The mean time from removal of the CPA tumour to the reanimation surgery was 11.5 months (min = 2, max = 84). Patients (n = 22, 84.62%) presented total facial nerve dysfunction as assessed by the House-Brackmann scale. Most patients (80.7%) achieved satisfactory outcome assessed by the May scale (grades III–V). The mean score of the FDI physical function subscale was 49.2. The mean score of the FDI social function subscale was 66. In our series no significant difference was found between the subgroups of different timing of facial nerve reinnervation surgery and the surgical outcomes as assessed by May scale and the quality of life of patients assessed by the FDI questionnaire (p = 0.1 and p = 0.8, respectively). Reinnervation is an effective technique for facial nerve reanimation in management of complications of skull base surgery. Using the hypoglossal nerve as a donor nerve has shown acceptable results in restoring the facial nerve function and ensuring a good patient’s quality of life.
About the Authors
A. S. Nechaeva
A.L. Polenov Russian Research Institute of Neurosurgery — branch of V. A. Almazov National Medical Research Center,
Ministry of Health of Russia; North-Western State Medical University named I. I. Mechnikov, Ministry of Health of Russia
Russian Federation
Russian Federation
A. Yu. Ulitin
A.L. Polenov Russian Research Institute of Neurosurgery — branch of V. A. Almazov National Medical Research Center,
Ministry of Health of Russia; North-Western State Medical University named I. I. Mechnikov, Ministry of Health of Russia
Russian Federation
Russian Federation
S. V. Pustovoy
A.L. Polenov Russian Research Institute of Neurosurgery — branch of V. A. Almazov National Medical Research Center,
Ministry of Health of Russia
Russian Federation
Russian Federation
M. M. Tastanbekov
A.L. Polenov Russian Research Institute of Neurosurgery — branch of V. A. Almazov National Medical Research Center,
Ministry of Health of Russia
Russian Federation
Russian Federation
References
1. Albathi, M. Early Nerve Grafting for Facial Paralysis After Cerebellopontine Angle Tumor Resection With Preserved Facial Nerve Continuity / М. Albathi, S. Oyer, L. E. Ishii et al. // Facial Plast Surg. — 2016. — Vol. 18(1). — P. 54–60. DOI: 10.1001/jamafacial.2015.1558.
2. Coca Pelaz, A. Complete facial palsy following surgery for acoustic nerve neurinoma: evolution and associated ophthalmological complications / A. Coca Pelaz, L. C. Fernandez, J. R. Gomez et al. // Acta Otorrinolaringologica Esp. — 2008. — Vol. 59(5). — P. 223–227. PMID: 18501157.
3. Celis-Aguilar, E. End-to-side interposed donor grafting as a facial nerve reinforcement technique after vestibular schwannoma surgery / E. Celis-Aguilar, L. Lassaletta, J. M. Roda JM et al. // Ann Otol Rhinol Laryngol. — 2013. — Vol. 122(8). — P. 520–523. DOI: 10.1177/000348941312200807.
4. Samii, M. Management of 1000 vestibular schwannomas (acoustic neuromas): the facial nerve preservation and restitution of function / M. Samii, C. Matthies // Neurosurgery. — 1997. — Vol. 40(4). — P. 684–694. DOI: 10.1097/00006123–199704000–00006.
5. Falcioni, M. Facial nerve function after vestibular schwannoma surgery / M. Falcioni, P. Fois, A. Taibah A et al. // J Neurosurg. — 2011. — Vol. 115(4). — P. 820–826. DOI: 10.3171/2011.5.JNS101597.
6. Tveiten, O. V. Patient- versus physician-reported facial disability in vestibular schwannoma: an international cross-sectional study / O. V. Tveiten, M. L. Carlson, F. Goplen et al. // J Neurosurg. — 2017. — Vol. 127(5). — P. 1015–1024. DOI: 10.3171/2016.8.JNS16707.
7. Koerbel, A. Evolution of vestibular schwannoma surgery: the long journey to current success / A. Koerbel, A. Gharabaghi, S. SafaviAbbasi et al. // Neurosurg Focus. — 2005. — Vol. 18(4). — P. e10. DOI: https://doi.org/10.3171/foc.2005.18.4.11
8. Rivas, A. A model for early prediction of facial nerve recovery after vestibular schwannoma surgery/ A. Rivas, K. D. Boahene, H. C. Bravo et al. // Otol Neurotol. — 2011. — Vol. 32(5). — P. 826–833. DOI: 10.1097/MAO.0b013e31821b0afd.
9. Socolovsky, M. 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 / M. Socolovsky, S. Roberto, G. Masi // Acta Neurochir. — 2016. — Vol. 158. — P. 945–957. DOI: 10.1007/s00701–016–2767–7.
10. Yetiser, S. Immediate Hypoglossal-Facial Anastomosis in Patients With Facial Interruption / S. Yetiser // The Journal of Craniofacial Surgery. —2017. — Vol. 00. — P. 00. DOI: 10.1097/SCS.0000000000004150.
11. Yetiser, S. Hypoglossal-facial nerve anastomosis: a meta- analytic study / S. Yetiser, U. Karapinar // Ann Otol Rhinol Laryngol. — 2007. — Vol. 36. — P. 303–308. DOI: 10.1177/000348940711600710.
12. Dziedzic, T. A. Hemihypoglossal-Facial Nerve Anastomosis for Facial Nerve Reanimation: Case Series and Technical Note / T. A. Dziedzic, P. Kunert, A. Marchel // World Neurosurg. — 2018. — Vol. 118. — P. e460-e467. DOI: 10.1016/j.wneu.2018.06.217.
13. Ozsoy, U. The hypoglossal-facial nerve repair as a method to improve recovery of motor function after facial nerve injury / U. Ozsoy, A. Hizay, B. M. Demirel et al. // Ann Anat. — 2011. — Vol. 193. — P. 304–13. DOI: 10.1016/j.aanat.2011.01.009.
14. Ferraresi, S. End-to-side intrapetrous hypoglossal–facial anastomosis for reanimation of the face. Technical note / S. Ferraresi, D. Garozzo, V. Migliorini et al. // J Neurosurg. — 2006. — Vol. 104. — P. 457–60. DOI: https://doi.org/10.3171/jns.2006.104.3.457.
15. Ghali, S. Reanimation of the middle and lower face in facial paralysis: Review of the literature and personal approach / S. Ghali, A. MacQuillan, A. O. Grobbelaar // J Plast Reconstr Aesthet Surg. — 2011. — Vol. 64. — P. 423–31. DOI: 10.1016/j.bjps.2010.04.008.
16. Guntinas-Lichius, O. Postoperative functional evaluation of different reanimation techniques for facial nerve repair / O. Guntinas-Lichius, M. Streppel, E. Stennert // Am J Surg. — 2006. — Vol. 191. — P. 61–7. DOI: 10.1016/j.amjsurg.2005.05.054.
17. Shipchandler, T. Z. Split hypoglossal-facial nerve neurorrhaphy for treatment of the paralyzed face / T. Z. Shipchandler, R. Seth, D. S. Alam // Am J Otolaryngol. — 2011. — Vol. 32. — P. 511–6. DOI: 10.1016/j.amjoto.2010.09.007.
18. May, M. Hypoglossal-facial nerve interpositional-jump graft for facial reanimation without tongue atrophy / M. May, S. M. Sobol, S. J. Mester // Otolaryngol Head Neck Surg. — 1991. — Vol. 104. — P. 818–825. DOI: 10.1177/019459989110400609.
19. Cusimano, M. D. Partial hypoglossal to facial nerve anastomosis for reinnervation of the paralyzed face in patients with lower cranial nerve palsies: technical note / M. D. Cusimano, L. Sekhar // Neurosurgery. — 1994. — Vol. 35. — P. 532–533. DOI: 10.1227/00006123–199409000–00027.
20. Darrouzet, V. New technique of side-to-end hypoglossal-facial nerve attachment with translocation of the infratemporal facial nerve / V. Darrouzet, J. Guerin, J. P. Bebear // J Neurosurg. — 1999. — Vol. 90. — P. 27–34. DOI: 10.3171/jns.1999.90.1.0027.
21. Lin, V. Global assessment of outcomes after varying reinnervation techniques for patients with facial paralysis subsequent to acoustic neuroma excision / V. Lin, M. Jacobson, J. Dorion et al. // J. Otol Neurotol. — 2009. — Vol. 30(3). — P. 408–13. DOI: 10.1097/MAO.0b013e31819a8e26.
22. House, J. W. Facial nerve grading system / J. W. House, D. E. Brackmann // Otolaryngol Head Neck Surg. — 1985. — Vol. 93. — P. 146– 147. DOI: 10.1177/019459988509300202.
23. VanSwearingen, J. M. The Facial Disability Index: reliability and validity of a disability assessment instrument for disorders of the facial neuromuscular system / J. M. VanSwearingen, J. S. Brach // Physical Therapy. — 1996. — Vol. 76(12). — P. 1288–98. DOI: 10.1093/ptj/76.12.1288.
24. Socolovsky M. Bell’s palsy and partial hypoglossal to facial nerve transfer: Case presentation and literature review / M. Socolovsky, M. D. Paez, G. D. Masi et al. // Surgical Neurology International. — 2012. — Vol. 3(1). DOI:10.4103/2152–7806.95391.
25. Gao, Z. Neurorrhaphy for facial reanimation with interpositional graft: Outcome in 23 patients and the impact of timing on the outcome / Z. Gao, X. H. Jia, J. Xu et al. // World Neurosurg. — 2019. — Vol. S1878–8750(19). — P. 30547–9. DOI: 10.1016/j.wneu.2019.02.124.
26. Пустовой, C. В. Комплексная коррекция дисфункции лицевого нерва в хирургии базальных опухолей задней черепной ямки: Автореф. дисс. канд. мед. наук / C. В. Пустовой. — Спб., 2010. — 103с.
27. Biglioli F. Facial reanimations: part II — long-standing paralyses / F. Biglioli // Head of Maxillo-Facial Surgery Unit. — 2015. — Vol. 53(10). — P. 907–12. DOI: 10.1016/j.bjoms.2015.07.001.
28. Terzis, J. K. Developmental facial paralysis: a review / J. K. Terzis, K. Anesti // J Plast Reconstr Aesthet Surg. — 2011. — Vol. 64. — P. 1318–33. DOI: 10.1016/j.bjps.2011.04.015.
29. Lieber, R. L. Structural and functional changes in spastic skeletal muscle. / R. L. Lieber, S. Steinman, I. A. Barash et al. // Muscle Nerve. — 2004. — Vol. 29(5). — P. 615–627. DOI: 10.1002/mus.20059.
30. Malik, T.H. A comparison of surgical techniques used in dynamic reanimation of the paralyzed face / T. H. Malik, G. Kelly, A. Ahmed et al. // Otol Neurotol. — 2005. — Vol. 26(2). — P. 284–91. PMID: 15793421
31. Fu, L. Psychological distress in people with disfigurement from facial palsy / L. Fu, C. Bundy, S. A. Sadiq // Eye (Lond). — 2011. — Vol. 25. — P. 1322–6. DOI: 10.1038/eye.2011.158.
32. Bradbury, E. T. Psychological and social factors in reconstructive surgery for hemi-facial palsy / E. T. Bradbury, W. Simons, R. J. Sanders // J Plastic Reconstr Aesth Surg. — 2006. — Vol. 593 (3). — P. 272–278. PMID: 16673541.
Review
For citations:
Nechaeva A.S., Ulitin A.Yu., Pustovoy S.V., Tastanbekov M.M. HYPOGLOSSAL-FACIAL NERVE ANASTOMOSIS FOR MANAGEMENT OF FACIAL PALSY. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2019;11(3):32-37. (In Russ.)
Views:
22
Email this article 