Treatment of complete facial palsy in adults: comparative study between direct hemihypoglossal-facial neurorrhaphy, hemihipoglossal-facial neurorrhaphy with grafts, and masseter to ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-03-15

AUTHORS

Mariano Socolovsky, Roberto S. Martins, Gilda di Masi, Gonzalo Bonilla, Mario Siqueira

ABSTRACT

BackgroundThe hypoglossal (with or without grafts) and masseter nerves are frequently used as axon donors for facial reinnervation when no proximal stump of the facial nerve is available. We report our experience treating facial nerve palsies via hemihypoglossal-to-facial nerve transfers either with (HFG) or without grafts (HFD), comparing these outcomes against those of masseteric-to-facial nerve transfers (MF).MethodA total of 77 patients were analyzed retrospectively, including 51 HFD, 11 HFG, and 15 MF nerve transfer patients. Both the House-Brackmann (HB) scale and our own, newly-designed scale to rate facial reanimation post nerve transfer (quantifying symmetry at rest and when smiling, eye occlusion, and eye and mouth synkinesis when speaking) were used to enumerate the extent of recovery.ResultsWith both the HB and our own facial reanimation scale, the HFD and MF procedures yielded better outcome scores than HFG, though only the HGD was statistically superior. HGD produced slightly better scores than MF for everything but eye synkinesis, but these differences were generally not statistically significant. Delaying surgery beyond 2 years since injury was associated with appreciably worse outcomes when measured with our own but not the HB scale. The only predictors of outcome were the surgical technique employed and the duration of time between the initial injury and surgery.ConclusionsHFD 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. More... »

PAGES

945-957

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00701-016-2767-7

DOI

http://dx.doi.org/10.1007/s00701-016-2767-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1031195778

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26979182


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