Hypoglossal-facial nerve anastomosis. Clinical observation.

We have reviewed 35 cases of hypoglossal-facial nerve anastomosis performed during the past 15 years for irreversible peripheral facial paralysis caused by surgery for acoustic neuroma. Of 27 patients who were followed more than 1 year after anastomosis, recovery of serviceable facial function was obtained in 25 (92.6%). Neural deficits secondary to transection of the hypoglossal-facial nerve were minimal or acceptable in most cases. The overall results were better in patients who underwent this procedure within 3 months after surgery for acoustic neuroma as compared with those who did so after 1 year or more. The 2 patients who underwent intracranial facial nerve reconstruction during surgery for acoustic neuroma and showed poor facial recovery have presented a challenge to our strategy in the treatment of such patients.