Pons Y, Gauthier J, Dagain A, Conessa C, Clement P, Desgeorges M, Poncet J L
Hôpital d'Instruction des Armées du Val de Grâce, Service d'ORL et de Chirurgie Cervico-Faciale, 74 Boulevard de Port Royal, 75230 Paris Cedex 05, France.
Rev Laryngol Otol Rhinol (Bord). 2009;130(3):169-74.
To evaluate the long term functional and esthetical results of the patients who underwent a facial palsy rehabilitation surgery by a hypoglossal-facial anastomosis.
In this retrospective study, 11 patients (8 males and 3 females) with a complete facial palsy (grade VI House-Brackmann) due to an otoneurosurgery performed between 1985 and 2006 (6 vestibular schwannomas, 1 facial schwannoma of the geniculate ganglion and 4 meningiomas) were evaluated (with the help of an auto-questionnary, a physical exam and electromyography) between July and september in 2008.
The voluntary palpebral closure was obtained in 8 cases out 11 (grade III of House-Brackmann). The lingual hemiatrophy was constant. It was major for the patients who didn't take part in a specific re-education. In these cases patients had troubles during feeding and elocution.
The hypoglossal-facial is a dynamic surgical rehabilitation of choice for the facial palsy. It nearly achived 80% of good palpebral results. The end-to-end anastomosis gives a lingual hemiatrophy which is not the case with a side to end anastomosis. This atrophy can be reduced with an intensive and specific reeducation. Moreover this re-education improves the functionnal and the esthetical results for the patients who underwent an hypoglossal-facial anastomosis. This lingual hemiatrophy was then responsible for troubles for feeding and elocution.
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