Warszawski Uniwersytet Medyczny, ul. Banacha 1 A, 02-097 Warszawa.
Neurol Neurochir Pol. 2011 Sep-Oct;45(5):452-60. doi: 10.1016/s0028-3843(14)60313-3.
Commonly used classic hypoglossal (CN XII) to facial nerve (CN VII) anastomosis has the disadvantage of tongue hemiatrophy. Thus, various attempts have been made to modify this method to reduce the tongue damage. The aim of this report was to present the results of hemihypoglossal-facial nerve anastomosis (HHFA) technique in relation to facial muscles reanimation and hemitongue atrophy.
The first 7 consecutive patients who underwent CN VII anastomosis with half of the CNXII, for which the follow-up period exceeded 12 months, were analysed. During the procedure, CN VII was transected as proximally as possible after drilling the mastoid process. CN XII was separated longitudinally into two parts at a short distance to allow suture of the stumps without any tension. One half of CN XII was transected and sutured to the distal stump of CN VII. Recovery from facial palsy was quantified with the House-Brackmann grading system (HB). Tongue function was assessed according to the scale proposed by Martins.
Features of initial reinnervation of facial muscles were visible after 6 months in all 7 patients. All patients achieved satisfactory outcome of CN VII regeneration (HB grade III) until the last control examination (12-27 months after surgery, mean 16). No or minimal tongue atrophy without deviation (grades I-II according to the Martins scale) was found in 4 patients. Mild hemiatrophy with tongue deviation < 30 degrees (grade III) was visible in 3 patients.
In our experience, HHFA is effective treatment of facial palsy and gives a chance to reduce damage of the tongue.
常用的舌下神经（CN XII）到面神经（CN VII）吻合术有舌半萎缩的缺点。因此，人们尝试了各种方法来修改这种方法以减少舌损伤。本报告旨在介绍半舌下神经-面神经吻合术（HHFA）技术对面部肌肉再神经支配和半舌萎缩的结果。
分析了前 7 例连续接受 CN VII 吻合术和半 CNXII 的患者，随访时间超过 12 个月。在手术过程中，在钻完乳突后尽可能近地切断 CNVII。将 CN XII 纵向分离成两部分，以便在没有任何张力的情况下缝合残端。切断 CN XII 的一半并缝合到 CNVII 的远端残端。用 House-Brackmann 分级系统（HB）量化面瘫的恢复情况。根据 Martins 提出的量表评估舌功能。
7 例患者均在 6 个月后可见面神经初始再支配的特征。所有患者均获得了满意的 CNVII 再生结果（HB 分级 III），直到最后一次检查（术后 12-27 个月，平均 16 个月）。4 例患者无舌萎缩或仅有轻微舌萎缩（根据 Martins 量表为 I-II 级）。3 例患者可见轻度半萎缩，舌偏斜<30 度（III 级）。
根据我们的经验，HHFA 是治疗面瘫的有效方法，并为减少舌损伤提供了机会。
