Han Ji Hyuk, Suh Mischelle J, Kim Jin Won, Cho Hyun Sang, Moon In Seok
a Department of Otorhinolaryngology , Yonsei University College of Medicine , Seoul , Korea.
b Department of Otorhinolaryngology-Head and Neck Surgery , Seoul Veterans Hospital , Seoul , Korea.
Acta Otolaryngol. 2017 Jan;137(1):99-105. doi: 10.1080/00016489.2016.1212398. Epub 2016 Aug 12.
In this series, the split type hypoglossal-facial nerve anastomosis resulted in more favorable outcomes in terms of both facial function and tongue atrophy.
This study compared surgical techniques for hypoglossal-facial nerve anastomosis after schwannoma removal and evaluated which technique achieves better facial outcomes and less tongue morbidity.
This study included 14 patients who underwent hypoglossal-facial nerve anastomosis after schwannoma removal and were followed for more than 1 year. Three surgical techniques were performed: end-to-end, end-to-side, and split anastomoses. Facial palsy and tongue atrophy after anastomosis were evaluated using the scales suggested by House-Brackmann and Martins, respectively. Tumor volume and the time to surgery were also evaluated, and the effects on facial outcomes were analyzed.
Overall, nine of 14 (64.3%) patients had favorable facial outcomes, and eight of 14 (57.1%) had favorable tongue outcomes. Regarding facial palsy, five of seven (71.4%) end-to-end, three of four (75%) split, and only one of three (33.3%) end-to-side patients had favorable facial function. Regarding tongue atrophy, all three (100%) end-to-side, three of four (75%) split, and two of seven (28.6%) end-to-end patients had favorable tongue outcomes. The effects of tumor volume and time to surgery on facial outcome were not significant.
在本系列研究中，就面部功能和舌萎缩而言，劈裂型舌下神经 - 面神经吻合术产生了更有利的结果。
本研究比较了神经鞘瘤切除术后舌下神经 - 面神经吻合术的手术技术，并评估哪种技术能实现更好的面部效果和更低的舌部并发症发生率。
本研究纳入了14例在神经鞘瘤切除术后接受舌下神经 - 面神经吻合术且随访时间超过1年的患者。实施了三种手术技术：端端吻合、端侧吻合和劈裂吻合。分别使用House - Brackmann和Martins建议的量表对面神经麻痹和吻合术后的舌萎缩进行评估。还评估了肿瘤体积和手术时间，并分析了它们对面部效果的影响。
总体而言，14例患者中有9例（64.3%）面部效果良好，14例中有8例（57.1%）舌部效果良好。关于面神经麻痹，端端吻合的7例患者中有5例（71.4%）、劈裂吻合的4例患者中有3例（75%）、端侧吻合的3例患者中仅有1例（33.3%）面部功能良好。关于舌萎缩，端侧吻合的3例患者全部（100%）、劈裂吻合的4例患者中有3例（75%）、端端吻合的7例患者中有2例（28.6%）舌部效果良好。肿瘤体积和手术时间对面部效果的影响不显著。
