Department of Otolaryngology, Hospital Universitario La Paz, Madrid, Spain.
IdiPAZ Research Institute, Madrid, Spain.
Head Neck. 2022 Jul;44(7):1678-1689. doi: 10.1002/hed.27076. Epub 2022 May 4.
This study evaluates facial and tongue function in patients undergoing side-to-end hypoglossal-to-facial transfer (HFT) with additional techniques.
Thirty-seven patients underwent a side-to-end HFT. Twelve had additional cross-face grafts, and 9 had an additional masseter-to-facial transfer. Facial was assessed with House-Brackmann (HB), Sunnybrook Facial Grading Scale (SFGS), and eFACE. Martins scale and the Oral-Pharyngeal Disability Index (OPDI) were used to assess tongue function.
Ninety-four percent of cases reached HB grades III-IV. Mean total SFGS score improved from 16 ± 15 to 59 ± 11, while total eFACE score from 52 ± 13 to 80 ± 5. Dual nerve transfers were a predictor for a better eFACE total score p = 0.034, β = 2.350 [95% CI, 0.184-4.516]), as well as for a higher SFGS total score (p = 0.036, β = 5.412 [95% CI, 0.375-10.449]). All patients had Martin's grade I. Mean postoperative OPDI scores were 84 ± 17 (local physical), 69 ± 16 (simple and sensory motor components), 82 ± 14 (complex functions), and 73 ± 22 (psychosocial).
The side-to-end HFT offers predictable facial function outcome and preserves tongue function in nearly all cases. Dual nerve transfers appear to improve the final outcome.
本研究评估了接受舌下神经-面神经侧端吻合术（HFT）并附加其他技术的患者的面部和舌功能。
37 例患者接受了侧端 HFT。其中 12 例接受了额外的面横肌移植，9 例接受了咬肌-面神经转移术。使用 House-Brackmann（HB）、Sunnybrook 面部分级量表（SFGS）和 eFACE 评估面部功能。Martins 量表和口腔 - 咽功能障碍指数（OPDI）用于评估舌功能。
94%的病例达到 HB 分级 III-IV。平均总 SFGS 评分从 16±15 提高到 59±11，而总 eFACE 评分从 52±13 提高到 80±5。双重神经转移是 eFACE 总分更好的预测因素（p=0.034，β=2.350[95%CI，0.184-4.516]），也是 SFGS 总分更高的预测因素（p=0.036，β=5.412[95%CI，0.375-10.449]）。所有患者的 Martins 分级均为 I 级。术后平均 OPDI 评分分别为 84±17（局部生理）、69±16（简单和感觉运动成分）、82±14（复杂功能）和 73±22（社会心理）。
侧端 HFT 可提供可预测的面部功能结果，并在几乎所有情况下保留舌功能。双重神经转移似乎可以改善最终结果。
