NDLI: Rehabilitation of central facial paralysis with hypoglossal-facial anastomosis.

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Rehabilitation of central facial paralysis with hypoglossal-facial anastomosis.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Corrales, C. Eduardo Gurgel, Richard K. Jackler, Robert K.
Description	Country affiliation: United States Author Affiliation: Corrales CE ( Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California 94305-5739, USA.)
Abstract	OBJECTIVE: To evaluate the ability of hypoglossal-facial nerve anastomosis to reanimate the face in patients with complete nuclear (central) facial nerve palsy. STUDY DESIGN: Retrospective case series. SETTING: Tertiary academic medical center. PATIENTS: Four patients with complete facial nerve paralysis due to lesions of the facial nucleus in the pons caused by hemorrhage due to arteriovenous or cavernous venous malformations, stroke, or injury after tumor resection. INTERVENTION: All patients underwent end-to-end hypoglossal-facial nerve anastomosis. MAIN OUTCOME MEASURES: Facial nerve function using the House-Brackmann (HB) scale and physical and social/well-being function using the facial disability index. RESULTS: The mean age of the patients was 53.3 years (range, 32-73). There were 3 female and 1 male patients. All patients had preoperative facial function HB VI/VI. With a minimum of 12 months' follow-up after end-to-end hypoglossal-facial anastomosis, 75% of patients regained function to HB grade III/VI, and 25% had HB grade IV/VI. Average facial disability index scores were 61.25 for physical function and 78 for social/well-being, comparable to results from complete hypoglossal-facial anastomosis after peripheral facial nerve palsy after acoustic neuroma resection. CONCLUSION: Patients with nuclear facial paralysis who undergo end-to-end hypoglossal-facial nerve anastomosis achieve similar degrees of reanimation compared with those with peripheral facial nerve palsies. This raises the intriguing possibility that reinnervation may also be of benefit in patients with the vastly more common facial dysfunction because of cortical stroke or injury.
File Format	HTM / HTML
ISSN	15317129
Issue Number	8
Volume Number	33
e-ISSN	15374505
Journal	Otology & Neurotology
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2012-10-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Humans Middle Aged Male Facial Nerve Intracranial Hemorrhages Journal Article Case Reports Facial Paralysis Vascular Malformations Etiology Surgery Adult Diplopia Female Retrospective Studies Disability Evaluation Complications Discipline Otolaryngology Nerve Regeneration Magnetic Resonance Imaging Pathology Central Nervous System Vascular Malformations Neurologic Examination Recovery Of Function Hypoglossal Nerve Otologic Surgical Procedures Anastomosis, Surgical Craniotomy Abducens Nerve Diseases Aged Rehabilitation Methods Hearing Loss
Content Type	Text
Resource Type	Case study Article
Subject	Otorhinolaryngology Sensory Systems Neurology (clinical)

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