Facial nerve anastomosis

Although medical technology is developing continuously and the number of successful surgeries is very high, there are still some cases of failure of facial nerve anastomosis. The face is the most important part of the human body. If the face has problems due to the failure of surgery, or even the nerves on the face have problems, it means that many hazards may occur. Therefore, facial nerve anastomosis must be understood about the surgical process as well as the evolution and development of the surgery.

1What is hypoglossal nerve-facial nerve anastomosis surgery?

When the facial nerve near the intracranial segment is severely damaged and cannot be repaired, the hypoglossal nerve trunk (or part of the nerve bundle) is anastomosed to the facial nerve, which is called hypoglossal-facial nerve anastomosis. After anastomosis, the facial expression muscles can receive impulses from the hypoglossal nerve and produce certain facial movements. Zhou Lei, Department of Otolaryngology, Zhongshan Hospital, Fudan University

2What are the evolution and development of hypoglossal nerve anastomosis surgery?

This is an ancient surgery with a long history. Modern facial nerve surgery no longer uses this procedure to reconstruct facial expressions. However, due to the lack of popularization of professional knowledge, some doctors still use this method when accidents occur during surgery, but it is difficult to achieve good results clinically.

3. To what extent can facial paralysis be recovered after hypoglossal nerve-facial nerve anastomosis?

The hypoglossal nerve is different from the facial nerve itself and cannot maintain the shape of the facial muscles. Therefore, patients who undergo hypoglossal nerve-facial nerve anastomosis will experience slow facial droop. The hypoglossal nerve drives facial expressions, which require actions such as the tongue pressing against the teeth, and the expressions are very unnatural.

4How is the hypoglossal nerve-facial nerve anastomosis coordinated?

This procedure can cause severe synkinesis and cause great pain to the patient. Some patients even ask to have the nerve cut off.

5What is the value of hypoglossal nerve anastomosis?

This surgery is a temporary remedy for unexpected loss of the facial nerve. Consult a facial nerve surgeon as soon as possible after surgery for other remedial surgery

6How to remedy the failure of hypoglossal nerve-facial nerve anastomosis?

Depending on the postoperative timing, either masseter-facial nerve anastomosis or free muscle transplantation can be chosen, and patients will achieve a better facial smile while avoiding linkage.

Facial nerve-hypoglossal nerve anastomosis

Classification

Otolaryngology/Inner ear and acoustic nerve, facial nerve surgery/Surgery for facial nerve paralysis

Indications

Anastomosis of the hypoglossal nerve to the facial nerve is indicated for:

Regardless of the cause of facial nerve injury, as long as the distal end of the facial nerve can be found and there is no fiber degeneration of the facial muscles, the proximal end of the nerve with at least some motor fibers can be anastomosed with the distal end of the facial nerve.

If the patient is a singer or orator who needs flexible tongue movements, facial nerve-hypoglossal nerve anastomosis cannot be performed, and anastomosis with the accessory nerve is more appropriate.