Reanimation of the face after facial nerve palsy resulting from resection of a cerebellopontine angle tumour

Abstract

Twenty-three patients with facial nerve paralysis following surgery for a cerebellopontine angle tumour had a facial-hypoglossal anastomosis and simultaneous anastomosis of the cervical ansa with the distal stump of the hypoglossal nerve. In 18 patients, simultaneously with the neural anastomoses, additional transpositions of the temporalis and masseter muscles were performed. At follow-up examination 3–87 months after reconstructive surgery, eight patients had House grade II, ten grade III and five grade IV outcome. The EMG evidence of reinnervation was observed 5–11 months after anastomosis. Combination of the facial-hypoglossal anastomosis with simultaneous myoplasty and with anastomosis of the distal hypoglossal nerve stump to the ansa cervicalis provides the advantage of immediate protection against ophthalmic complications, prevents hemiatrophy of the tongue and gives good functional results when reinnervation of the facial muscles takes place.

Key Words:

• Cerebello-pontine angle tumour
• facial palsy
• facial-hypoglossal anastomosis
• myoplasty
• cervical ansa