Facio-hypoglossal anastomosis for the treatment of facial palsy after acoustic neuroma resection

Abstract

Despite current micro-neurosurgical techniques the facial nerve may be irrecoverably damaged in up to 40% of operations for large acoustic neuromas. The results of 121 facio-hypoglossal anastomoses performed since 1960 for post-operative facial palsy are reported. Patients began to recover facial function after an average of 2.5 months and at final follow-up 91% had good function (grade 2 or 3 according to Lye³). The functional result was dependent on the age of the patient, those over 50 years having a poorer, but still acceptable result. The result was not critically dependent on the delay in performing the procedure; in 10 patients with non-functioning but nevertheless intact nerves, the procedure was delayed for 12–15 months to allow for spontaneous recovery, with little detriment to outcome. There was no operative mortality and only minimal morbidity from hypoglossal loss.

Key Words:

• Acoustic neuroma
• facial palsy
• facio-hypoglossal anastomosis