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

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.