Hypoglossofacial anastomosis for facial palsy after resection of acoustic neuroma.

Twelve patients with facial palsy after resection of acoustic neuromas were treated by hypoglossofacial anastomosis. The nerve anastomosis were performed 1-2 months after resection of the tumor in 10 cases (group A). Two cases (group B) had the anastomosis performed more than 2 years after damage to the facial nerve. All the cases had been followed for more than 9 months. The results of reinnervation of the paralyzed facial muscles were quite satisfactory, i.e., over 80% of the cases obtained a good functional recovery. Although there was a 2-month delay in functional recovery of group B patients, the final results were practically the same in both groups. Therefore, the effect of the duration of the paralysis of the facial nerve seems to be less important in facial nerve surgery than in nerve surgery of the extremities. The procedures of anastomosis of descendens hypoglossi to the distal stump to the hypoglossal in 7 of the 10 patients using the hypoglossal as the donor nerve was of little help in prevention or restoration of the hemiatrophy of the tongue. In spite of long-term inconvenience in speaking and eating after section of the hypoglossal, all the patients were able to make enough adjustments about 2-3 months after nerve surgery.