Management of Traumatic Injury of the Facial Nerve: XII./VII. Cranial Nerve Anastomosis

Orkhan ALİZADAa, Mustafa Onur ULUb
aBaşkent University İstanbul Hospital, Department of Neurosurgery, İstanbul, Türkiye
bİstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Neurosurgery, İstanbul, Türkiye

Alizada O, Ulu MO. Management of traumatic injury of the facial nerve: XII./VII. cranial nerve anastomosis. In: Sanus GZ, Batıoğlu Karaaltın A, eds. Surgical Management of Facial Nerve Paralysis. 1st ed. Ankara: Türkiye Klinikleri; 2022. p.133-8.

Article Language: EN

ABSTRACT
Facial nerve (FN) palsy is one of the most devastating nerve injuries. Its social effect on patients life is crucial because it causes disruption of the symmetry of the face, failure to close the eye and difficulty in swallowing. Notwithstanding drastic developments in the microneurosurgery field, FN palsy remains the headmost complication of vestibular schwannoma (VS) surgery. In case of loss of the proximal part of the FN at the brainstem, destruction of the facial motor nucleus or internal axonotmesis neurotisation technique may be used. On the purpose of reinnervating the FN, several options draw attention. Spinal accessory, phrenic, hypoglossal and contralateral FNs constitute presumptive options for FN reanimation. When evaluated in the context of satisfactory results, hypoglossal-facial end-to-end anastomosis stands out as the most preferred method. In this procedure, which enables reinnervation between 4 and 12 months, it’s possible to obtain satisfactory results in 70% of patients.

Keywords: Facial nevre; hypoglossal nerve; anastomosis; vestibular schwannoma; nerve palsy

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