Hypoglossal-Facial Anastomosis in Complete Unilateral Facial Palsy

Hypoglossal-facial nerve anastomosis is a popular technique for the treatment of unilateral complete facial palsy when restoration of the continuity of the facial nerve by grafting or repair is not possible. Thirteen cases of complete facial palsy treated with hypoglossal-facial nerve anastomosis between 1984 and 1995 are reviewed. In 11 patients good facial symmetry at rest was restored. All patients achieved voluntary facial movements to varying degrees by learned changes in placement of the tongue. Hemi-atrophy of the tongue was eventually noted in all cases, being marked in 2. However, no patient described subjective difficulty with speech or swallowing. Twelve of the 13 patients expressed satisfaction with the outcome of the procedure.