[Analytical study of the treatment of facial paralysis by hypoglossal-facial anastomosis. Apropos of 25 cases]. / Etude analytique du traitement de la paralysie faciale par anastomose hypoglosso-faciale. A propos de 25 cas.

ABSTRACT

Hypoglosso-facial anastomosis (HFA) is an already old alternative for the surgical treatment of facial paralysis. 25 patients, 17 men and 8 women, with complete facial paralysis were operated according to this technique, 6 to 12 months after onset of the paralysis. Based on analysis of the results, the authors describe the advantages and disadvantages of this technique. The advantages are facial symmetry at rest, protection of the cornea, voluntary movements of facial muscles. The disadvantages are paralysis and atrophy of one side of the tongue, absence of expression of emotional and involuntary states on one half of the face, synkinesia, disorders of mastication. Disorders of deglutition improve with time. In this series of 25 patients, the authors never observed eyelid movements independent of movements of the labial commissure. By comparing these advantages and disadvantages, the authors consider that HFA should no longer be proposed for the treatment of facial paralysis. In the current state of microsurgery, if the facial nerve cannot be repaired by direct suture or graft, the authors recommend revascularized, reinnervated muscle transfer onto the facial nerve of the healthy side.