Hypoglossal-Facial Nerve Anastomosis in Facial Reanimation: A Review

Abstract

With the advancement in surgical techniques and instrumentation, especially after the introduction of operating microscopes and neuromonitoring, the incidence of iatrogenic facial nerve (FN) injury has decreased dramatically. However, the incidence of trauma and the traumatic injuries to the temporal bone/skull base have been increasing steadily, resulting in debilitating injury to the FN. Therefore, there has been a renewed interest among surgeons for various facial reanimation procedures. The backbone of these procedures is the hypoglossal-facial nerve anastomosis, which was introduced by Korte al [1]. However, this classical hypoglossal-facial nerve anastomosis leads to hemiglossal atrophy. To prevent hemiglossal atrophy and improve the quality of life, this classical procedure had undergone several modifications. In this review article, in addition to the description of classical hypoglossal-facial nerve anastomosis and its various modifications, we will discuss the management issues in patients with FN injuries.