Zusammenfassung
Anhand von 10 Fällen mit Hypoglossus-Fazialis-Anastomose werden Methode, Ergebnis
und die Stellung zur Nerventransplantation besprochen. Unter strenger Indikation stellt
das genannte Verfahren einen effektiven Eingriff zur Rehabilitation der gelähmten
Gesichtshälfte dar. Die Ergebnisse in diesem Bereich sind um so besser, je mehr eine
solche Operation dem Zeitpunkt des Nervenausfalles angeschlossen wird. Die oralen
Behinderungen sind gering und stehen in keinem Verhältnis zum Gewinn des wiedererlangten
Gesichtsmuskeltonus.
Summary
Ten patients with unilateral facial nerve paralysis had been treated by hypoglossal-facial
nerve approximation in the years 1971-1979. The proximal part of the facial nerve
inside the petrous bone and at the inner ear entrance had been destroyed by tumor
or accident without chance for repair. Therefore the hypoglossal nerve had been used
to contact the intact main tunk and its intact peripheral nerve and mimic muscle system.
3 to 4 epineural nerve sutures had been placed with 8/0 vicryl suture material for
approximation. In one patient anastomosis could be obtained by splitting the hypoglossal
nerve with remarkable result to the mimic function, while the muscular atrophy of
the tongue was minimal.
With regard to the results the achieved mimic reinnervation took place in 3,5 to 6
months, but was found to be refined up to 2 years. Oral discomfort, swallowing, and
speech disorders lasted 2œ to 6 weeks postoperatively, depending upon the age and
the patients mental activity, since the patient has to learn by using his tongue for
mimical expressions. The final result obtained a balanced closure of the mouth and
eyes, a complete movement of the lips and cheeks, a rarely delayed innervation of
the frontal muscles. Due to reinnervation the denervated half of the tongue had developed
a marked increase of activity from nerve fiber in growth of the intact side. The patient
finally feels little to complain about the favourable facial result.
