Comparison of 3 procedures for hypoglossal-facial anastomosis.
The HB grading system House and Brackmann, was used to evaluate the severity of paralysis before the anastomosis, at the first rehabilitation assessment and at follow-up sessions 12, 18 and 36 months after surgery. Although we tried to measure abnormal coactivation contraction of muscles, it is possible that there may be abnormal whisker synchronization. However, many patients receiving HFA experience disturbing abnormal synchronous movements synkinesis of the facial e. Their paralysis have a cosmetic effect due to facial cosmetic and function asymmetry due to changes in tearing and peribuccal muscle tone. Proximal to its descending branch we open a window in the epineurium in the lateral most portion of the hypoglossal nerve, in order to visualize the funiculi. Argomenti di Terapia Occupazionale.
Hypoglossal–Facial Nerve Anastomosis | SpringerLink
During the next phase, at the first signs of reinnervation, patients, using mirror feedback, need to learn which tongue positions thrust against teeth or palate produce the desired facial expressions. Clinical assessment The HB grading system House and Brackmann, was used to evaluate the severity of paralysis before the anastomosis, at the first rehabilitation assessment and at follow-up sessions 12, 18 and 36 months after surgery. Most of our patients, who underwent targeted rehabilitation, already had good facial symmetry at 18 months after surgery. Facial nerve function had to be reported according to the House-Brackmann scale. Timing is therefore a fundamental issue in HFA, especially after facial nerve injury in CPA, as in vestibular schwannoma surgery. The maximal retraction angle in degrees was subtracted from the maximal protraction angle and divided by the mean whisking amplitude obtained from intact animals.
The distal segment of the sural nerve is tunneled to the contralateral gingivobuccal sulcus and tagged with a hemoclip and prolene suture. Indeed, despite significant advances in microsurgical and neurootological techniques, functional recovery remains less than optimal [ 4 , 8 ]. This value was used to estimate whisker movements in comparison to intact animals. The Status of Neurosurgery. In terms of individuals seeking lower facial reanimation, there are a few key issues that need to be determined.