Abstract
Background: To evaluate the face-specific quality of life after hypoglossal-facial jump nerve suture for patients with long-term facial paralysis.Methods: A single-center retrospective cohort study was performed. Forty-one adults (46% women; median age: 55 years) received a hypoglossal-facial jump nerve suture. Sunnybrook and eFACE grading was performed before surgery and at a median time of 42 months after surgery. The Facial Clinimetric Evaluation (FaCE) survey and the Facial Disability Index (FDI) were used to quantify face-specific quality of life after surgery.Results: Hypoglossal-facial jump nerve suture was successful in all cases without tongue dysfunction. After surgery, the median FaCE Total score was 60 and the median FDI Total score was 76.3. Most Sunnybrook and eFACE grading subscores improved significantly after surgery. Younger age was the only consistent independent predictor for better FaCE outcome. Additional upper eyelid weight loading further improved the FaCE Eye comfort subscore. Sunnybrook grading showed a better correlation to FaCE assessment than the eFACE. Neither Sunnybrook nor eFACE grading correlated to the FDI assessment.Conclusion: The hypoglossal-facial jump nerve suture is a good option for nerve transfer to reanimate the facial muscles to improve facial motor function and face-specific quality of life.
Highlights
Facial nerve reconstruction after complex damage of the peripheral facial nerve, especially if the central stump of the facial nerve is not available for nerve suture, or after longer denervation time, still is a challenge
The jump technique has overcome the until popular classical hypoglossal-facial nerve suture with transposition of the complete hypoglossal nerve and end-to-end nerve suture directly to the facial nerve
A hypoglossal-facial jump nerve suture was proposed to the patient in different scenarios: First, the procedure was indicated if an early reconstruction within 12 months after onset of the lesion was possible, but the facial nerve stump proximal to the lesion was not available, or if the proximal stump was available but the defect was that large that a combined approach was needed [3, 4, 13]
Summary
Facial nerve reconstruction after complex damage of the peripheral facial nerve, especially if the central stump of the facial nerve is not available for nerve suture, or after longer denervation time, still is a challenge. The jump technique has overcome the until popular classical hypoglossal-facial nerve suture with transposition of the complete hypoglossal nerve and end-to-end nerve suture directly to the facial nerve. The complete transection of the Outcome of Hypoglossal-Facial-Jump Nerve Suture hypoglossal nerve unavoidably resulted in homolateral paralysis and hemitongue atrophy. Due to the tongue dysfunction many patients complained of permanent swallowing and speech problems [2]. These problems are not seen after the jump technique with preservation of the function of the hypoglossal nerve. To evaluate the face-specific quality of life after hypoglossal-facial jump nerve suture for patients with long-term facial paralysis
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