Hypoglossofacial Anastomosis –  Three Case Reports

Authors: R. Tomáš;  J. Klener
Authors‘ workplace: Neurochirurgické oddělení, Nemocnice Na Homolce, Praha
Published in: Cesk Slov Neurol N 2015; 78/111(5): 585-590
Category: Case Report


Authors present their early experience with a hemihypoglossofacial anastomosis in the treatment of neurosurgical patients with complete postoperative facial palsy after removal of tumors in the posterior fossa or skull base.

Patients and method:
In three patients undergoing an open surgery for complete facial palsy between 2009 and 2014, the hemihypoglossofacial anastomosis according to Cushimano and Sekhar was performed. Facial palsy was due to a large vestibular schwannoma in two patients and a facial nerve schwannoma in one patient.

Functional reinnervation of grade III according to the House and Brackmann scale was achieved in two patients and reinervation of grade IV in one patient. All patients had mild hemilingual atrophy only that did not lead to any functional disturbances in chewing, swallowing or speech. The mean follow-up period was 39, 3 months.

Our early experience showed very good functional reinervation in patients after hemihypoglosofacial anastomosis. We consider this method together with other modifications (Darrouzet, LeClerc) to be very effective in the treatment of facial plegia with low risk of side effects.

Key words:
facial nerve – facial palsy – hypoglossal nerve – hypoglossofacial anastomosis – end-to-side anastomosis – ansa cervicalis

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.


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Paediatric neurology Neurosurgery Neurology

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