Extra-Temporal Facial Nerve Reconstruction

Abstract

Hypoglossal-facial anastomosis (HFA) as an end-to-end anastomosis (EEA) has several advantages, and indirect HFA with interposition graft is a safe and excellent method. The extended HFA is the method of choice for all malignant tumors that require extensive resection of the facial plexus, especially when combined with a neck dissection. Facio-facial anastomosis combined with HFA leads to excellent results when resection defect is restricted to the central portion of the facial plexus. Good functional rehabilitation of the musculature of the oral sphincter system is achieved using the hypoglossal nerve. To innervate the musculature of the ocular sphincter system, a facio-facial anastomosis between the nerve trunk and the cranial nerve branches is made using a free nerve transplant. Dynamic reanimation involves nerve repair, nerve transfer, regional muscle transfer, or free-muscle transfer. Dynamic reconstructive techniques can yield improved facial symmetry, spontaneous and symmetrical smile, eye closure and protection, and oral competence.