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Journal of Korean Neurosurgical Society 1994;23(4): 434-441.
Surgical Treatment of Facial Nerve Injury Following Removal of Acoustic Neurinoma.
Chang Wan Oh, Hyun Jib Kim, Dong Gyu Kim, Dae Hee Han
Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
To evaluation effectiveness of internal anastomosis and facial-hypoglossal anastomosis the medical records of 29 patients with facial nerve injury in the course of operation for acoustic neurinoma were reviewed. In 8 patients, the interrupted facial nerves were anastomosed at the end of tumor operation, and facial-hypoglossal anastomoses were performed in 20 patients. One patient underwent facial-hypoglossal anastomosis 6 months after internal anastomosis. All the patients had been treated from January 1983 to March 1993 and were followed up for more than 1 year. After primary internal anastomoses, 7 patients resulted in symmetric face at rest and only one failed to show improvement of facial muscle tone. The mean time to the first evidence of facial reinnervation was 5.3 months. In 20 patients with facial-hypoglossal anastomosis, improvement of facial muscle tone was demonstrated in 19 patients and in one patient there was no improvement. Thirteen cases(68%) showed facial symmetry at rest and 5 of them could close their eyes completely. The first evidence of reinnervation was noted between 3 and 12 months after anastomosis with a mean of 6.3 months. The anastomoses were performed between 8 days and 22 months after injury of the facial nerve, and the time to reinnervation after anastomosis was significantly influenced by the duration of nerve injury(P=0.0439). Primary internal anastomosis revealed better recovery of facial muscle function compared with facial-hypoglossal anastomosis(P=0.0299).
Key Words: Interanl anastomosis; Facial-hyplglossal anastomosis; Facial nerve injury; Acoustic neurinoma
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