Direct intratemporal facial nerve to hypoglossal nerve coaptation for facial reanimation
Reviewed by Bilal Gani Taib

The hypoglossal nerve is a common axonal source for dynamic facial nerve rehabilitation. In its regular and modified forms of splitting the nerve it is associated with tongue hemiatrophy, speech and swallow dysfunction, facial movement and hyper contracture. This case series looks at 20 patients between 2005–2014 that underwent facial re-animation. This was done by exposing the mastoid segment of the facial nerve, which measures between 15 and 20 mm and tunnelling this through the parotid gland to join the hypoglossal nerve. Of the patients analysed 16/17 patients had improved facial animation. The median time for return of facial muscle one was 7.3 months (2.0–12.0 months). There was a significant reduction in facial asymmetry. No patient developed any tongue pathologies. One patient who had their nerve coaptation proximal to the ansa cervicalis branching point developed mild facial movement on swallowing which resolved over time. In conclusion, this case series suggests that this is an effective technique with minimal morbidity.

Transposition of the intratemporal facial to hypoglossal nerve for reanimation of the paralyzed face: the VII to XII transpositiontechnique.
Kochhar A, Albathi M, Sharon JD, et al.
JAMA FACIAL PLASTIC SURGERY
2016;18(5):370-8.