Clinical Outcome of Hypoglossal-Facial Nerve Anastomosis in Severe Facial Nerve Paralysis: An Experience from Khyber Pakhtunkhwa

Objectives:  Facial nerve injury is one of the most devastating complications occurring as a result of any chemical, mechanical or ischemic insult. This study aimed to determine the surgical outcomes of limited experience in lower motor neuron facial palsy in the last decade. Materials and Methods:  A Prospective case series was done at Neurosurgery Department, Prime Teaching Hospital, MTI Lady Reading Hospital, and Irfan General Hospital Peshawar Khyber Pakhtunkhwa Pakistan. Patients were diagnosed after thorough clinical examination and radiological findings; conduction studies these as severe facial paralysis (House and Brackmann 4 – 6). Surgical treatment is done with end-to-end hypoglossal-facial nerve anastomosis. Outcomes and complications were documented. Entered data into specifically designed proforma. Results:  Out of 13 patients, who underwent a surgical procedure, 8 were male (61.5%) and 5 patients were female (38.5%). The mean age of presentation was 46 years. Patients were labeled on House and Brackmann scale. Improvement was defined as ? 1 grade improvement on the H&B scale, after 1 year of follow-up, 11 patients improved (84.6%) while 2 (15.4%) remained static. The complication was observed as hemiatrophy of the tongue without physiological weakness. Conclusion:  Hypoglossal-Facial nerve anastomosis is recommended treatment for severe facial paralysis, during the first year of insult. Keywords:  Facial Nerve Paralysis, Hypoglossal-facial nerve, House & Brackmann.