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Long-term electrophysiological assessment after hypoglossal-facial anastomosis

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Abstract

Purpose

To investigate and provide objective documentation of the possible differences in the axonal reinnervation process of facial muscles after hypoglossal-facial nerve anastomosis. Then, to search for the presence of the trigemino-hypoglossal reflex and determine whether it indicates better peripheral recovery.

Methods

Electrophysiological examination performed on 20 patients who had undergone VII–XII anastomosis, with follow-up periods of more than 2 years.

Results

The mean follow-up time after surgery was 4.1 ± 1.3 years (range 2–8 years). The degrees of axonal reinnervation for the orbicularis oculi (OOc) and orbicularis oris (OOr) were 46.91 ± 19.77 and 32.65 ± 14.85, respectively. And the difference between these muscles was statistically significant (p = 0.018) in favor of the OOc. In addition, R1 blink reflexes that were not followed by R2 components were observed in 30% of the patients. However, these 6 patients with short-latency potential did not differ from the others in terms of latency, the amplitude of compound muscle action potential (CMAP), and degree of axonal reinnervation (p > 0.05) at both muscles (OOc and OOr).

Conclusion

The recoveries of the lower face and upper face are different after VII–XII anastomosis, and in our patients the OOc healed better. In addition, R1 blink reflexes that were not followed by R2 components were observed in 30% of the patients. However, the patients with these blink reflexes did not have better peripheral healing in their neuromuscular units, which suggests that the blink reflex is not an indicator for peripheral recovery.

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Acknowledgements

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Funding

The authors declare that they had no financial support to disclose.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Gazi University School of Medicine, Ankara, Turkey

    Hakan Tutar, Fakih Cihat Eravcı, Furkan Karaloğlu, Vildan Baştürk Tutar & Recep Karamert

  2. Department of Otorhinolaryngology, Meram Medical Faculty, Necmettin Erbakan University, Hocacihan Mah. Abdulhamid Han Cad. No:3, Konya, Turkey

    Fakih Cihat Eravcı

  3. Department of Neurology, Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey

    Metin Mercan

  4. Department of Neurology, Gazi University School of Medicine, Ankara, Turkey

    Metin Mercan & İrem Yıldırım

  5. FK Private Clinic, Otorhinolaryngology, Ankara, Turkey

    Furkan Karaloğlu

  6. Private Practice, Otorhinolaryngology, Ankara, Turkey

    Vildan Baştürk Tutar

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  1. Hakan Tutar
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Correspondence to Fakih Cihat Eravcı.

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Approved by the local ethics committee (Approval number: 493/2014).

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Tutar, H., Eravcı, F.C., Mercan, M. et al. Long-term electrophysiological assessment after hypoglossal-facial anastomosis. Eur Arch Otorhinolaryngol 277, 2533–2538 (2020). https://doi.org/10.1007/s00405-020-05954-4

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