Acta Neurochirurgica

, Volume 149, Issue 12, pp 1205–1210 | Cite as

Surgical results of the Hypoglossal-Facial nerve Jump Graft technique

  • L. P. Flores
Clinical Article


Background. The Hypoglossal-Facial nerve crossover has appeared as a surgical option for those scenarios where the facial nerve is injured in its intracranial course, but the conventional technique unequivocally leads to twelfth cranial nerve deficit. In recent years a number of different surgical approaches have been introduced with a view to avoiding the complete section of the hypoglossal nerve, such as the Jump Graft technique. This paper aims to present the results of the Hypoglossal-Facial nerve Jump Graft technique in relation to facial musculature reanimation capability and hemitongue function preservation.

Methods. A retrospective analysis of the records of eight patients submitted to Hypoglossal-Facial nerve Jump Graft technique was performed. The surgical approach was characterised by the interposition of a short graft sutured to the distal stump of the transected facial nerve and sutured end-to-side to the hypoglossi, with cutting of only a third of the diameter of the latter.

Findings. The facial nerve injuries were secondary to temporal bone trauma in five cases and to cerebellopontine angle tumour surgery in three. Grafts were harvested from the greater auricular nerve in six patients and from the sural nerve in two. The results of facial reanimation demonstrated facial symmetry and improvement in the facial tone in all cases, and classified as House-Brackmann grade IV in three (37.5%) and grade III in five (62.5%) patients. There was no incidence of definitive hemitongue atrophy and no patient complaint of swallowing or speech difficulty.

Conclusions. The modification of the conventional technique of Hypoglossal-Facial nerve anastomosis by means of sectioning one third of the hypoglossal nerve area does not lead to dysfunction of this nerve and the surgical results in terms of facial reanimation are satisfactory.

Keywords: Hypoglossal-Facial anastomosis; nerve graft; cranial nerve surgery; temporal bone trauma. 


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  1. Arai, H, Sato, K, Yanai, A 1995Hemihypoglossal-facial nerve anastomosis in treating unilateral facial palsy after acoustic neurinoma resectionJ Neurosurg825154PubMedCrossRefGoogle Scholar
  2. Asaoka, K, Sawamura, Y, Nagashima, M, Fukushima, T 1999Surgical anatomy for direct hypoglossal-facial nerve side-to-end “anastomosis”J Neurosurg91268275PubMedGoogle Scholar
  3. Bernat, I, Vitte, E, Lamas, G, Soudant, J, Willer, JC, Tankere, F 2006Related timing for peripheral and central plasticity in hypoglossal-facial nerve anastomosisMuscle Nerve33334341PubMedCrossRefGoogle Scholar
  4. Donzelli, R, Maiuri, F, Peca, C, Cavallo, LM, Motta, G, de Divitiis, E 2005Microsurgical repair of the facial nerveZentralbl Neurochir666369PubMedCrossRefGoogle Scholar
  5. Farraresi, S, Garozzo, D, Migliorini, V, Buffatti, P 2006End-to-side intrapetrous hypoglossal-facial anastomosis for reanimation of the face. Technical noteJ Neurosurg104457460Google Scholar
  6. Fernandes, E, Pallini, R, Palma, P, Lauretti, L 1997Hypoglossal-facial nerve anastomosisJ Neurosurg87649650Google Scholar
  7. Franco-Vidal, V, Blanchet HLiguoro, D, Darrouzet, V 2006Side-to-end hypoglossal-facial nerve anastomosis with intratemporal facial nerve translocation. Long-term results and indications in 15 cases over 10 yearsRev Laryngol Otol Rhinol12797102Google Scholar
  8. Guntinas-Lichius, O, Streppel, M, Stennert, E 2006Postoperative functional evaluation of different reanimation techniques for facial nerve repairAm J Surg1916167PubMedCrossRefGoogle Scholar
  9. Hammerschlag, PE 1999Facial reanimation with jump interpositional graft hypoglossal facial anastomosis and hypoglossal facial anastomosis: evolution in management of facial paralysisLaryngoscope109123PubMedCrossRefGoogle Scholar
  10. House, JW, Brackmann, DE 1985Facial nerve grading systemOtolaryngol Head Neck Surg93146147PubMedGoogle Scholar
  11. Koh, KS, Kim, JK, Kim, CJ, Kwun, BD, Kim, SY 2002Hypoglossal-facial crossover in facial nerve palsy: pure end-to-side anastomosis techniqueBr J Plast Surg552531PubMedCrossRefGoogle Scholar
  12. Malik, TH, Kelly, G, Ahmed, A, Saeed, SR, Ramsden, RT 2005A comparation of surgical techniques used in dynamic reanimation of the paralyzed faceOtol Neurotol26284291PubMedCrossRefGoogle Scholar
  13. Manni, JJ, Beurskens, CH, van de Velde, C, Stokroos, RJ 2001Reanimation of the paralyzed face by indirect hypoglossal-facial nerve anastomosisAm J Surg182268273PubMedCrossRefGoogle Scholar
  14. May, M 2000Nerve substitution techniques: XII–VII Hook-up, XII–VII Jump Graft and Cross-Face GraftSchaitken, BMMay, M eds. The facial nerve: May’s2Thieme Medical PubNew York611635Google Scholar
  15. Rebol, J, Milojkovic, V, Didanovic, V 2006Side-to-end hypoglossal-facial anastomosis via transposition of the intratemporal facial nerveActa Neurochir (Wien)148653657CrossRefGoogle Scholar
  16. Rosenwasser, RH, Liebman, E, Jimenez, DF, Buchheit, WA, Andrews, DW 1991Facial reanimation after facial nerve injuryNeurosurgery29568574PubMedCrossRefGoogle Scholar
  17. Salame, K, Ouaknine, GE, Arensburg, B, Rochkind, S 2002Microsurgical anatomy of the facial nerve trunkClin Anat159399PubMedCrossRefGoogle Scholar
  18. Sawamura, Y, Abe, H 1997Hypoglossal-facial nerve side-to-end anastomosis for preservation of hypoglossal function: results of delayed treatment with a new techniqueJ Neurosurg86203206PubMedGoogle Scholar
  19. Streppel, M, Heiser, T, Stennert, T 2000Historical development of facial nerve surgery with special reference to hypoglossal-facial nerve anastomosisHNO48801808GerPubMedCrossRefGoogle Scholar
  20. Vacher, C, Dauge, MC 2004Morphometric study of the cervical course of the hypoglossal nerve and its application to hypoglossal facial anastomosisSurg Radiol Anat268690PubMedCrossRefGoogle Scholar
  21. Tatagiba, M, Matthies, C, Sammi, M 1994Facial nerve reconstruction in neurofibromatosisActa Neurochir (Wien)1267275CrossRefGoogle Scholar
  22. Tatagiba M, Marques E, Sammi M (2003) Anastomose hipoglosso facial. In: Tatagiba M, Mazzer N, Aguiar PHP, Pereira CU (eds) Nervos Periféricos. Rio de Janeiro Ed. Revinter, pp 131–134Google Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • L. P. Flores
    • 1
  1. 1.Unit of NeurosurgeryHospital de Base do Distrito Federal BrasíliaDistrito FederalBrazil

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