Abstract
We report the results of a histological study of facial nerve specimens obtained at the time of faciohypoglossal anastomosis. We examined sections from 24 patients using light and electron microscopy in order to determine the extent of the degenerative process with time and its relationship to the functional results of the anastomosis. We graded the histological features associated with degeneration, regeneration, and fibrosis on an ordered nominal scale from 0 to 3 and correlated them with duration of facial palsy and postoperative facial function. There was no histological evidence of increasing collagenosis or fibrosis with duration of facial palsy, and endoneural fibrosis was a very infrequent finding. There was no evidence that the relative numbers of endoneural fibrocytes or the degree of collagenosis had any bearing on the functional result. The presence of large numbers of endoneural tubes, containing nonmyelinated axons, showed a positive correlation with the postoperative facial function, whereas the presence of active axon degeneration showed a negative correlation.
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- Conley J., Baker D. C. Hypoglossal-facial nerve anastomosis for reinnervation of the paralyzed face. Plast Reconstr Surg. 1979 Jan;63(1):63–72. doi: 10.1097/00006534-197901000-00011. [DOI] [PubMed] [Google Scholar]
- Felix H., Eby T. L., Fisch U. New aspects of facial nerve pathology in temporal bone fractures. Acta Otolaryngol. 1991;111(2):332–336. doi: 10.3109/00016489109137396. [DOI] [PubMed] [Google Scholar]
- Fisch U. Surgery for Bell's palsy. Arch Otolaryngol. 1981 Jan;107(1):1–11. doi: 10.1001/archotol.1981.00790370003001. [DOI] [PubMed] [Google Scholar]
- Frey M., Happak W., Girsch W., Bittner R. E., Gruber H. Histomorphometric studies in patients with facial palsy treated by functional muscle transplantation: new aspects for the surgical concept. Ann Plast Surg. 1991 Apr;26(4):370–379. doi: 10.1097/00000637-199104000-00013. [DOI] [PubMed] [Google Scholar]
- Gavron J. P., Clemis J. D. Hypoglossal-facial nerve anastomosis: a review of forty cases caused by facial nerve injuries in the posterior fossa. Laryngoscope. 1984 Nov;94(11 Pt 1):1447–1450. [PubMed] [Google Scholar]
- Hitselberger W. E. Hypoglossal-facial anastomosis. Otolaryngol Clin North Am. 1974 Jun;7(2):545–550. [PubMed] [Google Scholar]
- SUNDERLAND S., BRADLEY K. C. Denervation atrophy of the distal stump of a severed nerve. J Comp Neurol. 1950 Dec;93(3):401–409. doi: 10.1002/cne.900930304. [DOI] [PubMed] [Google Scholar]
- Sabin H. I., Bordi L. T., Symon L., Compton J. S. Facio-hypoglossal anastomosis for the treatment of facial palsy after acoustic neuroma resection. Br J Neurosurg. 1990;4(4):313–317. doi: 10.3109/02688699008992740. [DOI] [PubMed] [Google Scholar]
- Ylikoski J., Brackmann D. E., Savolainen S. Facial nerve abnormalities after acoustic tumor removal. Morphological and clinical study of seven patients with postoperative facial paralysis. Arch Otolaryngol. 1982 Dec;108(12):795–800. doi: 10.1001/archotol.1982.00790600039009. [DOI] [PubMed] [Google Scholar]
- Ylikoski J., Hitselberger W. E., House W. F., Sanna M. Degenerative changes in the distal stump of the severed human facial nerve. Acta Otolaryngol. 1981 Sep-Oct;92(3-4):239–248. doi: 10.3109/00016488109133260. [DOI] [PubMed] [Google Scholar]