38 The Facial Reanimation: Multidisciplinary Approaches

Alvaro Campero, Amparo Sáenz, Juan F. Villalonga, Guido Caffaratti, Carolina Martins, and Mariano Socolovsky

Abstract

Facial palsy is a devastating condition that can cause aesthetic, functional, and psychological consequences to the patient. Functionally the most relevant defect is lack of corneal lubrication because of inability to close the eyelid or blink. Nevertheless, the loss of facial symmetry and expression have psychosocial devastating effects in the patients. Functional preservation of the facial nerve during removal of lesions in the cerebellar pontine angle has been an ongoing concern in skull base surgeons. In spite of the remarkable development in surgical techniques, facial paralysis is not an uncommon complication, up to 10% of patients undergoing removal of cerebellar pontine angle tumors present with direct injury to the nerve. Various reconstructive techniques have been described, but there is no consensus regarding their indication. The most widely used to date being the classical hypoglossal-facial nerve anastomosis. The aim of this article is to describe the indications for which each technique is used, their results and the ideal time when each one should be applied.

Key words

facial nerve - facial palsy - hypoglossal-facial anastomosis - skull base

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