To investigate the efficacy and safety of hypoglossal-facial nerve anastomosis in the treatment of peripheral facial paralysis associated with surgery for cerebellopontine angle lesions.

A retrospective analysis was conducted on the clinical data of 37 patients with peripheral facial paralysis after resection of cerebellopontine angle lesions who were admitted to the Department of Neurosurgery, the First Medical Centre, Chinese PLA General Hospital from July 2011 to March 2022. All patients underwent hypoglossal-facial nerve end-to-end anastomosis. The facial nerve function of patients before and after operation was evaluated by House-Brackmann (H-B) grading system and the complications after anastomosis were documented. There were 3 cases of H-B grade Ⅴ and 34 cases of H-B grade Ⅵ before operation. We also explored the factors affecting the recovery of facial nerve function in patients.

At 12 months post operation, H-B grade Ⅱ was reported in 4 cases, grade Ⅲ in 29 cases, grade Ⅳ in 3 cases and grade Ⅴ in 1 case. The rate of effectiveness (defined as postoperative H-B grade of Ⅰ-Ⅲ) was 89.2% (33/37). The recovery of facial nerve function was related to the course of facial paralysis (P=0.001), which it had no correlation with the patient′s gender, age or preoperative H-B grade (all P>0.05). At 12-month follow-up post operation, there were no significant complications such as dysarthria or dysphagia.

Hypoglossal-facial nerve end-to-end anastomosis is an effective method for peripheral facial paralysis after resection of cerebellopontine angle lesions and the complications seem mild. Patients with facial paralysis lasting for ≤ 6 months may have better facial nerve function recovery after anastomosis.

Facial paralysis; Neurosurgical procedures; Treatment outcome; Hypoglossal-facial nerve anastomosis; Root cause analysis