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Inicio Acta Otorrinolaringológica Española La anastomosis hipogloso-facial como solución a una parálisis facial residual ...
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Vol. 57. Issue 5.
Pages 223-227 (May 2006)
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Vol. 57. Issue 5.
Pages 223-227 (May 2006)
La anastomosis hipogloso-facial como solución a una parálisis facial residual completa. Nuestra experiencia
Hypoglossal facial anastomosis as a solution to a total peripheral facial palsy. Our experience
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D. López Aguado1, D. López Campos, M.E. Campos Bañales
Servicio de O.R.L. Hospital Universitario de Canarias. La Laguna Tenerife).
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Resumen

Realizamos anastomosis hipogloso-facial en cuatro pacientes que presentaban una parálisis facial completa aparecida, en tres casos, tras la exéresis quirúrgica de un neurinoma del acústico y en uno tras la presencia de un proceso expansivo hemorrágico protuberancial. El tiempo transcurrido entre la intervención quirúrgica y la anastomosis hipogloso-facial estaba entre 3 y 12 meses. Los resultados obtenidos fueron valorados en la clínica siguiendo un cuestionario estandarizado y la clasificación de House- Brackmann y electrofisiológicamente mediante la electroneuronografía ENoG). El seguimiento de los pacientes se realizó durante 4 años obteniendo buenos resultados en el movimiento facial en tres pacientes 2 pacientes grado II y 38-40% en la ENoG y un paciente grado III y 35% en la ENoG) y en un paciente fue pobre grado V y 27% en la ENoG). Concluimos que la anastomosis hipogloso-facial da resultados satisfactorios en la recuperación de la motilidad facial fundamentalmente cuando es realizada de manera temprana a la presencia de la parálisis facial.

Palabras clave:
Anastomosis hipogloso-facial
Parálisis facial
Neurinoma del acústico
Aneurisma protuberancial
Abstract

Hypoglossal-facial anastomosis was performed in four patients with total peripheral facial palsy after removal of cerebellopontine tumors three patients with neurinoma) and pontine aneurysm one patient). The anastomosis was performed after a period of 3 months to one year from surgery. The results obtained, concerning the facial activity, were clinically valued according to the tests used questionnary, and the House-Brackmann paralysis index); the EnOG was used for its electrophysiological assessment. The follow-up period was 4 years with a good facial recovery in three patients and poor in one class V, 27% in ENoG). We observe that the improvement in function greatly depends on the early surgical process performance.

Key words:
Hipoglossal-facial nerve anastomosis
Facial palsy
acoustic neurinoma
pontine aneurisma

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