[Hypoglossofacial anastomosis, results in 19 cases].

Hypoglossofacial anastomoses was performed in 19 patients, in the majority of cases for tumors located in the pontocerebellar angle. Results were a total success in 16 cases, one patient has not been seen again, and operation had been performed too recently to assess results in two cases. Anastomosis was conducted during initial surgery in 12 cases, and at a later stage in the other 7. In one patient, anastomosis 3 years after facial paralysis following excision of an acoustic nerve neuroma resulted in satisfactory re-innervation of the face after 13 months. Results were not significantly different in 6 patients with an intramastoid anastomosis and in 13 where it was performed in the parotid region. In 11 cases, a classical anastomosis was performed, involving suture of the XIIth and VIIth nerve trunks (type I anastomosis). A more complex procedure in the remaining 8 cases involved separate anastomosis of the XIIth and facial nerve branches, with, in some patients, implantation of sternothyroid muscle fragments, supplied by the descending branch of XII, into the orbicularis muscle. Results were good using these modifications, but valid comparison with those following classical methods cannot be made at the present time. Technical features of the procedure employed are described. Hypoglossofacial anastomosis is currently the only method giving satisfactory constant results when end-to-end suturing of the facial nerve or a superficial cervival plexus graft is obligatory.