Hypoglossal-facial nerve anastomosis: a clinical and electrophysiological follow-up.

Eight patients with acoustic neuroma and five patients with hemifacial spasm, who had undergone hypoglossal-facial nerve anastomosis 1-14 years previously, were reviewed clinically and electrophysiologically with an electrically elicited blink reflex. Functional recovery from the anastomosis, as rigorously judged on a scale of good, fair and poor, was fair to poor. Electrically it was found that the blink reflex was present in eight patients, suggesting facial nerve re-innervation of the facial musculature. This was confirmed by the mild recurrence of hemifacial spasm in four patients. Implications for the future role of this operative procedure are discussed.