Results of Phrenicofacial Nerve Anastomosis for Facial Paralysis

SURGICAL treatment of facial paralysis by anastomosis of the facial with the spinal accessory or the hypoglossal nerve has been used since the beginning of the century. Many excellent results have been reported. However, inherent disadvantages result from the use of these nerves. Section of the hypoglossal nerve is followed by hemiparalysis and atrophy of the intrinsic muscles of one side of the tongue and produces a bothersome dysarthria and some disability in manipulating food within the mouth. Section of the spinal accessory nerve produces weakness and atrophy of the trapezius and sternomastoid muscles with asymmetry of the musculature of the neck and shoulder and not infrequent aching discomfort of the shoulder and arm. In either case, associated mimetic movements of the ipsilateral facial muscles occur when the tongue moves or on motions of the head, neck, and shoulder, and emotional and reflex responses fail to return. In certain cases,