Hypoglossal-facial anastomosis in facial nerve damage of various etiologies

Facial nerve injury is a common complication during surgical interventions on the middle ear and skull base, particularly in cases of cerebellopontine angle and temporal bone tumors. When proximal nerve reconstruction is not possible, hypoglossal-facial anastomosis is considered one of the most effective methods for reinnervation. This study presents a retrospective analysis of 36 surgical procedures involving end-to-end hypoglossal-facial anastomosis in patients with facial nerve injury of various etiologies. The effectiveness was assessed using the House–Brackmann scale and facial muscle electromyography over a 12-month postoperative period. The results demonstrated gradual recovery of facial muscle function, especially in the orbicularis oculi and frontalis regions, with positive dynamics in 77.4% of cases. Complete facial symmetry was restored in nearly half of the patients. However, the technique is associated with potential complications such as hemiglossal atrophy and speech difficulties. The findings support the rationale for early anastomosis - within 12 months of injury — and highlight the need for further optimization of surgical and rehabilitative strategies