A comparative retrospective study: hypoglossofacial versus masseterofacial nerve anastomosis using Sunnybrook facial grading system

Introduction: The aim of our study is to compare the functional results between two surgical techniques for reanimation of facial paralysis: hypoglossal-to-facial versus masseteric-to-facial nerve anastomosis. Methods: This is a retrospective study of 13 patients treated for complete facial paralysis in two medical tertiary centers. The patients were classified into two groups. First group: masseteric-to-facial nerve anastomosis. Second group: hypoglossofacial nerve anastomosis. Sunnybrook facial grading system was used to evaluate the functional results. The mean scores were compared using Mann-Whitney test. The correlation between the age at surgery, the delay in time from the onset of the facial paralysis to the time of surgery and the results of Sunnybrook scores was studied using correlation and linear regression. Results: No significant statistical difference was found between the mean of total score of the two groups (first group=38 +/- 4.898, second group=37.83 +/- 4.956). All the patients treated by hypoglossofacial nerve anastomosis presented with hemiglossal atrophy. We found slight superiority for the masseterofacial nerve anastomosis in dynamic movements, whereas at rest the hypoglossofacial anastomosis is slightly better. All the differences were not statistically significant. No correlation was found between the age at surgery (age range included 32-73 years) and post-operative results. No correlation was found between the delays up to 24 months from the onset of the facial paralysis and post-operative results. Conclusion: Our study showed that both types of anastomosis are effective with comparable results. The masseterofacial nerve anastomosis is preferred when possible to avoid the hemiglossal atrophy and its complications.