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Hypoglossal Nerve Transfers
Nerve transfers are indicated when the main trunk of the facial nerve is damaged or unavailable but the distal nerve branches and facial muscles remain viable. These techniques are best suited to cases of facial paralysis less than 2 years in duration. Adjacent functioning nerves can be divided and connected to the damaged facial nerve.
The hypoglossal-to-facial nerve transfer often produces strong facial motion. The recovery of facial movement frequently comes at the expense of some degree of tongue atrophy and impairment of post-operative speech and eating. These problems can be largely overcome by utilizing a partial hypoglossal transfer.
In the partial hypoglossal technique the motor nerve to one side of the tongue is incompletely divided and a nerve graft is utilized to redirect the regenerating nerve fibers to the damaged facial nerve.