Modified hypoglossal-facial nerve anastomosis for peripheral-type facial palsy caused by pontine infarction: A case report and literature review
Xiaomin Cai,
Baimiao Wang,
Tingting Ying,
Mengshu Qian,
Shiting Li
Affiliations
Xiaomin Cai
Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, The Cranial Nerve Disease Center of Shanghai Jiaotong University, Shanghai, 200092, China
Baimiao Wang
Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, The Cranial Nerve Disease Center of Shanghai Jiaotong University, Shanghai, 200092, China
Tingting Ying
Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, The Cranial Nerve Disease Center of Shanghai Jiaotong University, Shanghai, 200092, China
Mengshu Qian
Department of Emergency and Critical Care Medicine, Kong Jiang Hospital of Yangpu District, Shanghai, 200082, China; Department of Emergency, The 904th Hospital of People's Liberation Army (PLA), Medical School of Anhui Medical University, Wuxi, Jiangsu, 214044, China; Corresponding author. Department of Emergency and Critical Care Medicine, Kong Jiang Hospital of Yangpu District, Shanghai, 200082, China. Department of Emergency, The 904th Hospital of People's Liberation Army (PLA), Medical School of Anhui Medical University, Wuxi, Jiangsu 214044, China.
Shiting Li
Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, The Cranial Nerve Disease Center of Shanghai Jiaotong University, Shanghai, 200092, China; Corresponding author. Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, The Cranial Nerve Disease Center of Shanghai Jiaotong University, Shanghai, 200092, China.
Background: Peripheral-type facial palsy could be caused by a lesion in the tegmentum of the pons, such as infarction, with a rare occurrence. We herein described a case of unilateral peripheral-type facial palsy induced by dorsolateral pontine infarction and treated this patient using modified hypoglossal-facial nerve anastomosis. Case presentation: A 60-year-old female presented with dizziness, hearing drop, diplopia, and peripheral-type facial palsy. Brain Magnetic Resonance Imaging showed a dorsolateral pontine infarction on the right side which exactly refers to the location of the ipsilateral facial nucleus or facial nerve fascicles at the pons. Subsequent electrophysiological examinations confirmed poor facial nerve function of this patient and modified hypoglossal-facial nerve anastomosis was then performed. Conclusions: This case reminded medical practitioners not to ignore the possibility of involvement of a central cause in peripheral-type facial palsy patients. In addition, modified hypoglossal-facial nerve anastomosis served as a useful skill improvement that may help reduce hemiglossal dysfunction while restoring facial muscle function.
