Skip to main content Accessibility help

The surgical management of bilateral facial paralysis: case report

  • A Hardy (a1), J Muzaffar (a1), R Kumar (a1) and R Irving (a1)



Unilateral total facial palsy is a debilitating condition that can affect an individual's physical, social and emotional wellbeing. When this occurs bilaterally, the severity of impact is extreme, with significant cosmetic disfigurement and functional morbidity. A variety of facial reanimation techniques have been used for unilateral facial weakness of varying House–Brackmann grades, and these are also applicable in bilateral cases. In bilateral cases, it is difficult to gauge successful improvement in comparison to the contralateral side, which also is afflicted.

Case report

This paper presents our experience with a bilateral facial paralysis patient who had a complex otological history. The patient, who presented with bilateral debilitating grade VI facial palsy, achieved a good result from bilateral facial reanimation with sequential hypoglossal–facial anastomosis. This is considered a reasonable option in cases of bilateral facial paralysis.


Corresponding author

Author for correspondence: Mr Alistair Hardy, Department of Otolaryngology, Queen Elizabeth University Hospital, Mindelsohn Way, Birmingham B16 2GW, UK E-mail:


Hide All

Mr A Hardy takes responsibility for the integrity of the content of the paper



Hide All
1Körte, W. A case of nerve grafting of the facial nerve to the hypoglossal nerve [in German]. Dtsch Med Wochenschr 1903;17:293–5
2Mohamed, A, Omi, E, Honda, K, Suzuki, S, Ishikawa, K. Outcome of different facial nerve reconstruction techniques. Braz J Otorhinolaryngol 2016;82:702–9
3Han, JH, Suh, MJ, Kim, JW, Cho, HS, Moon, IS. Facial reanimation using hypoglossal-facial nerve anastomosis after schwannoma removal. Acta Otolaryngol 2017;137:99105
4May, M, Sobol, S, Mester, S. Hypoglossal-facial nerve interpositional-jump graft for facial reanimation without tongue atrophy. Otolaryngol Head Neck Surg 1991;104:818–25
5Beutner, D, Luers, JC, Grosheva, M. Hypoglossal-facial-jump-anastomosis without an interposition nerve graft. Laryngoscope 2013;123:2392–6
6Guntinas-Lichius, O, Streppel, M, Stennert, E. Postoperative functional evaluation of different reanimation techniques for facial nerve repair. Am J Surg 2006;191:61–7
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed