{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:55:16Z","timestamp":1790668516606,"version":"4.1.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Science and Technology"},{"name":"Shanghai Science and Technology Commission"},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Traditional end-to-end hypoglossal-to-facial anastomosis (HFA) was a common surgical procedure for uncured severe facial palsy, however, was related to tongue dysfunction. We developed a modified hypoglossal-to-facial anastomosis (MHFA) procedure with the additional process of the anastomosis of the transected hypoglossal nerve and the ramus descendens hypoglossi, aiming to salvage the tongue function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively collected 45 cases of MHFA in our center from January 2020 to December 2022. A comparative analysis was conducted from MHFA and 27 cases of HFA in the early stage at our center. The tongue disability index was used to evaluate the tongue function during the follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were comparable between HFA (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f27) and MHFA (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f45) groups (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05). MHFA demonstrated longer operative time (198.27 vs. 157.78\u202fmin,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Up to the last follow-up, MHFA showed superior outcomes: smaller tongue deviation angle (13.38\u00b0\u202f\u00b1\u202f9.56\u00b0 vs. 23.86\u00b0\u202f\u00b1\u202f10.52\u00b0, mean difference 10.47\u00b0[95%CI 5.65\u201315.29],\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), lower incidence of severe deviation (&amp;gt;30\u00b0: 8.9% vs. 37.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.003), and reduced tongue-related complications (24.4% vs. 66.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Specifically, MHFA had significantly fewer swallowing (11.1% vs. 37.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.009) and articulation defects (13.3% vs. 44.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.003). TDI scores were markedly lower in MHFA (1.63\u202f\u00b1\u202f0.53 vs. 2.23\u202f\u00b1\u202f0.50, mean difference 0.60 [0.34\u20130.85],\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), particularly in swallowing, articulation, and psychological subdomains (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Strong correlation existed between tongue deviation and TDI scores (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.890,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Facial nerve recovery showed no intergroup difference (HB score improvement: 2.40\u202f\u00b1\u202f0.69 vs. 2.33\u202f\u00b1\u202f0.73,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.699).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MHFA appears promising for reducing tongue morbidity, but its clinically relevant advantage over HFA requires prospective validation using standardized outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1738616","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T05:36:30Z","timestamp":1789968990000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Revaluation of the tongue function of the modified hypoglossal-to-facial transfer: a comparative cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Ying","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Department of Pathology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongding","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinda","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baimiao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomin","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianda","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luonan","family":"Ni","sequence":"additional","affiliation":[{"name":"Neurological Disease Prevention and Treatment Center, Yanjin County People's Hospital","place":["Yanjin, Yunnan Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gongqiang","family":"Li","sequence":"additional","affiliation":[{"name":"Neurological Disease Prevention and Treatment Center, Yanjin County People's Hospital","place":["Yanjin, Yunnan Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunling","family":"Jiang","sequence":"additional","affiliation":[{"name":"Neurological Disease Prevention and Treatment Center, Yanjin County People's Hospital","place":["Yanjin, Yunnan Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lifeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiting","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"ref1","article-title":"Bell's palsy","volume":"2014","author":"Holland","year":"2014","journal-title":"BMJ Clin Evid"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1424","DOI":"10.1177\/02692155221110727","article-title":"Physical therapy for facial nerve paralysis (bell's palsy): an updated and extended systematic review of the evidence for facial exercise therapy","volume":"36","author":"Khan","year":"2022","journal-title":"Clin Rehabil"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e245","DOI":"10.3346\/jkms.2020.35.e245","article-title":"Acute peripheral facial palsy: recent guidelines and a systematic review of the literature","volume":"35","author":"Kim","year":"2020","journal-title":"J Korean Med 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