Facial nerve anatomically in tact with no stimulation at end of surgery

[sbass6508]

Has anyone had no facial nerve stimulation at the end of surgery (but nerve left in tact) and still had facial paralysis recovery? I had no symptoms before surgery and according to my medical records, my tumor was 22mm by 22mm and had covered the facial nerve. The records show facial nerve stimulation throughout surgery until the very end. Electrical current was ran through the flake of tumor during bipolorization. It was at this time the facial nerve stopped responding to stimulation. I was hoping maybe someone has experience in whether this means facial nerve recovery can still occur or if this means it will not. Thanks to everyone and I look forward to reading responses! As always it is helpful to hear from people who have been through this as they know much more than any doctors we can consult with

[v357139]

Sbass,
You can have facial nerve issues even when the nerve in intact.  Even slight jostling of the nerve when the tumor is being dissected off of it can cause facial issues.  You should also ask your doctor what your chances are for facial recovery.  But he may say he does not know.  Recovery is not an exact science.  If you have facial issues, at some point you should definitely go for facial rehab.  I think that will be the only way to know what is possible, to try rehab.  Jackie Diels is supposed to be very good, and she may also have some insight into your questions.

Best of luck and keep us posted.
Rich

[caryawilson]

I know this doesn't help answer your question, but go see Dr. Boahene at Hopkins.  He's a facial reconstruction surgeon.  Amazing doctor.  I know you don't want to consider this, but besides letting you know your options for improving this condition, he can offer you his opinion therapy options.   Ask Dr. Tarmargo's team to help with the appointment.

By the way my facial nerve was surgically removed and Dr. Boahene did AN amazing job in a couple nerve grafts to help reconstruct my face.

[sbass6508]

Caryawilson,
I actually met him on my 6 week follow up and I was very impressed with him. He gave me an eye weight to help since my right eye was not closing. He did this in his office the same day. He mentioned that he read my report and that people with my surgical status tended to be later in progression but that you really couldn't tell. We talked and both decided to see what happens by the 6 month mark when I go back for my second follow up and then consider nerve grafting if I haven't seen any progress. He also told me the earlier you did the nerve graft the better, that by the first three months the better the results would be and that by sixth months it may not be quite as good a result and so on. I noticed this seems to be the opposite advice that many of the other members have posted on here where they were given the advice not to do anything for the first year or so. I guess different doctors have different opinions. I also saw where he had done many facial reconstructions for soldiers with severe facial injuries so in sure he is top notch (not to mention he had a wonderful personality!)

[nancyann]

hi sbass: I had the T3 surgery done by Dr. Patrick Byrne at John's Hopkins - my nerve WAS cut, so no chance of regeneration.  The T3 gave me back some symmetry, and a 'Mona Lisa' smile when I bite down.  Botgh surgeons are phenomenal & I wish you the best!

[caryawilson]

I think the difference in waiting duration between the surgeons, is the time to wait for the nerve to heal itself. Some surgeons prefer to wait a year, while Boahene wants to make a decision quicker than six months. I think the thought is if you are NOT seeing ANY improvement after this time then it will probably not happen. There are always exceptions to this rule, and people have reported improvement after 1-2 years. I haven't seen any  statistical valid analysis but I think it would be safe to assume your odds go down after six months

I had the cross facial graft and trigeminal (jaw) graft. So far only the trigeminal nerve graft worked (so I need to bite to smile). In the end, no guarantees with this stuff.

Also, go see one of the optomologists at Hopkins. Boahene is amazing but you want someone to look closer at the eye.