Facial therapy post-op or wait for nerves to regrow? Or both?

[CaliKate]

I just had a retrosigmoid removal of a fast growing 2.7cm AN. The Kaiser neurosurgeon removed the whole tumor because even the outer edge of it was wrapped around the facial nerve. As a result, I have pretty severe palsy and major blurriness in one eye. it doesn’t look like Kaiser provides facial therapy. (Maybe is it better to wait for nerves to grow on their own anyway?)

But, if I wanted to explore this more as a Bay Area resident, what would any of you recommend?
-Facial nerve experts to see?
-Facial massage and/or acupuncture?
-Eye treatment options? Should I be wearing a night patch or a day patch for example?

It just seems like everything I have read talks about the benefit of facial therapy, but none is being provided. Just don’t want to miss an opportunity to work on these weaknesses now if it will help.
Thanks for any advice,
Katrina Ryan

[LakeErie]

If your neurosurgeon has not already told you, you should see an ophthalmologist soon to prevent exposure problems from inadequate eye lid closure. I believe protecting your eye is the most important first consideration in coping with facial paralysis. Drops, gels, punctual plugs ( which block tear drainage, ) moisture chambers, and other measures can be taken to protect your eye. You need professional advice on how to best treat your particular situation until you know how your paralysis resolves.

You do not state exactly how long since your surgery or if your paralysis was immediate or delayed. Were you given any steroids post surgery? Steroids can help inflammation and swelling of the cranial nerves and decadron helped me in both instances of my facial weakness following both surgery and radiation.

I am not an expert, but I do believe most therapists feel giving yourself some time after surgery before starting exercises and other treatments is best. You  have some time to decide about starting these things.

Hope this helps you get started and good luck 

[CaliKate]

I am just a week post-op. I did see an opthamologist yesterday, so I feel a little more prepared on the eye-front of things.

I know so much of the facial nerve issues have to do with waiting for nerve regrowth, so I’m just trying to figure out if doing any massage or accupunture for the face now is just a waste of time, or can it be helpful anyway while awaiting regrowth?

I am on a course of steroids for another week or so. I will be very curious to see what, if any, progress there will be two weeks post-op compared to today.

Thanks LakeErie for your response before!

[Cheryl R]

Facial nerve recovery is a slow process and letting the nerve heal is the most important.      It is super hard for us to be patient and let it work.      It can take several months before you do know what the eventual end result may be.      Trying to do too much too early can cause more problems than letting it heal on its own.       You can do light massage on the face yourself.      Facial muscles do not atrophy like regular muscles do.         Just make sure you are doing good eye care to keep moisture in the eye.          Hang in there.    Many of us know how frustrating it is to wait.                 Cheryl R

[LakeErie]

CaliKate, good to know you have an eye doctor and that you have been, and still are, on steroids. As you know, everyone's recovery is different, but it may help you to know my history. Following GK, paralysis began Jan 24, 2017, I started immediately on prednisone for a week with no result. I then went on a decadron taper for the month of February. I still had no improvement in March, but on April 10th I started to get some movement back. By July I had good lid coverage of my eye and punctual plug was removed. In essence, I went from House Brackkman grade 4 to grade 2 over 3 months. My prior bout with facial weakness was in 2011 after a subtotal surgical removal and it was minimal from the start, grade 2. It resolved completely in a few months after one 2 week taper of decadron.
Just know that steroids do not necessarily have an immediate impact but they can work eventually in many cases.