Meeting with Surgeon

[janitorx]

Hi!  Well, I met with a surgeon this morning to discuss some reconstructive options and here's the scoop:  7-12 jump would not be effective in my case because the nerve was intact after the surgery and I have had some nerve regeneration since then.  I would be a good candidate for either the sural nerve graft or the T3 procedure.  I could have this done within two weeks, but he suggested I wait a few months because he finds the presence of a crease by my mouth very encouraging.  The cheek on my paralyzed side also moves a bit when i purse my lips.

I am willing to wait a few months because I'd hate to have an unnecessary procedure.  I am also getting used to it--Although, I hate being photographed.

That said, are any of you willing to share your experiences with either procedure.

Thanks so much!

[lori67]

Well, I'm certainly not questioning your doctor, but I had an intact facial nerve and some very minor regeneration after my translab and I had the 7-12.  I waited until my 18 month post-op point to give my facial nerve an opportunity to come back to life on it's own, but I only had very minimal movement at that point (5 on the House-Brackmann scale) and the movement I did have was not useful.

I had the 7-12 at the end of this past September and was told it would be about 6 months before I'd see any improvement, but about 2 weeks after, my eye started to tear and in the past few weeks my mouth is symmetrical at rest, I see some fluttering in my eyelid, like it wants to blink, I can feel my earlobe, which I haven't been able to feel for almost 2 years now and last night my husband noticed that the muscle just below my cheekbone was twitching.  I'm taking all of these as good signs of things to come.

I've also had 2 people that I see only sporadically tell me that I look much better than the last time they saw me.  That makes me feel better, but I am like you and I hate having my picture taken.  Of course, I didn't really like it taken even before all this!   

I don't know about the other surgeries, but I'm sure Kay and Nancy can chime in on the T3.  Good idea to investigate all your options.

Good luck!
Lori

[saralynn143]

I think waiting a few more months is a jim-dandy idea since you are comfortable doing that.

I understand not liking to be in photographs. I think I look much worse in photos than I do in person. I noticed the same thing about LADavid and Lainie in the photographs and video from the Los Angeles get-together. In the photos you could see their facial weakness while it was not noticeable in the video. My theory is that a stationary photo can't capture the dynamics of our facial expressions.

Lori, I am so happy about your progress. I'll be watching for updates from both of you.

Sara

[Kaybo]

Oh my GOODNESS, LORI... you didn't tell me about the progress - WHOO-HOO for you!!

JanitorX~
I would be more than happy to talk with you about the T3 surgery - I had it this past March.  I am SO glad and I love the results!!  HOWEVER, I WOULD WAIT!  Of course, you wouldn't have to wait as long as I did (12 years)!!  LOL!!  Aside from wasting time & money if you don't need to, I would hate to inhibit the natural healing process if you are having already - I NEVER had any movement whatsoever!

K

[catlover]

Hi,
Now I get curious! I have no idea what a T3 or a 7-12 are, but I understand that it is some kind of surgery that you can do with your nerves if you have paralysis after surgery. Is that correct? Can you tell little more about how these surgeries are made and what is the outcome.

I'm only curious and want to know about everything that can help you heal afterwards. 

Hope you had a great New Year!

Hugs from Helene

[saralynn143]

Here is an excerpt from one of my favorite websites, Management of Facial Paralysis after Intercranial Surgery:
(http://neurosurgery.mgh.harvard.edu/CranialBaseCenter/b95.htm#Reconstruction)

Each patient with facial paralysis requires a detailed analysis of the individual's particular concerns and physical deformities. Multiple surgical techniques have been described and advocated for facial reanimation after facial nerve paralysis. In our experience the most versatile technique for early facial reanimation utilizes temporalis muscle transposition. This technique can be used to achieve early facial reanimation and improve facial symmetry without affecting potential facial nerve recovery. Because of this, it can be performed in the early postoperative period when long-term results remain uncertain. Patients can expect an immediate improvement in facial symmetry at rest, and in the majority of cases, movement in the corner of the mouth which allows the patient to produce an organized and controlled smile within six weeks of the operation.

So T3 surgery will not halt nor inhibit future nerve regeneration. I suppose that the patient would just have to quit biting down to produce a smile once normal smile function returns.

Sara

[jazzfunkanne]

Hi if your having movment i would wait at least 3 years, i am just seeing improvments at 2 years post op.

[janitorx]

It is a tough call.  What bothers me the most is not having a smile.  I am leaning towards waiting until next fall and then possibly having the T3. 

Kaybo, does the T3 guarantee at least a pseudo-smile?  Also, how long is the recovery time? 

[nancyann]

Hi there  janitorx:  there are pictures of my before/after T3 surgery:  it's under this topic Facial Issues, go to page 8, scroll about 1/2 way down, the subject is Post Temporalis Transfer - the pictures are on pg. 2.  The pictures are 7 weeks post op.  My face was still swollen, I can't remember how long before it finally came back to 'normal' - maybe 6-8 months ?,  but you can see the results right away.   My right side is still paralyzed but it looks much more symmetrical.   
I agree with everyone else re:  waiting for 'nature' to do it's thing.  I was 1 year & 5 months before the T3 procedure, also, my facail nerve was cut & re-attached, so no nerve growth/movement (still none).
I wish you all the best.    Always good thoughts,    Nancy

[Kaybo]

JanitorX~
I don't really know if the T3 "guarantees" anything - actually, I think that the information that Sara put up is more than I even knew when I had the surgery done!  I just had gone SO long (12 years) with NO movement that I was willing to give anything a shot!     I guess that the healing time really varies from person to person...I know that Nancy said 6-8 months...I don't think mine was near that long...& I had LOTS of complications (don't worry - has only happened to 1 other person, but if something "CAN" happen, it will happen to me!).  Yes, you can definitely see results immediately - even thru the bruising!  I don't know what area you are in, but I went (from Texas) to Baltimore and had Dr. Patrick Byrne do it and LOVE, LOVE, LOVED him!  It is my understanding that he is the one that pioneered this (or at least in the states) - no one else was doing it last spring!  I would DEFINITELY recommend him!  Please feel free to ask anything else I can TRY to help you with!

K

[leapyrtwins]

JanitorX -

as Kaybo and Nancy both said, they had the T3 and the pictures I saw of each of them are phenomenal.  A big difference post op.

Lori -

you didn't tell me about your great progress from the 7/12 surgery either, but then again, I should have asked (sorry) 

Like K said "WHOO-HOO" 

Jan

[saralynn143]

I just want to add that all of the post-op pictures I have seen are closed-mouth smiles. Biting down pulls up the corner of the mouth into a "Mona Lisa" type smile. If you are looking for the return of a big toothy grin, the T3 will not help with that.

Sara

[Kaybo]

VERY good point, Sara - I should have pointed that out b/c I had a HUGE "toothy" smile before and now it is close-mouth BUT better than NOTHING...well, 1/2, not NOTHING!

K   

[lori67]

I'm being cautiously optimistic about the movements I see!  They are so minimal that I'm probably the only one who notices - unless you are really looking for it.

I'm just waiting on the referral from my doctor to go through my insurance company so I can start PT!

This is the one time I was fully prepared to wait 6 months to see any results, and I'm hoping it's a sign of good things to come that I'm seeing anything at all at this point.

Helene, I'm not sure anyone answered your question about the different procedures.  While I can't answer any about the T3 since I never had it, I know if you search under facial issues, there are all sorts of posts about the 7-12 - or if you want to look it up on the internet, like I did initally, it's also called a hypoglossal-facial nerve anastamosis.

Lori

[saralynn143]

janitorx, please be sure to check out this post called Facial Progress posted by Jeanlea. It took three years, but she made AMAZING progress. I revisit this post every time I am feeling impatient or frustrated.

http://anausa.org/forum/index.php?topic=7247.0

Sara