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Author Topic: masseter to facial nerve transfer  (Read 8003 times)

rsteph

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masseter to facial nerve transfer
« on: March 27, 2009, 07:16:02 am »
Anyone familiar with this surgical procedure or known anyone that has had this procedure 'masseter to facial nerve transfer'     http://www.methodistfacialparalysis.com/masseter/       ??
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3.7 cm AN Translab Aug 08' 100 percent removal UT Southwestern - CSF leak, Bacterial Meningitus. Rt side Facial Paralysis.  Partial facial movement returned 11 months post op.  Still healing

Jim Scott

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Re: masseter to facial nerve transfer
« Reply #1 on: March 27, 2009, 03:15:32 pm »
Rsteph ~

This procedure is new to me and I don't recall seeing it mentioned on the forums (I could be mistaken, of course).  I skimmed the information on the link you provided and it seems quite encouraging.  The before-and-after photos are impressive.   I trust you'll receive more feedback as more folks see this thread. 

Jim
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4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

lori67

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Re: masseter to facial nerve transfer
« Reply #2 on: March 27, 2009, 03:39:39 pm »
I've never heard of this one either.  I had the hypoglossal - facial nerve graft and am doing well with it.  But I can see how this one would have its advantages and it looks like they've had some good results.

I'd be interested to hear what you find out about it.

Lori
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Right 3cm AN diagnosed 1/2007.  Translab resection 2/20/07 by Dr. David Kaylie and Dr. Karl Hampf at Baptist Hospital in Nashville.  R side deafness, facial nerve paralysis.  Tarsorraphy and tear duct cauterization 5/2007.  BAHA implant 11/8/07. 7-12 nerve jump 9/26/08.

Kaybo

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Re: masseter to facial nerve transfer
« Reply #3 on: March 27, 2009, 04:24:55 pm »
Rsteph~
I quickly looked over the link that you provided.  I had the 7/12 (12 years ago) like Lori and then I also had the Temporalis Tendon Transfer just last year - sounds like this is kind of like the T3 in that the movement/ smile is produced by "clenching".  Are you from Houston?  I have not heard of this doctor but I am certainly not familiar with every doc there! ;)  I used Dr. Brissett last year for some repair work on the T3 that I h ad done in Baltimore (LONG story but he was a friend of the Dr. I used at Johns Hopkins and it was MUCH closer to come there) - anyway, I LOVED him!  How did you find out about this??

K
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Translab 12/95@Houston Methodist(Baylor College of Medicine)for "HUGE" tumor-no size specified
25 yrs then-14 hour surgery-stroke
12/7 Graft 1/97
Gold Weight x 5
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Facial Paralysis-R(no movement or feelings in face,mouth,eye)
T3-3/08
Great life!

nancyann

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Re: masseter to facial nerve transfer
« Reply #4 on: March 27, 2009, 06:34:12 pm »

I've heard of this surgery,  but not involving the nerve.  This looks okay to me.

I would want to ask the doc if you will have voluntary movement or not.
Find out about what the surgery, post op will involve.
I had what Kay had,  the Temporalis Tendon Transfer.  It's for those with paralysis with no chance of recovery.
 I still have right facial paralysis, ( no voluntary movement),  but when I bite down I can raise the corner of my mouth
(so I have a 'Mona Lisa' smile).I am very happy with the results.  I've also had approx. 5 surgeries on my eye, & since using
an oculoplastic surgeon the last 2 surgeries,  my eye looks better than ever !   quite symmetrical !

Take your time !  & check out your options.

Always good thoughts,   Nancy
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2.2cm length x 1.7cm width x 1.3cm  depth
retrosigmoid 6/19/06
Gold weight 7/19/06, removed 3/07
lateral tarsel strip X3
T3 procedure 11/20/07
1.6 Gm platinum weight 7/10/08
lateral canthal sling 11/14/08
Jones tube insert right inner eye 2/27/09
2.4 Gm. Platinum chain 2017
right facial paralysis

rsteph

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Re: masseter to facial nerve transfer
« Reply #5 on: March 28, 2009, 12:53:52 pm »
thank you all for your responses.  My Ent recommended a 7/12 and the plastisurgeon.  The plasitc surgeon said he does about one 7/12 a year, which means none, and said he does not like 7/12 and usually does not see good results and preferred a T3.  I personnally know and visit with two people that have had both and I see their results.  The T3 to me is a last option because it simply connects your mouth by tendon to forehead/jaw muscle.  I can see the tendon on my friend's face.  The Masseter to facial nerve transfer looks promising. Post surgery requires eating soft foods for about a month and wait time is 6 months to year for results.  I went to a local AN meeting and was referred to a doctor in Fort Worth who examined me better than any doctor to date and did it all with his hands.  He told me about a couple of doctors that trained in Canada that were doing some radical surgeries to give a full smile restoration.  So I am still attempting to research them and find where they practice.  There names are Dr. Ralph T. Manktelow, MD and Dr. Ronald M. Zuker, MD if any of you would like to research them.   I located the Houston Facial Paralysis Center Methodist Hosp on my own and was satisfied with the free consultation with the doctor.  He has performed about 15 of these surgeries.  If your nerve was not  cut, he will not see you until a year has past.  Any help would be appreciated as always.  thank you all for your devotion to this forum
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3.7 cm AN Translab Aug 08' 100 percent removal UT Southwestern - CSF leak, Bacterial Meningitus. Rt side Facial Paralysis.  Partial facial movement returned 11 months post op.  Still healing

nancyann

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Re: masseter to facial nerve transfer
« Reply #6 on: March 28, 2009, 01:24:07 pm »
rsteph:  There's also the cross nerve graft,  which is the one I would have chosen had I gone for a nerve graft.  It grafts the facial nerve on the non AN side with
the AN side facial nerve jumping it with a nerve from another area, sometimes the leg, etc.
& I believe it's easier to negotiate (for want of a better term) than using the hypoglossal nerve.
Just another thought,

Always good thoughts,   Nancy
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2.2cm length x 1.7cm width x 1.3cm  depth
retrosigmoid 6/19/06
Gold weight 7/19/06, removed 3/07
lateral tarsel strip X3
T3 procedure 11/20/07
1.6 Gm platinum weight 7/10/08
lateral canthal sling 11/14/08
Jones tube insert right inner eye 2/27/09
2.4 Gm. Platinum chain 2017
right facial paralysis

rsteph

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Re: masseter to facial nerve transfer
« Reply #7 on: March 28, 2009, 01:54:16 pm »
The cross facial nerve graph, 7/12, and T3 were all discussed with my first two consultations  Both plastic surgeons did not favor the cross facial nerve graph. I can't remember why. Outcomes I believe were not good.  I understand that none of us will find a surgeon who is experienced with any of these surgeries because they are rare.  The pros of the masseter to facial nerve transfer are that you have fewer post complications related to tongue, taste, and speech from what I read.  I can move my bottom lip and never had problems with drinking.  The doctor said that was unusual.  Sometimes when I press my tongue against the top of my mouth I  can feel a pulling sensation in my AN side cheek that is paralysed.  IF you are happy with your surgery, that is all that matters.  I know someday they will be able to regrow our facial nerves.  I recently read an article about a man who created the coclear (ms) ear implant.  He has now created a very small device call a 'Bion" that may connect damaged nerves and be activated by a remove device outside your body.  Radical stuff but forthcoming...
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3.7 cm AN Translab Aug 08' 100 percent removal UT Southwestern - CSF leak, Bacterial Meningitus. Rt side Facial Paralysis.  Partial facial movement returned 11 months post op.  Still healing

nancyann

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Re: masseter to facial nerve transfer
« Reply #8 on: March 28, 2009, 02:02:13 pm »
How long ago was your surgery ?   I ask because you can move your lower lip,  no problems drinking (YEA !).
Are you sure further movement won't come back on it's own ?     
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2.2cm length x 1.7cm width x 1.3cm  depth
retrosigmoid 6/19/06
Gold weight 7/19/06, removed 3/07
lateral tarsel strip X3
T3 procedure 11/20/07
1.6 Gm platinum weight 7/10/08
lateral canthal sling 11/14/08
Jones tube insert right inner eye 2/27/09
2.4 Gm. Platinum chain 2017
right facial paralysis

sgerrard

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Re: masseter to facial nerve transfer
« Reply #9 on: March 28, 2009, 02:51:04 pm »
Dr. Ronald Zuker and Dr. Ralph Manktelow:

http://smile-surgery.com/index.html

Steve  :)
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8 mm left AN June 2007,  CK at Stanford Sept 2007.
Hearing lasted a while, but left side is deaf now.
Right side is weak too. Life is quiet.

rsteph

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Re: masseter to facial nerve transfer
« Reply #10 on: March 28, 2009, 04:56:01 pm »
My surgery was Aug 08.  3.7 cm trans.  total removal.  No stimulation at end of surgery.  I hope for some spontaneous movemen but I have no movement yet.  Lots of tingling and more feeling.  Thank you for that link. 
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3.7 cm AN Translab Aug 08' 100 percent removal UT Southwestern - CSF leak, Bacterial Meningitus. Rt side Facial Paralysis.  Partial facial movement returned 11 months post op.  Still healing

nancyann

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Re: masseter to facial nerve transfer
« Reply #11 on: March 28, 2009, 06:02:35 pm »
Wow,  it's only been about 7 months,   take your time finding the right doctor.
because it seems to me you may have more 'natural' movement in the coming months.

I had no nerve stimulation from the moment they hooked up the monitor.
You seem to have some nerve viability,  & you're only in your 7th month of recovery.

Always good thoughts,  Nancy
« Last Edit: March 28, 2009, 06:04:19 pm by nancyann »
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2.2cm length x 1.7cm width x 1.3cm  depth
retrosigmoid 6/19/06
Gold weight 7/19/06, removed 3/07
lateral tarsel strip X3
T3 procedure 11/20/07
1.6 Gm platinum weight 7/10/08
lateral canthal sling 11/14/08
Jones tube insert right inner eye 2/27/09
2.4 Gm. Platinum chain 2017
right facial paralysis

MAlegant

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Re: masseter to facial nerve transfer
« Reply #12 on: March 30, 2009, 07:48:37 pm »
Good to see you posting, rsteph, and I trust you'll make the right decision at the right time.  At 8 months (remember I was just ahead of you) I still have a ways to go before I am completely recovered.  Though I've no paralysis, I've had weakness (gotten better) and numbness and pain, which, just now, is starting to subside or at least is improving somewhat.
Best,
Marci
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3cmx4cm trigeminal neuroma, involved all the facial nerves, dx July 8, 2008, tx July 22, 2008, home on July 24, 2008. Amazing care at University Hospitals in Cleveland.
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