Facial paralysis and plastic surgery

[LizH]

Can plastic surgery be used to deal with facial paralysis after AN surgery?  thanks. Effiya

[daylilly]

I will be seeing a plastic surgeon to discuss my facial paralysis. Though I have no movement at all on
the left side of my face, I do have control of my lower lip so they do not want to do a graft. I do
not have a totally dead nerve but a  very severely damaged nerve. I was told when I called that
they would not do any plastic surgery until two years past surgery to allow time for nerve regeneration.
If you google the facial nerve center in Pittsburgh they have a summary of the plastic surgery procedures
that can be done.  Sue

[yardtick]

Hi,
I have AN on my facial nerve in the boney tunnel.  I'm told the entire nerve has to be removed and another nerve will be grafted in its place.  The neurosureon told me he will also give me a mini face lift at the same time.  Maybe I understood him wrong.  He had an intern and resident in with him and he was speaking over my head at them.  I was not prepared for what he told me.  I am seeing him again this coming Tues.  My husband will be with me this time.  I have many questions and I need another pair of ears. 
Anne Marie
 

[Cheryl R]

Hello Anne Marie.           I had a facial neuroma and had surgery for it in March 2006.      My facial nerve was cut and maybe a small piece taken out but not all of it.     I had a piece of nerve taken out of my neck and grafted in.   The incision was was just extended down longer than the regular translab.       I do have numbness in the ear area which has improved a little bit.        I was told not to expect any return of facial function for over 8 mos and that was about right.    I now look pretty much ok if you just look at me but have only a little movement on that side.   I was droopy at first but defintely see improvement.       I never had the face lift part you mentioned.              This was not my first surgery on this side as I had a regular AN already with surgery in 2001.     I have NF2 or bilateral tumors so my tumors grow more aggressively than regular AN's.         This was not a regrowth but a whole new tumor.          The 2nd time around I never had to deal with balance issues too much as had already dealt with that in 2001 and was already deaf on that side.          I also had to have a CSF leak surgery 2 weeks later as my hospital was trying a new type of product to help hold things in in there and it didn't work well and 3 pts had leaks.     They had to go back in and use another product and do more fat packing.          So i was delayed a bit in my recovery but still was back to work in my part time job as a nurse in 2 mos.     I was 53 at the time of this surgery.   
 I hope this helps you and feel free to ask if you have any more questions.
                                           Cheryl R
   

[yardtick]

Hi Bruce,
I live in Ont Canada, and I've been thinking about going to the US for a 2nd opinion.  I do not know if OHIP will cover the cost but I realy do not care.  Since I'm close to the US border can you make a suggestion.  The neurosurgeon I'm seeing is head of the neurology dept at the university in the city I live in and he is the chief neurosurgeon for all of the hospitals in the city.  I see him on Tues and I do want to know how many AN surgeries he has preformed especially the facial type. 
This thing has been a real learning experience.  I was misdiagnosed and it took a year from the first visit to the family dr to the surgery.  Even the ENT had no idea I had AN until the lab results came in.  It wiped out the three bones in my middle ear and destroyed my ear drum.  The dr's could not explain why I had numbness, pain, dizziness and fatigue.  Thankfully the neurologist told me where the AN was located (boney tunnel where all the nerves converge) and it is 9mm in size.  What was the size prior to the 1st surgery?  She put me tegratol and it has help but sometimes nothing helps.
I've read almost everything on line.  I found this site by googling Acoustic Neuroma Forum.  I wish I found it months ago.  I'm going to tell some of my co-workers to read some of the threads.  Maybe they will understand a little bit more. 
Thanks for the welcoming, and your concern,
Anne Marie

[yardtick]

Hi Bruce,
I was told by the neurologist that Cybknife surgery is not an option because the tumor is in the boney tunnel.  The radiation cannot penetrate through the bone.  I will still e-mail the Dr's and see what they have to say.  I was told the location of the tumor is very rare and the fact that it originated on my facial nerve is also very rare.  When I had the surgery the ENT told me he had "debulked" the facial nerve.  He actually suggested going in a year later to see what was going on.  He was very vague at the time.  I asked questions but he said we had to wait and see.  After the MRIs was when he referred me to the neurosurgeon.  I had called the ENT after I saw the neurosurgeon to see if he could explain to me what was going on but he told me I was in Dr Reddy's care now. 
My family Dr has been seeing me on a monthly basis now because he knows I need help in digesting all of the info.  Since  I'm seeing the neurosurgeon on Tuseday I'm going to ask him questions.  I find here in Canada the Dr's do not move as quickly as they should, I feel its all about the OHIP billing.  I'm just sounding off because I'm frustrated.  I'm so glad I found this site.
Thanks again for reading my rambling e-mails,
Anne Marie

[Mark]

Hi Anne Marie,

In response to the statement by your neurologist:

I was told by the neurologist that Cybknife surgery is not an option because the tumor is in the boney tunnel.  The radiation cannot penetrate through the bone.

Ask him what his skull is made out of because I think most of us would say "bone". Last time I checked the radiation had to pass through that to get to the tumor and it's a lot thicker than the IAC ( which I assume is what he means by "boney tunnel"). The facial nerve and hearing nerve both share this canal and even though you have a facial neuroma, it would be the exception for all of us with AN's not to have had it start somewhere in there as well. The radiation enters and exits the skull at a very low dosage for each beam and converges on the Tumor to create a lethal level for the AN.

Personally, I would suggest you finding a new doctor who knows how radiation works 

Mark

[Windsong]

Dear Anne Marie,

I am sending you a private message. Please check that too.

If i understand correctly now, you had an op last year, the growth was removed and now you have a 9 mm facial neuroma in the IAC and they want to take that out? I must say that I am exceedingly perplexed about a surgeon saying that radiation won't go through the bone of the IAC... that is bizzare to say the least.

I had my radiation treatment in Toronto  (PMH) and the team there was marvellous... couldn't have been in better hands. My radiation oncologist deals with many many many brain tumours each year. My neurotologist who has done many many Ans and ear ops and he is also in Toronto. Also has anyone mentioned the GK treatment now available at Toronto Western? I met with them too prior to treatment and discussed things with the director and wonderful neurosuregon and also the radiation oncologist. I made my choice knowing stats and details about all my options.

Seems to me you would benefit from some more research and consultations with some of the top docs here.... was there a neurotologist surgeon involved in your first oepration? Seems to me that with the involvement of your middle ear bones and eardrum and all that, one should be closely tied in with any treatment you have?

I  am sending you hugs and good wishes here as it sounds like you have lots of questions that need answering and you need to explore all your options.

It's a real shock I know to be told we have these kinds of tumours and it is really important to get accurate feedback and info regarding the best treatment choices as each is individual for sure.... but truly you should not be getting outright wrong statements.....radiation can't go through bone? bah humbug.

You are doing the right thing questioning all these aspects. Pm me ok?

Windsong