Treatment Options > Radiation / Radiosurgery

Radiation and a Weakened Facial Nerve

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LCT:
Does anyone have any experience with radiation following a surgery that weakened the facial nerve?  I ask because I am unfortunately part of the group that has experienced regrowth (or a new tumor on the same side).  The uncertainty is because the current AN did not appear until 10 years after my initial surgery.  I am in wait-and-watch mode now.  Unlike the first time (4.5 cm AN), I have many options this time.  My last MRI had tumor # 2 at around 11mm.  I am leaning heavily toward radiation this time around.  My only question is what can I expect to happen to my facial nerve?  My facial nerve was NOT cut during the previous surgery, but it was weakened.  I have partial facial paralysis on my left side.  I would hate to lose what I do have as I look somewhat symmetrical at rest.  I am not looking for opinions on machines - Cyberknife, Gamma Knife, Novalis, etc., as we are fortunate to have many options in Texas.

But I am looking for information on radiation to an already damaged facial nerve.  Thanks in advance.

jerseygirl:
Hi, LCT,

My tumor has also recurred 10 years after the initial surgery and I have been waiting and watching for 8 years and decided fianallly to take it out this summer. My facial nerve was not cut during the first surgery and is functioning perfectly, no paralysis whatsoever. However, every surgeon, regardless the approach (micro or radio) says that there must be some structural damage to my facial nerve because of the original huge tumor and the surgery to remove it. The radiation specialists say that the radiation will hit the facial nerve along with the recurrent tumor because there is no way to know how close to the tumor surface the nerve is, it might run right through the tumor. In this case, radiation will probably do an additional mild damage. So, the original mild damage plus the new mild damage in my case can translate into moderate damage. The prognosis, obviously, is a lot better for people who have not had a surgery previously. On the positive side, I was told, the facial nerve is one of the most resistant to radiation cranial nerves. It is the hearing nerve ( the one I no longer have) that is more of a problem. My tumor is now medium sized and is pressing on the brainstem, so I decided against radiation and going for another surgery, this time endoscopic.

There is no right and wrong decision here. Only you can decide what is best for you and which risks and consequences you are willing to live with, so research, research and research. Talk to as many experts that you can and listen to every one of them. Then you will be satisfied that you left no stone unturned and gave yourself the best opportunity. Good luck and best wishes.

                Eve

Dealy:
I have too agree with jersey girl. I also I radiation-FSR-Linac in Fractionated segments. Was also told my doctors that facial nerve is the most resilient. However since yours has been comprismised somewhat already-I would get a definite stong 2nd opinions on the aftermath of radiation. However-lucky for you tumor as you say appears small enough that perhaps that much will not be affected. Not familiar what you have in Texas-but choose a facility that can give you a good track record and not just numbers to impress. Good luck on your choice. Not always an easy one too do. Thanks-Ron

macintosh:
Dear LCT--

I don't have direct experience with this issue, but I can pass on what I've seen in the medical literature. The effects of one-shot radiation on the facial nerve have been dramatically reduced since the establishment of lower doses in the mid-90s. Since serial radiation uses even lower doses, the theory is that this should be even safer. The studies I've read tend to indicate that it's difficult to show, with statistical certainty, that serial radiation is actualy superior. If I were in your position, though, that's probably what I would do. I had one-shot LINAC radiation a month ago for a small AN, no noticeable side effects so far.

Mac

MLB57:
Hi LCT--I have a re-growth of my 1 cm rt AN removed Jan 2001 via retrosigmoid sub-occipital approach(UMass Med Ctr, Worc MA).I have since last June consulted w/UMass Neursourgeons/Radiation speicalists and also w/Dr Noren (NE Gamma Knife Ctr, Prov,RI) and was ready to have GK but one UMass MD wanted me to see Dr Barker at Mass General (Boston, MA) for another opinion. I have an app't to see him tomorrw (March 26). One of my questions will be if I decide on Gamma, in his opinion, will it affect my already compromised facial nerve. My AN was "densely" adherred to my facial nerve and the right corner of my mouth always feels "stuck" and my right eye closes but not as tightly as my left eye. Dr Noren of RI alluded to the fact that my facial nerve would not be further damaged--but I know radiation can cause post-treatment swelling (months later), and if the tumor is growing right along the same spot as before I would think the facial nerve could be further irreparably damaged. It is refreshing to know that accodingi to other posts here the facial nerve is most resilient. In any event I will ask and let you know... ::)

Regards, Mary from MA (one of the NE Maxwell Brunch ladies!)

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