Anatomic Preservation of Facial Nerve

[Darren]

Hi Everyone-

I'm glad I found this website.  I'm 4 weeks since my AN removal(3.3 cm right side) removed via Translab approach.  I'm 29 yrs old and and otherwise great health( besides the CSF leak and lumbar drain)  The surgery lasted 6.5 hrs and I awoke with no facial movement on the operated side(HB grade 5). The nerve was left intact however, drs. said it was very weak( said it looked very thinned out like cellaphane sp?)  The doctors said that since it was intact I have a 90% chance at HB grade 1 or 2 in a year given the size of the tumor and status of the nerve.  They said there was some stimulation with a "wand" at the nerve but not much after surgery. I have read much different online, especially if palsy is seen immediately after surgery.  your chances are lower for a full recovery.  My face has good symmetry, besides a slight droop @ my lips- doctors said it is cause of my age that I dont have a full droop of the face- Any insight on intact nerve recovery? or age in recovery of the nerve??

Thanks,

Darren

[saralynn143]

Darren -- please see this website, particularly the section of Predicting Nerve Recovery:
http://neurosurgery.mgh.harvard.edu/CranialBaseCenter/b95.htm

It sounds like you fall into this group:
Facial nerve is anatomically intact, stimulates at low voltage, but no movement immediately after surgery. In this group of patients, ENoG may be particularly useful in the postoperative period. If the compound action potential of the paralyzed side remains greater that 10% of that of the normal side after one week, then a good recovery usually occurs, although it may require several months.

I fall into the same group, though I awoke at HB 6. I see a facial nerve specialist at Washington University in St. Louis. He told me I can probably expect to get back to a 3 by 18 months post-op, but my personal goal is 2. At a year post-op I have symmetry at rest and my smile is not there yet but improving. I have a platinum weight in my eyelid which helps a lot.

I'll join you in hoping for the best.
Sara

[suboo73]

Darren, 

Welcome to the Forum - hope you find the answers you are looking for.
I cannot help you with any of your questions since i am still in W & W mode.

Just know that this is the best Forum ever, and the folks here are fantastic!
Take care and best wishes for continued healing.

Sincerely,
Sue

[Joef]

its really hard to say....I had NO movment until 13 months!!  the doctors at first told me 3-6 months. so I say if you see monment in under 6 months ... you might see a full recovery... if its over a years... you still might get a lot back ... I'm about 4 years... I was totaly no movement after surgery.. now its not too bad ..(but not perfect)

nerves dont heal like muscles do ... its a VERY slow process... (watching paint dry is lightning fast in comparision)  I heard of a case of a woman I think... after 15 years her face suddenly came to life ... so who knows!

[Darren]

Thanks for your replies! The ENOG test is interesting. I will ask and see if I can get this test at my Drs.

[rsteph]

My tumer size, surgery, complications, and outcome were almost identical to your situation except I also had bacterial meningitis.  Complete tumer removal and nerve left intact with no stimulation.  I started getting movement on my AN side at the beginning of June.  It is not much but it has been improving my symmetry.  You definitely should give it a year.  My doctors also said my nerve was stretched thin and he thought I would not get any spontaneously movement back esp after my six month appointment revealed a very weak EMG (facial nerve test) result not favorable for returned movement.  Goes to show no one knows. 

[mimoore]

Hi Darrem,
Welcome!
I too had facial paralysis when I woke up and was told that the nerve was still intact but stretched and although it showed up when stimulated it was faint. I got a copy of my surgery report so I could read all of the technical terms and research it.

I had to comment on EMG nerve testing. I had an EMG at 6 weeks and it showed nothing! I was so disheartened - I cried. It is important to remember that an EMG is just a snap shot in time, it does nothing to predict your nerve recovery. If after a substantial time Dr's may request a nerve test to see if anything is going on that is not visible to the naked eye.

I had to think for a minute - I am 14 months post op and I have been slowly getting movement back... yes watching paint dry or grass grow is much faster. I certainly have learned a thing or two about Patience and I hate that word now. I just noticed a tiny bit of movement on my forehead which is cool, my top lip doesn't do squat but I will never give up hope.

Stay strong, believe in yourself and note that we are here for you... no sense reinventing the wheel. One or all of us have been there, done that or tried something that worked.

Hugs Michelle 

P.S. Loving the spell check option guys!