Facial Reanimation Surgery in Dallas, Frisco, and Fort Worth, TX
The facial nerve is a nerve that is responsible for powering the muscles of facial expression. Its neurons travel from the motor cortex of the brain, through the brainstem, through the skull base and temporal bone, and exit the mastoid on their way to the muscles of the face. Because the facial nerve travels through the anatomy of the temporal bone, neurotologists offer procedures to treat specific pathologies of the facial nerve.
If you or a loved one is experiencing facial nerve issues, expert care is available. Contact our specialized team in Dallas, Fort Worth, and Frisco at 469-803-5555 for advanced treatment options that can help restore facial function and improve quality of life.
The facial nerve may be injured by tumors of the skull base, skull base tumor resections, viral inflammation (Bell’s palsy), autoimmune conditions (Melkersson-Rosenthal syndrome), or traumatic disruption (skull fracture).
Procedures to repair the facial nerve can be categorized as nerve decompression, primary anastomosis, cable grafting, alternative nerve anastomosis, muscle sling, gold weighting, or adjunct procedures.
Nerve decompression is used when swelling of the nerve within the bony confines of the skull is causing nerve dysfunction. Bone over the swollen nerve segment is removed, releasing the nerve and allowing for return of function.
Primary anastomosis is indicated when the injured nerve is severed. The severed ends of the nerve are directly stitched together.
In some cases, the ends of the nerve cannot reach one another. In these cases, the ends are connected by a nerve graft. The nerve graft is typically a less important sensory nerve such as the nerve that gives sensation to the ear lobe (great auricular nerve). This may also be accomplished by synthetic collagen tubes.
With pathologies that disrupt the root of the nerve so severely that it cannot be reattached, alternative nerve anastomoses are used. A masseter-facial anastomosis involves connecting a branch of the nerve that powers chewing function to the severed end of the facial nerve. Although it is less ideal than restoring facial nerve continuity, powering the facial nerve with the masseter nerve is a good fit for patients with severe pathology of the facial nerve root. In a similar way, the facial nerve may also be powered by the contralateral facial nerve or by the nerve that drives the function of the tongue.
Sometimes, the nerve branches are severely disrupted near their connection to the muscles of facial expression. This makes facial nerve repair impossible. In these situations, a plastic surgeon may attach part of the chewing muscle to the corner of the mouth to allow for smiling. They may place a tiny weight made of gold in the upper eye lid and tighten the lower eyelid to assist with eye closure. They may perform face lift, eye lid reduction, brow lift, and rhinoplasty to assist with facial droop associated with facial paralysis as well.
In summary, neurotologists offer several procedures to help with facial nerve injury. The causes of injury include surgical injury, tumor compression, viral inflammation, autoimmune inflammation, or traumatic injury. Decompression, nerve repair, or nerve transposition may be indicated to heal the facial nerve. Adjunctive procedures such as temporalis sling, gold weights, brow lift, blepharoplasty, face lift, rhinoplasty may help rehabilitate the patient suffering from facial paralysis as well.
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If you or a loved one is experiencing facial nerve issues, expert care is available. Contact our specialized team in Dallas, Fort Worth, and Frisco for advanced treatment options that can help restore facial function and improve quality of life.