Can facial nerve damage be restored

Nerves are an important part of the human body and have a certain impact on people's perception and ability to move. For example, facial nerves can ensure that people can make various expressions. However, many people have problems with facial nerve damage, which can actually be treated through certain methods! The following is an introduction to the treatment of facial nerve damage.

1. Facial-accessory nerve anastomosis

This surgery involves end-to-end anastomosis of the central segment of the accessory nerve with the peripheral segment of the facial nerve. The surgical method is simple and has a high success rate. Most patients will have restored facial muscle movement 3 to 5 months after the operation. The disadvantage is that the sternocleidomastoid muscle and trapezius muscle innervated by the original accessory nerve will become paralyzed and atrophied, resulting in drooping shoulders. However, if the sternocleidomastoid branch of the accessory nerve is used and the trapezoidal branch is retained, scapulohumeral obstruction can be avoided; or the descending branch of the hypoglossal nerve is anastomosed with the peripheral segment of the accessory nerve to reduce the disadvantages of scapulohumeral obstruction.

Surgical method:

The operation is performed under local or general anesthesia, with the patient lying on his back with his head tilted to the healthy side. Starting from the root of the mastoid behind the ear on the affected side, make an incision about 7 cm long along the front edge of the sternocleidomastoid muscle to slightly below the midpoint of the muscle, separate the subcutaneous tissue, first perform blunt dissection between the upper end of the front edge of the sternocleidomastoid muscle and the parotid gland, carefully identify and free the facial nerve with the help of a surgical microscope, then go retrograde along the nerve trunk to the stylomastoid foramen, cut the facial nerve at a high position, and protect the broken end with a saline cotton pad for later use. Then free the front edge of the sternocleidomastoid muscle, turn the muscle outward, and find the sternocleidomastoid branch of the accessory nerve at the posterior edge near the midpoint of its deep surface (the trapezius branch continues to run parallel to it and enter the trapezius muscle posteriorly), cut this branch close to the muscle, and free it in retrograde motion upward so that there is no tension during the anastomosis. Then, use 7"0" non-invasive sutures to perform end-to-end anastomosis of the nerves, and 4 to 5 stitches of the epineurium are sufficient. After the operation, the incision layers were sutured as usual, and a rubber patch was placed under the skin for drainage for 24 hours. Nerve growth factor was given after the operation to promote nerve growth.

2. Facial-phrenic nerve anastomosis

That is, the central segment of the phrenic nerve and the peripheral segment of the facial nerve are anastomosed end to end. This operation is more complicated than the facial accessory nerve anastomosis. The phrenic nerve needs to be freed from the neck, and then retrogradely pulled subcutaneously to the facial nerve incision for anastomosis. However, its advantage is that the phrenic nerve has a strong regenerative ability, and there are more anastomotic branches connecting the two phrenic nerves. At the same time, fibers of the 9th and 12th intercostal nerves are also incorporated. Therefore, after one side of the phrenic nerve is cut off, there is only a temporary movement disorder of the diaphragm on the affected side, which can be compensated and recovered soon.

Surgical method:

The method for exposing the facial nerve is as described above, and only the incision is shortened to the plane of the mandibular angle. Also, 3 to 4 cm above the clavicle, with the posterior edge of the sternocleidomastoid muscle as the center, make an incision about 5 cm long parallel to the clavicle. Separate the subcutaneous tissue and platysma muscle, free the posterior edge of the sternocleidomastoid muscle, flip it forward, and expose the anterior scalene muscle. With the help of a surgical microscope, the phrenic nerve can be seen crossing the superficial surface of the anterior scalene muscle from the posterior superior to the anterior inferior. Carefully cut the fascia along the nerve, bluntly separate the nerve to a low position, and free it downward as much as possible to obtain sufficient length, and then cut it off. Then separate it upward along the central segment of the phrenic nerve until the phrenic nerve can be retrogradely introduced from the deep surface of the sternocleidomastoid muscle into the facial nerve incision.

3. Diet and health care

Depending on the different symptoms, there are different dietary requirements. Please ask the doctor specifically and formulate different dietary standards for specific diseases.