Nerve Transfer

Paralysis is muscle weakness or paralysis on one or both sides of the face caused by damage to the nerve that controls the muscles of the face (the facial nerve). This can affect basic functions such as loss of facial expression, speech, swallowing and even closing the eyelids. Great advances have been made in the treatment of facial paralysis in recent years, and facial nerve transfer has become one of the most promising treatment methods in this field. If you would like to learn more about this promising treatment method, please take a look at our website.

What is a Nerve Transfer?

Nerve transfer is a surgical technique to repair nerve damage and restore function. This technique is usually performed in cases where nerves have been severely damaged by accident, trauma or disease, and a healthy nerve is taken from another part of the body and transferred to the damaged part. In this procedure, healthy nerves are usually taken from another part of the body (for example, the leg or neck) and implanted in place of the damaged nerve, allowing muscles to regain muscle tone and sensory function. Nerve transfer is therefore used in the treatment of diseases such as hand surgery and facial paralysis and is an important treatment method to ensure neurological recovery. 

What İs Nerve Transfer Smile Reanimation?

It is possible for the person not to laugh in a healthy way and to be prevented by muscle spasm while laughing. At this point, smile reanimation applications are highly preferred. With Smile reanimation, nerve transfer can be performed and smile symmetry can be achieved without depending on the type and causes of facial paralysis.

In patients with facial paralysis, muscle transplantation or nerve transfer can be applied with various methods. Nerve transfer trauma can also be determined according to the patient's symptoms and muscle dysfunction. Nerve transfer can be performed with microsurgical facial nerve repair, microsurgical facial nerve repair, and nerve transfer with transverse facial nerve graft, as well as 5-7 nerve transfers can be used for visual reanimation. If there is a tümör in the face and it disrupts vision, vision reanimation can also be performed with leg nerve transfer graft. As a result, you can also regain your smile by using part or all of the Temporalis muscle.

How is Nerve Transfer Surgery Performed?

The nerve transfer procedure performed under general anesthesia changes the type of surgery depending on the type of nerve used and the region of application. In this context, the surgery is also equalized according to the nerve taken from the leg or the nerve taken from the face. When the masseter nerve is used, it is directed to the selected region in the facial nerve. First, the doctor makes an incision from the natural fold in the ear according to the application area. After the incision, the nerves are examined, electrical stimulation is applied to them and the nerve branch to the masseter nerve is searched. After it is found, the long branch of the nerve is loosened from the muscle. The loosened muscles establish a connection between the facial nerve and the masseter nerve with the help of sutures. Nerve fibers from the masseter nerve pass through the empty spaces in the damaged area and provide direction to the muscles. After the procedure, aesthetic stitches are applied and bands are placed on the area. Finally, the possibility of bleeding is controlled with resistance or other methods.

What Are Nerve Transfers for Facial Paralysis?

Nerve transfer treatment also varies depending on the size of the area affected by the paralysis and the loss of function it causes and the condition of the muscles or nerves. Methods such as nerve transfer microsurgery are also a good way of nerve transplantation. Apart from this, nerve transfers in facial paralysis;

• Nerve transfer surgery
• Gracilis muscle resuscitation and muscle transplantation surgery
• Muscle transfer surgery 
• Facial nerve transplantation 
• Masseter nerve transplant
• Temporalis in Nakli
• Microsurgical yünerve repair 

These are surgery options and aesthetic applications can also be used. Brow lift, face lift, eyelid revitalization surgery can be performed. 

Benefits of Nerve Transfers for Facial Paralysis

The nerve transplant method applied to patients who suffer from facial paralysis due to various reasons directly and indirectly improves the quality of life of the patient. The number of benefits that the person will provide after receiving nerve transfer treatment is quite high. Facial nerve transfer benefits at this point;

• It restores facial function losses and enables functions to be performed without problems.
• The person can perform facial movements more comfortably and effectively. 
• Nerve transfer treatment offers long-term results. You do not have to resort to continuous surgery or other treatment methods.
• Expressing emotions becomes easier. In some patients, even small facial expressions can be regained.
• General facial symmetry is achieved.
• Since the nerve has restored its function, muscle stimulation can also be restored.
• Smile symmetry is achieved.
• The person regains control of their muscles.
• Speech disorders are also corrected.
• The person is allowed to eat or drink without difficulty.
• It is even easier to make facial movements.
• If the temporalis muscle is deemed suitable for nerve transplant &cc;chewing functions can be restored.
• It increases the person's quality of life.
• It allows for comfortable communication with others and to continue living without hesitation. 
• Since the patient has difficulty expressing their feelings or causes involuntary facial expressions, this problem is eliminated. 
• You can perform daily activities without support. 
• You become open to social interaction. 

What are the Risks and Complications of Nerve Transfers for Facial Paralysis?

As with any surgical procedure, nerve transfer surgery carries some risks and complications may develop. However, the technique used, the success rate of the surgery and the expertise of the doctor eliminate these risks. The patient's compliance with the preoperative precautions also affects the likelihood of risk development. Nerve transfer surgery risks and complications;

• Temporary swelling after surgery
• Possibility of bruising in the application area
• Feeling numb for a while
• Mild change in facial appearance
• Nerve injury
• Blood accumulation under the skin
• Nerve not growing as desired
• Longer than normal recovery period
• Need for additional procedures after surgery

Most of these risks can be seen in every surgery. If there is loss of function in your face and problems in eating, it is best to consult with a specialist in the field. Surgeries performed by doctors specialized in these issues provide success in a large ölçü. The risk of developing complications during or after surgery is also low. It is best to get support from the best facial nerve transfer doctor.

Which Nerves Are Used as Donor Nerves for Facial Paralysis?

The use of the masseter nerve as a donor nerve is very common. The reason for this is that since the masseter nerve forms a branch of the trigeminal nerve, it activates the pincering muscle. Thus, the fact that only one branch of the nerve is sufficient for transplantation during surgery does not require finding a new nerve. If it is not possible to use this nerve, a branch of the hypoglossal nerves or spinal accessory nerves can be used. 

During a Nerve Transfer, is The Donor Nerve Attached to the Entire Facial Nerve or Just Part of it?

The condition of the patient's nerves and muscles is an important factor. Depending on the extent of the damage to the paralyzed facial nerve, the extent to which it can be revived is taken into consideration in nerve transfer procedures, and the functions of the facial nerve and its potential for recovery after surgery are also evaluated. However, if it is not possible for the facial nerve to recover and regain its activity, the donor nerve is connected to the facial nerve trunk. If the facial nerve is partially paralyzed, then it is connected to the facial nerve branches. The choice of branch transfer or trunk transfer depends on the extent of damage to the patient's nerves and muscles. The doctor will also select the appropriate nerve, taking into account muscle and nerve stimulation and loss of function.

Will I Get a Completely Normal and Spontaneous Smile When a Non-Facial Nerve is Used to Reanimate My Face?

To activate the closure of the eyelids after surgery, the patient needs to bite down a little. However, depending on the patient, this is not necessary after a few months or at the end of 1 year. Even if the downward bite is not realized, normal gülümseme is achieved in time.

When the masseter nerve is used, physical therapy and rehabilitation process starts after the transplantation. In this physical therapy process, even though the nerve outside the face is used, the patient teaches the muscles and nerves how to move with physical therapy. Since the rate of development of new nerve branches after transplantation is also high, normal and spontaneous gülümsmeme can be caught.

Things to Consider Before and After Facial Nerve Graft

Sometimes, the fact that it is a very difficult procedure and the possibility of developing complications makes it necessary to comply with the things to be considered before and after nerve transfer surgery önl;rürece the risk of developing complications during surgery. It allows the appropriate nerves to be seen more clearly before the nerve transfer graft is performed. It accelerates the postoperative healing process. Therefore, you can ensure that the surgery is beneficial for you by following the things to be considered before and after the nerve transplant.

Things to Consider Before Facial Nerve Surgery

Things that a person with facial paralysis should pay attention to before facial nerve surgery;

• If you are taking medicines, you should inform your doctor about which medicines you are taking. 
• Chemotherapy drugs, steroid drugs should not be taken until a few weeks before surgery. Your doctor will inform you when to stop taking these medicines.
• Blood thinners such as aspirin and ibuprofen should also be stopped for a while. These medications increase the risk of bleeding during surgery. 
• The patient should inform the doctor about existing health problems. 
• Since it is a procedure to be performed under anesthesia, you should stay for a while before surgery.

Things to Consider After Facial Nerve Surgery

A successful surgery does not mean that the process is over. After facial nerve surgery is just as important as the surgery. In this context, things to be considered after facial nerve surgery;

• You may need to stay in hospital for at least 1 day and up to 5 days after surgery. 

• It is necessary not to apply pressure to the treated area for a while after the operation.
• Diren or dressings should not be touched. Your doctor will remove them at the appropriate time.
• Do not shower for at least 2 days and up to 3 days. 
• Hot water should not be used during bathing. 
• Your doctor will give you antibiotics in case of infection. You should use this regularly. 
• You should care for the incision sites as prescribed by the doctor. 
• Since the surgical sutures will dissolve over time, it is not possible to remove them. The existing scar will also become indistinct after a while. 
• For the risk of postoperative infection, it is recommended not to go out for a while. 
• You should consult with your workplace and take time off to rest for a while..You should consult with your workplace and take time off to rest for a while.
• When the anesthesia wears off, you may experience pain in thin scars. This is natural and your doctor will prescribe appropriate painkillers. After a day you will not feel any pain.
• There may be medicines that you should not take for a while. You should get information from your doctor. 
• You should not interrupt the physical therapy and rehabilitation process after nerve transplant. After the wounds heal, it is mandatory to make physical therapy plans as soon as possible according to the situation. In order to achieve complete success from the surgery, postoperative physical therapy is recommended. In this way, the nerves and muscles will regain their lost function and the muscles will be taught movements.

Who Are Candidates for Nerve Transfers?

The type of patients who will receive a nerve transplant will be determined by the doctor's examination. People with facial paralysis, Bell's palsy, Ramsay Hunt, etc. are good candidates for effective results with nerve transfer. Since nerve surgery is not only performed to improve the person's görünümümünü it is also very important to restore the loss of function. Patients who have been diagnosed with facial paralysis but for whom physical therapy and medical treatment have not yielded results are good candidates.

In order to make the application even more effective and to increase the success rate of nerve transfer surgery, treatment can be started within 12 months after the stroke. This time period is very important for smile reanimation and improvement of facial movements. It offers effective results in more than 3 weeks of persistent facial paralysis and restoration of facial movements. Although some patients have congenital defects in the facial nerves, good results can be obtained with this method. For such patients, new nerve branches can be created, as well as nerve transfer microsurgery can restore facial movements and restore their functions.

The patient's ability to tolerate the risks of nerve transfer surgery also gives information about the suitability of the surgery. Your doctor will give the most accurate information as a result of the condition of the nerves and muscles and the examination of the patient. Your expectations from the surgery and what you have gained after the nerve transfer graft will be evaluated.

Nerve Transfers For Facial Paralysis Cost

While facial paralysis can be various, the techniques that can be used in its treatment are also many. Nerve transfer surgery cost will vary depending on the type of surgery. The patient's risk status, data on the extent of damage and deterioration are also closely related to nerve transfer surgery cost

. In some patients, nerve removal from the leg, temporalis muscle surgery, and dual nerve transfer surgery will expand the scope of the procedure. The doctor performs procedures on the facial nerves and muscles with more than one surgery. These types of procedures, which also affect the number of people who will undergo surgery, cause the patient to overlook a certain cost. Other factors that affect nerve transfer surgery cost include;

• The need for additional procedures for the surgery whether or not
• The doctor's surgical success
• The difficulty of the case
• The condition of the nerves and muscles
• The degree of difficulty of the surgery
• Equipment used for nerve transfer surgery
• Choice of microsurgical methods
• Complexity of the surgical technique
• Quality of the equipment
• Number of materials and equipment to be used in the surgery
• The patient's risk range
• Location of the place where the doctor will provide service

FAQ

When Should I Expect to See Results from a Nerve Transfer?

This topic depends on the patient's age, the technique, type of nerve used, duration of paralysis in nerve transfer, and age of the patient. Whether the patient has a recurring disease such as cancer is also an important factor in the recovery process. Generally, the effect of nerve transfer surgery is seen within the first 6 months depending on the patient's condition. In some patients, this period may take up to 2 years. The period will vary depending on variables and other factors.

Which nerves are used as donor nerves in facial paralysis?

The masseter nerve can be used. This nerve allows natural smiling. It is used to preserve the function of the masseter muscle. A small portion of the spinal accessory or hypoglossal nerves are also available for use.

Will I have a completely normal and spontaneous smile when an extra facial nerve is used to reconstruct my face?

There are some procedures that will increase the chance of spontaneous smiling. Depending on the type of surgery and the patient's condition, these procedures can be used. A cross facial nerve graft can be taken from the healthy side and added to the other side. Sometimes a facial nerve graft from the healthy side can be used. Your doctor will provide information about the rate of achieving a normal smile according to your condition.