45 yo woman, 20 years s/p XRT for nasopharyngeal CA. Developed acute onset FP 10 weeks ago. Had facial nerve decompression by her neurotologist 3 days after onset. Continues with HB 6/6. EMG showed some reinnervation in her marginal branch but no where else. My plan is to observe for at least 6 months but if no discernible recovery I will for 5-7 transfer as well as a jump graft from 12-7 using great auricular. Should I operate sooner? Or is 6 months the minimum time to wait to offer surgery?
autoimmune Bell Palsy bulbar palsy Cases disscusstion Cranial nerve transfer Cross face nerve graft elderly Electro-stimulation Facial Therapy flaccid paralysis Free muscle transfer Grading systems middle ear multiple cranial nerve palsy myositis nerve graft Objective analysis Pediatric PROMs Reanimation sterno-omohyroid muscle flap Subjective analysis Traumatic Facial Palsy tumor vestibular schwannoma viewpoints