Cranial Nerve Surgery

Always at the forefront of advances in facial cosmetic and reconstructive surgery, Dr. Jose Barrera is excited to share more about a groundbreaking area of focus called cranial nerve surgery. With leading edge treatment, Dr. Barrera offers relief and hope to patients facing two very devastating conditions: facial paralysis and obstructive sleep apnea.

Facial Reanimation for Facial Paralysis

Facial paralysis is the inability to move some or all of the muscles on one or both sides of the face, making it difficult to speak, chew, smile and/or blink. Common causes of facial paralysis include Bell’s palsy, tumors, surgery to remove part or all of a tumor (e.g., parotidectomy), trauma, stroke or congenital malformations. Facial paralysis is diagnosed through a consultation with a doctor, a physical examination, imaging of the face and brain and other testing.

Cranial Nerve Transfer

By transplanting or transferring muscles and nerves or rewiring nerves, Dr. Barrera can greatly improve facial reanimation in people with certain types of facial paralysis.

For example, during masseter to facial nerve transfer, Dr. Barrera sews together the facial nerve and masseteric nerve (which activates the chewing muscle). As a result, the masseteric nerve helps to reanimate the paralyzed functions of the face. Or, during temporalis tendon transfer, the temporalis tendon, which connects the temple to the jaw, is transferred to the corner of the mouth to restore movement to the lips.

Protecting the Eyes with Weights

One of the most serious consequences of facial paralysis is the inability to close the eyelids. Dr. Barrera can surgically implant tiny gold or platinum weights inside the upper eyelid; using the power of gravity, the weights enable the patient to blink and close the eyelid.

Botox for Facial Synkinesis

Another consequence of facial paralysis is facial synkinesis, or an abnormal synchronization of facial movements (e.g., the eyes narrow when smiling, or the cheeks or chin twitch). Dr. Barrera can inject small amounts of Botox or Dysport to temporarily relax unwanted muscle movement and reduce tension in hyperactive areas of the face.

Nerve Stimulation for Sleep Apnea

Another exciting area in which cranial nerve surgery is taking place is the treatment of obstructive sleep apnea. The current mainstay of sleep apnea treatment is wearing a bulky, heavy, uncomfortable CPAP machine to keep the airway open while sleeping. But certain people find CPAP machines intolerable or cannot get consistent benefits from them.

Dr. Barrera offers a breakthrough advance called hypoglossal nerve stimulation, which uses a pacemaker-like device implanted in the patient’s chest to increase airflow without waking them. The device monitors the patient’s natural breathing patterns and delivers mild stimulation to the hypoglossal nerve, which controls muscles in the upper airway. This keeps the airway open to allow patients to get restorative sleep without snoring and wake up in the morning feeling rested and refreshed.

To speak with Dr. Barrera about these revolutionary treatments, please contact our San Antonio office today.