LYCOS RETRIEVER 
Facial: Nerves
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Occasionally, and more frequently with malignant parotid tumors, the facial nerve must be cut to adequately remove the entire tumor. Sometimes it is possible to perform a neural graft at the time of surgery, in order to promote regeneration from the native facial nerve stump. In situations where the tumor extends deeply along the nerve or extensively into the facial musculature, grafting is not feasible, and delayed facial paralysis management is employed.
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When the part of the facial nerve that comes from the brain is badly damaged or otherwise unsuitable for repair, other sources of innervation may be needed. In these cases, a nerve that performs a separate function is cut and sewn to the facial nerve stump or its branches to provide innervation of facial muscles. This is shown in Figures 5 and 6.
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Removal of all diseased tissue in the middle ear and mastoid surgery necessitates exposing a segment of the facial nerve in its bony canal. This exposure can result in nerve inflammation which can lead to temporary facial nerve paralysis. This type of injury generally shows recovery within weeks to months.
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The fine control of the facial muscles is made possible by the branches of the facial nerve. This control allows a person to move several facial muscles at once (as in a grimace) or to move only one region at a time (as in raising a single eyebrow). Facial movements can be broken down into subsets, which correspond to clusters of muscles, and motion of the face can be studied for each branch of the facial nerve.
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Problems with the facial nerve result in weakness or paralysis of the face muscles and possibly, a loss of taste on the affected side. This nerve loss is one of the most disfiguring since it involves facial movement. Without the nerve connection (innervation) intact, the eye does not close, there is loss of facial muscle tone, and movement on the affected side is reduced or lost.
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Sometimes removal of an acoustic neuroma, or other skull base tumor in a similar location, results in postoperative facial palsy. This is related to manipulation of the facial nerve during tumor removal. Nerves are extremely sensitive to any manipulation, and can be either temporarily or permanently altered by any surgical procedure around them.
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