Bengaluru 16 September 2024- Gabriel Pascal an optometrist , aged 43 hailing from Nigeria suffered from facial nerve paralysis secondary to a bony tumour involving his ear bones and was struggling to smile or speak and was also having difficulty closing his eyes. This had troubled him immensely since food used to escape from his mouth and there was excessive watering of eyes. His notable problem was in difficulty to express any emotions on his face driving him to become depressed and social isolation. The patient had researched various treatment options and zeroed in on Trustwell hospitals for his advanced medical and surgical care. He underwent the complete Tumour excision and reconstruction by a surgical oncology team at a different hospital successfully, after which he was transferred to Trustwell hospitals for surgical and rehabilitative treatment of his face Paralysis.
The procedure called as Facial reanimation, is a very complex surgical procedure done to give life back to the nerve and muscle of the face especially mouth by joining new donor nerves from other areas to the faulty facial nerve to make the face work again. This involves a prolonged operating time of 10 -12 hrs with stringent intraoperative nerve monitoring where the nerve and muscle activity is understood by an electrode machine interface interacting with the nerves of the body continuously. Being a specialised surgery requiring high end diagnostic and therapeutic surgical option, there are very few centres in the country performing Comprehensive Facial paralysis management.
The surgical team headed by Dr Vishwas Vijayadev who is the first International Board-certified Diplomate facial plastic surgeon from USA, performed this complex procedure with his team of Dr Anand Subhash, Dr Stuti Mahajan, Dr Sravya Kakollu, done first time in the country involving a double nerve transfer. This involved transferring a nerve from the leg on to the face and connecting it from the normal side of the face with functioning facial nerve, second nerve used for chewing and rerouting the current to the paralysed nerve on the face. The anaesthetic team headed by Dr NS Chandrashekhara and Dr Jaydev handled the complex interplay of anaesthetic medications in the prolonged surgery during which nerve stimulation had to be appreciated for the surgical teams to identify and delineate the nerves for surgery.
The Nerves are living organs which can be transferred from one part of the body to the other and they come alive after gap of few months, but this requires delicate and trained handling of the tissues and specialised techniques to join the nerves across the face without causing further damage to the face. Additionally, to improve the eye closure innovative and evolved surgeries were performed on this patient as compared to the conventional surgeries being done in India. This surgery lasting 11 hours was done at Trust well hospital since the hospital has started a separate department of Facial plastic surgery and Facial nerve disorders by equipping it with the latest infrastructure from USA, Europe, Israel , Taiwan and state of the art Operating theatre ,High dependency Units, surgical Intensive care units.
Advanced rehabilitative surgery of this type is seldom available to the public. With the intention of having the latest cutting edge surgical solutions with best safety and outcomes for the patients, Trustwell has put its might behind this unique case and subspecialised Doctors and Surgeons like Dr Vishwas Vijayadev , who have trained abroad and moved to India for developing newer realms and areas where treatments have so far been dismal and incurable.
Facial paralysis treatment has been one such area wherein treatment has evolved tremendously abroad along with newer diagnostic modalities which are yet to be introduced into mainstream practise in India. Dr Vishwas Vijayadev has actively also taken up the role of training many of his colleagues in the diagnostic, rehabilitative and surgical challenges involved in this interdisciplinary branch. The best reward to the teams involved is when the happy patient who is able to smile and speak after the nerves start firing in a few months.
Speaking on the occasion Guruprasad Director strategy Trustwell said, “We are delighted that our doctors could handle this very difficult case with precision & the patient is on the recovery mode & will lead normal life once cooling period is completed.
