What is nerve transposition?
Nerve transposition is also known as facial-hypoglossal transfer. It is an operation that restores movement to the side of the face that has been paralyzed. The facial (or 7th cranial) nerve is responsible for moving the face. The hypoglossal (or 12th cranial) nerve is responsible for moving one half of the tongue. With the stump of the 12th nerve is hooked up to the end of the 7th nerve, the face will move when the tongue is moved. With practice and with physical therapy, one can learn to move the face independently of moving the tongue. If your doctor feels that the facial nerve will never function again, and if the injury to the nerve had not bee too remote, you may be a good candidate for nerve transposition. In most cases, half the tongue will undergo shrinkage, or atrophy, but this should not affect your ability to eat or speak.

How is a nerve transposition performed?
The surgeon will make a small incision that curves from the angle of the jaw into the upper neck. After locating both nerves, the ends of the two are sutured together under an operating microscope--using suture smaller than a human hair. Nerve transposition is usually performed under general anesthesia. Your doctor may want you to stay in the hospital overnight. The operation lasts for about two hours.

What is the recovery from surgery like?
Recovery from nerve transposition surgery involves several phases. Since general anesthesia is used, you may experience some nausea for the first 24 hours, and you should avoid eating substantial amounts of food. The sutures or surgical staples are removed after about a week. Limiting strenuous activity and keeping the head elevated will cut down on swelling. It may take as long as 6-12 months for the face to begin moving again.

When should I come back to the doctor?
In most cases, you should come back one week after surgery. Your doctor will want you to meet with your physical therapist on a regular basis to ensure optimal results from surgery.

When can I go back to work?
Workers that perform heavy tasks should avoid work for a week or so. After about a week, patients may resume their normal exercise routines. Some office-type workers are able to return to work after 4-5 days to read mail, make phone calls and do some work with the computer.

Will my insurance pay for this?
Most insurance companies consider nerve transposition a functional procedure and do provide coverage.