Instead of using the patient’s own nerve, the surgeon uses AxoGen's Avance Nerve Graft to successfully reconstruct a missing portion of the patient's facial nerve.
May 7, 2010
In 2009 James Mejia, a New York paramedic and paramedic teacher, developed a golf-sized parotid tumor (salivary gland tumor) on the side of his face. Without surgery, there was a significant chance his tumor would eventually threaten his life.
To remove the tumor, the surgeon would need to cut the nerves that control movement in the face and lips. As a result, James could lose the ability to speak clearly and even smile. In standard cases, surgeons repair this defect by removing nerve tissue from another part of the patient’s body.
The nerve graft is used to bridge or “reconnect” the portion of facial nerve that is taken with the tumor. But this procedure requires patients to undergo a second surgical incision to remove nerve tissue—usually from the arm or leg. And it causes permanent loss of sensation in the area where nerve is removed.
To avoid this problem, Dr. Renata Weber, Assistant Professor of Plastic Surgery at Albert Einstein College of Medicine and attending plastic surgeon at Montefiore Medical Center, decided to use an innovative new technology for James.
After the surgical oncologist removed the tumor including the portion of the facial nerve that was invaded by the tumor, she used AxoGen's Avance Nerve Graft, a processed human nerve allograft, to reconstruct the missing portion of the facial nerve. Just like James’ own nerve, the allograft allows for nerve regeneration – eventually permitting the nerve to grow through the graft and into the nerve branches leading to the facial muscle to restore movement of facial expression.
While nerve reconstruction with nerve grafts is common, using nerve allografts instead of the patient’s own nerve is relatively new and James is one of the first patients in the world to be treated using this procedure to repair his facial nerve. It was a complex surgery that required three separate grafts that were sewn together with suture the thickness of a single strand of hair.
The results were remarkable. Within three months, he was able to smile and return to his job as an instructor for paramedic students. According to Dr. Weber, these results compare favorably with the procedure where nerve tissue is harvested from the patient, but without the need for an additional scar on the body and loss of sensation in that area. Based on this success, surgeons may be able to use nerve allografts to treat other nerve injuries all over the body in the years ahead.