You may experienced this prior to your surgery, after or beyond. For me it was a noticeable flattening of the crease line on the AN side of my face. That was the tumour stretching the facial nerve. You might also have some tingling in your face. For me it was around my chin. Dry eye and trouble blinking can also start prior to receiving treatment for this tumour. Depending on the size and location of your Acoustic Neuroma, your mileage may vary after treatment. For me, most of my face came back. However, I have slight palsy, a crooked smile and my eyelid blinks slightly slower than my non-AN eye. I also have chronic dry eye. Either way be prepared for the possibility of facial nerve damage with an Acoustic Neuroma.
You Have Facial Droop
Whether or not your tumor has facial nerve involvement you will have facial droop. For those with no facial nerve involvement it will probably go away. If you have some facial nerve involvement prior to treatment you probably won’t get it all back. You may hear your doctors refer to something called the House-Brackmann Scale which classifies facial function. You will be graded any where between I and V with I being the best and V being the worst. Now what they might tell you right after surgery will more than likely change over time so do not get discouraged, you will improve. However, you really have no exact idea how much you will improve. Jackie Diels has a great talk on how you can deal with your face after treatment using neuromuscular retraining. It is worth a watch.
Your Eyelid Doesn’t Blink Like it used to or not at all
I mentioned in a previous blog post how it is important it is to exercise proper eye care. The issues you experience with your eyelid is related to your face. The facial nerve is responsible for a lot of function and the eyelid is part of that. The nerve is so raw (especially after surgery) the eyelid might not be able to stay closed because it is so weak and tear production may stop (re: facial nerve). Protecting the eye and keeping it lubricated with non-preservative eye drops, patches and ointment is critical. After your recovery period you may need to keep doing this. Other measures include gold weights, eye springs, punctal plugs and scleral lenses.
You Have Intermittent Tingling or Moving of Your Face
You may be going about your day and all of the sudden your feel a tingling somewhere on your face. For me it is usually my forehead or around my eyebrow. I also notice that a part of my chin on my AN side will just start dancing. It is quite comical really (LOL). From what my neurosurgeon told me about this phenomenon were two things. With respect to tingling it is like phantom pain. Like when a person has lost a leg but for some reason feels like the leg is still there. It is the brain trying to reconcile with itself. The other issue with your face moving has to do with the nerve itself. It has some damage to it so signals from your brain are being transmitted poorly or inappropriately causing the random movement. It is like a wire that is partially broken. Some signals get through but unfortunately the ones that do might be garbled.
You Have Reduced Feeling in Your Face
This is caused by the possibility of damage to the facial nerve during treatment. I have numb spots on my face and really on parts of my head where the muscles were cut to make the incision to resect the tumour. I always say to my friends “If I have to take a punch for you, make sure it is on that side!” LOL
Your Face is Generally Achy
The muscles on that side of your face at times can just ache. For me it is the muscles around my jaw. I don’t even chew that much on that side since my chewing favours the non-AN side of my mouth. If I got regularly massaged on that side of my face it would be great!
I am sure I haven’t listed all the possible issues you might have with your face but I have basically explained what I have gone through and still deal with on a daily basis. Depending on your treatment outcome you have none, some, all or even more of these when considering facial issues with your Acoustic Neuroma. With proper treatment and perseverance, you will be able to handle it.