The USC Facial Nerve Center offers patients access to a world-class team of experts dedicated to facial nerve rehabilitation. By combining physician leaders from multiple specialties, patients are afforded unparalleled access to national leaders in the diagnosis and treatment of facial nerve disorders.
Participating services include Facial Plastic and Reconstructive Surgery, Neurotology, Neurosurgery, and Physical Therapy. Patients have access to a broad array of diagnostic and treatment options, including surgical and non-surgical treatment for a variety of facial nerve disorders.
Our mission is to deliver seamlessly integrated and patient-centered treatment for all disorders affecting the movement of the face.
Your face is the instrument through which you communicate with the world, and it is how the world sees you. Facial dysfunction is not only a complex clinical problem, but also a highly personal struggle for many of our patients. It is best treated by a team of experts who work together seamlessly on a routine basis. Our philosophy is that you deserve an integrated team of experts who are singularly committed to the restoration of facial function.
The USC Facial Nerve Center offers unparalleled surgical treatment for facial paralysis and facial spasm. Importantly, our surgical treatment is integrated with our non-surgical services. We offer access to neuro-diagnostics that can help to determine the likelihood of recovery without surgery. If surgery is required, physical therapy is an essential addition to mastering the restored movement of your face.
As an academic center of excellence, we seek to advance the care of facial dysfunction through cutting edge research. Clinical research and basic science (laboratory) research are therefore critical components of our mission.
Treatments and Services
In cases of facial nerve paralysis that have lasted, in general, 1 year or less, a nearby motor nerve can be connected to a portion of the facial nerve in order to restore movement. The most common of these procedures is called the Nerve to Masseter Transfer. This involves the use of the nerve to the masseter muscle as a donor nerve to supply electrical input to the facial nerve in order to restore a patient’s smile. Patients usually stay in the hospital for one or two days following this procedure.
Once the gracilis muscle is transplanted to the paralyzed side of the face, it must be connected to a new nerve, so that it may move the paralyzed side of the face. The gracilis muscle may be connected to the nerve to master (which is normally used for biting/chewing), to a cross-facial nerve graft, or to both nerves simultaneously. These options are decided based on a discussion between the surgeon the patient. In general, the gracilis may be performed in a single surgery, or in two surgeries that are separated by approximately 9-12 months. Patients usually stay in the hospital for approximately five days after this surgery.
Dr. Giannotta’s multidisciplinary team has developed neurosurgical techniques to treat hemifacial spasm and trigeminal neuralgia. The neurosurgical team has experienced extremely low complication rates with a high degree of success and has published its results in medical journals.
Clinical trials are scientific studies conducted with volunteers in order to evaluate new treatments. Before a new treatment is tried with human patients, it is carefully studied in the laboratory. Laboratory research points out the new methods most likely to succeed but this early research cannot predict exactly how a new treatment will work with patients. With any new treatment there may be risks as well as possible benefits. There may also be some risks that are not yet known. Currently, we have the following active clinical trials to benefit patients with Bell’s Palsy.
Active clinical trials
Targeted electrical stimulation for treatment of poor prognosis Bell’s Palsy
Current clinical practice guidelines encourage the use of electrodiagnostic testing in patients with severe Bell’s palsy as a means of determining prognosis of recovery and candidacy for possible surgery. In patients who forgo surgery, there is no additional medical treatment offered outside of routine use of oral steroids and antiviral medication. This double-blind, randomized controlled trial seeks to enroll patients with severe Bell’s palsy, who may benefit from targeted electrical pacing of the buccal branch of the facial nerve.
Visit clinicaltrials.keckmedicine.org to view a list of active trials currently available at Keck Medicine of USC.
Basic science research
Using the latest technology in genetics, stem cell medicine, neuroscience and biomedical engineering, researchers find advanced solutions for disorders of the head and neck. Our researchers at the USC Facial Nerve Center are currently studying the role of stem cells in the treatment of peripheral motor nerve injury in facial paralysis. To learn more, visit the USC Caruso Department of Otolaryngology – Head and Neck Surgery at the Keck School of Medicine here: www.keck.usc.edu/otolaryngology/research/basic-science-research
The USC Facial Nerve Center is led by Jon-Paul Pepper, MD, a Facial Plastic and Reconstructive surgeon. He is a fellowship-trained facial nerve expert, and leads a multi-disciplinary team of specialists in providing care for patients with facial nerve dysfunction. He also maintains an active research program dedicated to improving outcomes after facial paralysis and identifying new therapeutics that may likewise improve the lives of patients with facial paralysis.
Practicing LocationsKeck Medicine of USC - Beverly Hills
USC Healthcare Center 4
Acoustic Neuroma, Meningioma and Facial Nerve Tumors, Skull Base Surgery, Microvascular Decompression, Chronic Ear Infections, Otosclerosis, Meniere’s Disease and Pediatric and Adult Cochlear Implants
Practicing LocationsUSC Healthcare Center 2
Cerebrovascular Disease of the Brain and Spinal Cord, Surgical Approaches to the Cranial Base, Stereotactic Radiosurgery, Microvascular Decompression for Bell’s Palsy, Lateral Skull Base Surgery for Facial Nerve Tumors
Practicing LocationsKeck Hospital of USC
Keck Medicine of USC - Downtown Los Angeles
Practicing LocationsUSC Healthcare Center 4
Extended Midface Lift for Facial Paralysis; Botulinum Toxin for Facial Spasm, Synkinesis and Contralateral Hyperkinesis; Brow Lift and Eyelid Surgery for Facial Dysfunction
Practicing LocationsKeck Medicine of USC - Downtown Los Angeles
Keck Medicine of USC - La Cañada Flintridge
USC Healthcare Center 4
Facial Reanimation Surgery; Nerve and Muscle Transfer Surgery; Botulinum Toxin for Synkinesis, Facial Spasm and Contralateral Hyperkinesis; Hyaluronic Acid Filler for Facial Asymmetry and Speech Improvement