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Microsurgery to save a child's severed nerves

Like most little boys his age, two-year-old Jax Cannon is full of mischief and fun. His parents, Jon and Kristi, love to see the giant grin that spreads over his face when he's having fun playing outside with his big brother, four-year-old Jace.

But last fall, a frightening household accident cut two branches of Jax's facial nerve and left his parents worried that his facial expressions were permanently damaged. A story I wrote appearing in today's Inside Stanford Medicine describes the surgery at Lucile Packard Children's Hospital that repaired Jax's damaged nerves:

"The nerves start to disintegrate after 72 hours," [plastic surgeon Rohit] Khosla, MD, said. Jax's surgery began about 60 hours after his injury.

In the operating room, [microsurgery expert James Chang, MD,] and Khosla gingerly re-opened Jax's wound. With a nerve stimulator, they tested the function of the facial nerve, which runs from the brain under the ear and along the underside of the jaw, splitting into five branches that control different facial muscles. Two branches of Jax's left facial nerve were bruised but intact. Three nerve branches were cut. The tube that carries saliva from the left parotid salivary gland into the mouth was also torn.

Using a microscope, a curved needle the size of an eyelash and sutures thinner than a human hair, Chang stitched together the severed nerves.

Jax is healing well. The nerve branches that control his smile, which were bruised rather than cut, recovered a few weeks after his accident. The nerves controlling the area around his left eye, which Chang and Khosla repaired, are regenerating and expected to regain full function. And as the grin in the photo above shows, Jax couldn't be happier.

Photo by Norbert von der Groeben

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