Potentially Permanent Facial Paralysis Reversed in 14-Year-Old Trauma Patient

MAYWOOD, Illinois—Months after receiving a novel treatment at Loyola University Medical Center (LUMC) that reversed facial paralysis caused by a devastating accident, 14-year-old Peyton Robinson is again laughing and smiling.

Peyton suffered multiple skull fractures, hearing loss and facial paralysis due to blunt force head trauma on April 12, when the ATV he was driving was struck by another vehicle. The teen from Bentonville, Arkansas was airlifted to a Level 1 trauma center in nearby Missouri where he was admitted and hospitalized for five days. Initially, doctors told Peyton’s parents—Rebecca and Robert “Trey” Robinson—that the nerve swelling caused by the accident would eventually subside, and that Peyton would regain full movement of his facial muscles. However, another doctor was less optimistic, and thought that additional treatment may be necessary.

While researching facial trauma, Peyton's father came across several studies highlighting the possibility of permanent paralysis without treatment within 90 days of injury, as well as several doctors who had successfully treated this type of injury. These physicians included John P. Leonetti, MD, neurotologist and program director of cranial base surgery at LUMC, the only doctor in the U.S. who combines surgical facial nerve decompression (a standard treatment for Bell’s palsy, a common, sudden weakness on one side of the face) with intraoperative electrical stimulation.

Five weeks after Peyton’s accident, Trey Robinson reached out to Dr. Leonetti who agreed to see Peyton in early June.

Under general anesthesia, Dr. Leonetti performed a mastoidectomy, which requires drilling and removing 2 millimeters of bone over the facial nerve. Dr. Leonetti then used a stimulating probe on the nerve for 30 seconds. The entire procedure lasted approximately 90 minutes.

“All patients show some facial movement after four weeks,” said Dr. Leonetti. “To everyone’s surprise, Peyton was able to move his face eight days following the procedure. At his most recent follow-up visit in October 2020, Petyton’s facial function was fully restored.

“From the beginning, we felt like we were part of a family here,” said Rebecca Robinson.

“We had all been praying and praying, asking God to give us a sign as to what we should do,” said Trey Robinson. “In fact, God was giving us so many signs, everything short of writing ‘Loyola’ in the clouds. It was really the answer to our prayers. We were immensely overwhelmed with the hospitality we received from Dr. Leonetti and his team at Loyola.”

The surgical techniques and treatment that Peyton received were born out of Loyola’s Facial Nerve Center, one of only a few specialized clinics in the country.

The electrical stimulation is the key, says Eileen M. Foecking, PhD, associate professor, otolaryngology at Loyola University Chicago Stritch School of Medicine, “which sends a message to the nerve cells, triggering regenerative genes needed to restore facial function.” Based on Foecking’s early successful research, Dr. Leonetti began adding nerve stimulation to his treatment protocol for adults with Bell’s palsy who were not recovering on their own.

Since the addition of facial electrostimulation to the treatment protocol in 2012, “all patients with Bell’s palsy have recovered some facial movement by their one-month follow-up visit,” said Dr. Leonetti.

Only patients who do not show signs of regaining facial movement three months following the onset of facial paralysis are eligible for the procedure.

Peyton says he is grateful for his recovery, Dr. Leonetti and his care.

“I’m happy that I can move my face again. I couldn’t laugh or smile,” said Peyton. “I feel more confident.”