Facial Paralysis

Overview: Facial Paralysis

Perhaps no other problem encountered by the facial plastic and reconstructive surgeon is as devastating both cosmetically, and functionally than paralysis of the facial musculature. The facial nerve courses from the brainstem, through the skull base and into the cheeks. There are five main trunks of the nerve that control the upper, middle and lower portions of the face. The facial nerve may be destroyed as a consequence of trauma or from removal of a cancerous tumor.

The facial nerve which controls these muscles is critical for a number of functions many of us do not even realize. This includes expression and animation of the face, closure of the eyelids and protection of the eye, pursing of the lips and providing oral tone that is necessary for speech and eating. If one or all the muscles of the face are paralyzed the consequences are quite severe.

Slight weakness may not be detected by the casual observer, however, more severe cases can have intense psychological and functional consequences for the patient. The inability to properly close the eye and its constant tearing and irritation can be a potential threat to one’s sight. Paralyzed facial muscles will make annunciation and speaking more cumbersome. Flaccid and weak lips and mouth will make eating much more difficult as foodstuffs and liquids will tend to leak from the corner of the mouth. Controlling one’s secretions will also me much more challenging. These are all things many of us take for granted.

Procedure Our unique training in head and neck surgery and facial plastic surgery has given us the tools in making a proper diagnosis, eliciting an appropriate prognosis and providing the maximal therapeutic regimen.

Treatment may entail nerve grafting and reconstitution of the integrity of the nerve to repositioning of the brow and forehead complex in addition to repositioning of the lower eyelid. We also strive to reposition the middle and lower thirds of the face with complex nerve grafting, muscle repositioning and facelifting.

We approach facial nerve paralysis with the utmost of seriousness and will do everything to correct the situation. We employ a multidisciplinary team to maximize the outcomes while providing continuous support for the patient.