Surgical Treatment of Facial Paralysis

Surgical Treatment of Facial Paralysis

Facial Palsy or 7th Cranial nerve paralysis involves loss of function of facial muscles innervated by the facial nerve.

Causes: Bell’s palsy, infections, trauma, tumors, or stroke. There is muscle weakness on one side of the face, causing asymmetry, loss of taste, decreased salivation and tear secretion, and hyper causes. Diagnosis is made by clinical evaluation & CT/MRI scans to rule out treatable causes. Treatment of the underlying cause if found and exercises in the case of Bell’s Palsy. Protection of the eye with artificial tears, eyewear is important to avoid corneal ulceration.

Surgery: Early surgery (within 18 months of paralysis) is aimed at restoring nerve function in the form of nerve transfers, either a cross-facial nerve transfer or a partial hypoglossal to facial transfer.
Late presentations are offered, static or dynamic procedures, where a temporalis muscle or a free functional gracilis muscle is used to reanimate the face. We present a patient with 5 years old facial palsy following surgery of a CP angle tumor done elsewhere. We used the temporalis muscle sling procedure where the temporalis origin was detached, turned down, and connected with fascia lata grafts, and attached to the upper and lower orbicular muscles and the angle of the mouth, to reinnervate the face.

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