[Surgical treatment of sequelae after facial paralysis]

This review describes some of the principal surgical possibilities in the treatment of established facial palsy of long duration in which the opportunity for nerve reconstruction is lost and no remission can be expected. In such cases, ipsilateral or cross-facial nerve grafting, followed by microneurovascular muscle transfer are the methods of choice for providing controlled and emotional movement of the paralyzed side. Regional muscle transfer is also applicable. For patients who are not candidates for these extensive surgical procedures, symmetry to the face can be restored by one of several static procedures. Lastly, the eye-related problems and their surgical solutions are also addressed. Modern plastic surgery has much to offer this group of patients, who should not be left to live with their ailment, but should be referred to a few national centres for specialised treatment.