Reconstruction of the paralyzed face

Area of Science:

• Plastic Surgery
• Neurology
• Otolaryngology

Background:

• Facial nerve paralysis presents significant functional, aesthetic, and psychosocial challenges.
• Treatment goals include achieving facial symmetry, protecting the cornea, ensuring oral competence, and restoring facial movements while minimizing synkinesis.

Purpose of the Study:

• To discuss the anatomy of the facial nerve.
• To review etiologic factors of facial nerve paralysis.
• To outline patient evaluation and surgical reconstruction options.

Main Methods:

• Review of static and dynamic surgical procedures for facial reconstruction.
• Discussion of facial nerve reapproximation and interpositional grafting techniques.
• Emphasis on patient counseling regarding reconstructive process expectations.

Main Results:

• Facial nerve reapproximation or interpositional grafting yields the best results.
• Dynamic procedures generally outperform static procedures.
• Optimal facial reconstruction often requires a combination of static and dynamic approaches and multiple surgeries.

Conclusions:

• Successful treatment of facial nerve paralysis necessitates a comprehensive approach.
• Multiple surgical interventions, combining static and dynamic techniques, are often required for optimal outcomes.
• Thorough patient counseling is crucial due to the lengthy and complex nature of facial reconstructive processes.