Management of Facial Paralysis Following Skull Base Surgery: A Comprehensive Narrative Review.

Area of Science:

• Neurosurgery
• Plastic Surgery
• Rehabilitation Medicine

Background:

• Facial paralysis is a common and debilitating complication of skull base surgery.
• It significantly impacts patients' quality of life, causing functional deficits and psychosocial distress.

Purpose of the Study:

• To provide a comprehensive review of current management strategies for post-skull base surgery facial paralysis.
• To outline an individualized approach to treatment selection based on paralysis characteristics and patient goals.

Main Methods:

• A narrative literature review was conducted.
• Analysis included surgical reanimation techniques (nerve grafts, transfers, muscle transfers), static procedures, and non-surgical interventions (physical therapy, botulinum toxin, psychological support).

Main Results:

• Dynamic surgical options like nerve grafting/transfers are effective for viable muscles; muscle transfers are used for long-standing paralysis.
• Static procedures improve resting symmetry and eye protection.
• Non-surgical methods enhance function, reduce synkinesis, and address emotional burden.

Conclusions:

• Management necessitates a multidisciplinary, patient-centered approach.
• Integrating surgical and non-surgical interventions maximizes functional and aesthetic outcomes.
• Restoring facial movement and psychosocial well-being are key goals.