Facial nerve: paralyses, surgical approaches, rehabilitation

The seventh cranial nerve (also called the facial nerve) is a neuroanatomical structure that arises from the brainstem near the lower part of the pons, enters the facial canal through the fundus of the internal auditory meatus, and finally emerges from the stylomastoid foramen, giving branches to the facial muscles. It innervates not only these muscles but also provides fibers to glands, including the lacrimal, salivary, and sublingual glands; therefore, malfunction of this nerve may result in dire clinical consequences. Because it is located mainly within bone, morphological variations may result in vulnerability to compression (because of the reduced lumen of the facial canal) and hence paralysis. Facial palsy is not only a severe problem from a medical point of view but also has sociological implications due to impaired facial expression. The aim of this review is to present the significance of facial nerve palsy, discuss possible surgical approaches and provide information on treatment and rehabilitation.