Facial nerve - paralyses, surgical approaches, rehabilitation

The seventh cranial nerve (also called the facial nerve) is a neuroanatomical structure that stems from the brainstem beside lower part of the pons, enters the facial canal by passing 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 the mentioned muscles but also provides fibres to glands (among others lacrimal, salivatory, sublingual); therefore, malfunction of this nerve may result in dire clinical consequences. Since it is localized mainly inside the 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 lack of facial muscle 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.