Rehabilitation of long-term facial paralysis

A wide variety or techniques have been developed over the years in an effort to reduce the devastating impact of facial paralysis on the patient. The authors choose to perform hypoglossal-facial nerve anastomosis when facial facial nerve anastomosis, or cross-over, or microvascular muscle transplantation are impossible. Nevertheless, these results appear always insufficient for palpebral occlusion. The authors propose to associate two rehabilitation technique to obtain optimal results. They perform hypoglossal facial nerve anastomosis using the technique modified by U. Fisch, and they associate temporal muscular transfer to improve ocular protection. This association imposes an increased strain on the patient in an effort to undertake double re-education which modifies twice his classic corporeal scheme. The surgical technique are associated after evaluation of the possibility of the patient adherence to the long duration physical therapy.