Facial paralysis is a devastating problem that can arise from a number of different medical conditions, such as stroke, cancer treatment, trauma, or complication of ear surgery. Facial paralysis can be temporary or permanent, mild or severe, and may involve a segment or the entire face. Outside of the cosmetic concerns, paralysis of the face will result in inability to move the brow or close the eye, and significant difficulty with speech and swallowing. Patients who suffer from facial paralysis can become withdrawn and depressed. If not treated properly, individuals can suffer from visual loss secondary to eye injury and malnutrition due to swallowing problems.
Management of facial paralysis will depend on the severity of the weakness, expected degree of recovery, and extent of facial involvement. When paralysis is expected to be temporary, conservative measures such as eye lubrication and speech and swallow therapy will suffice. If the paralysis is likely to be permanent, surgical maneuvers are often necessary to protect the eye, allow for better lip function, elevate or suspend the face, or possibly restore natural facial movement.
Cosmetic surgical techniques such as brow lift or facelift will help elevate or suspend droopy facial muscles and skin. Eyelid paralysis is treated with a simple procedure known as gold-weight placement where a thin wafer of gold is placed in the upper eyelid to help close it. Static mouth closure can be achieved with slings from the cheekbone to the corner of the mouth. Alternatively, a muscle transfer from the temple to the corner of the mouth (temporalis muscle transfer) can allow dynamic mouth closure. More functional rehabilitation of facial paralysis can be achieved with nerve transfer from the tongue or a nerve transfer from the opposite side of the face (hypoglossal-facial nerve transfer, or cross facial nerve transfer). Simple office treatments with Botox can help fine tune minor persistent facial asymmetries.
Dr. Khosh is an expert in surgical treatment of facial paralysis. He works closely with other providers such as neurologists, ophthalmologists, speech and swallow therapists, and cancer or ear surgeons to deliver comprehensive and timely care to patients who suffer from facial paralysis. Please contact us for a private consultation should you or a loved one suffer from an acute or old facial nerve dysfunction.