Treatment considerations in facial paralysis.
Facial nerve paralysis and its sequelae are devastating to patients. For the reconstructive surgeon, the management of the patient with facial paralysis is challenging. There is a lack of consensus regarding the initial management. Then, there is the dizzying array of treatment options for each patient, including nonoperative observation, nerve transfers, static slings, dynamic muscle transfers, and chemodenervation. The appropriate timing of any intervention is often not clear. In this article, we will briefly outline some important considerations for the facial plastic surgeon in the management of facial paralysis. This includes the relevant anatomy and the initial evaluation. An overview of treatment options, with suggestions for the appropriate use of each option, is then provided.
Chu
Eugene A
EA
Department of Otolaryngology-Head and Neck Surgery, and Division of Facial Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
Byrne
Patrick J
PJ
D003952:Diagnostic Imaging; D004568:Electrodiagnosis; D005154:Facial Nerve / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D005158:Facial Paralysis / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008487:Medical History Taking; D018482:Muscle, Skeletal / Q000637:transplantation; D016067:Nerve Transfer; D010347:Patient Care Planning; D010808:Physical Examination; D019651:Plastic Surgery Procedures / Q000379:methods*; D013997:Time Factors