title: Surgical management of facial nerve paralysis in the pediatric population.
abstract: BACKGROUND
  In the pediatric patient population, both the pathology and the surgical managements of seventh cranial nerve palsy are complicated by the small size of the patients. Adding to the technical difficulty is the relative infrequency of the diagnosis, thus making it harder to become proficient in the management of the condition. The magnitude of the functional and aesthetic deficits these children manifest is significantly troubling to both the patient and the parents, which makes immediate attention, treatment, and functional restoration essential.
  
  
  METHODS
  A literature search using PubMed (http://www.pubmed.org) was undertaken to identify the current state of surgical management of pediatric facial paralysis.
  
  
  RESULTS
  Although a multitude of techniques have been used, the ideal reconstructive procedure that addresses all of the functional and cosmetic needs of these children has yet to be described. Certainly, future research and innovative thinking will yield progressively better techniques that may, one day, emulate the native facial musculature with remarkable precision.
  
  
  CONCLUSIONS
  The necessity for surgical intervention in children with facial nerve paralysis differs depending on many factors including the acute/chronic nature of the defect as well as the extent of functional and cosmetic damage. In this article, we review the surgical procedures that have been used to treat pediatric facial nerve paralysis and provide therapeutic facial reanimation.
authors.affiliation: Institute of Reconstructive Plastic Surgery, New York University Langone Medical Center, New York, NY 10016, USA.
authors.forename: Jason S
authors.initials: JS
authors.lastname: Barr
authors.forename: Karin A
authors.initials: KA
authors.lastname: Katz
authors.forename: Alexes
authors.initials: A
authors.lastname: Hazen
mesh_terms: D000367:Age Factors; D000465:Algorithms; D020330:Bell Palsy / Q000601:surgery; D002648:Child; D019299:Decompression, Surgical / Q000379:methods; D004954:Esthetics; D005149:Facial Expression; D005155:Facial Nerve Diseases / Q000601:surgery*; D020220:Facial Nerve Injuries / Q000601:surgery; D005158:Facial Paralysis / Q000601:surgery*; D006257:Head / Q000254:growth & development; D006801:Humans; D018482:Muscle, Skeletal / Q000294:innervation / Q000637:transplantation; D016067:Nerve Transfer / Q000379:methods; D009929:Organ Size; D020127:Recovery of Function; D013524:Surgical Flaps; D016896:Treatment Outcome