title: Update in facial nerve paralysis: tissue engineering and new technologies.
abstract: OBJECTIVE
  To present the recent advances in the treatment of facial paralysis, emphasizing the emerging technologies. This review will summarize the current state of the art in the management of facial paralysis and discuss the advances in nerve regeneration, facial reanimation, and use of novel biomaterials. This review includes surgical innovations in reinnervation and reanimation as well as progress with bioelectrical interfaces.
  
  
  RESULTS
  The last decade has witnessed major advances in the understanding of nerve injury and approaches for management. Key innovations include strategies to accelerate nerve regeneration, provide tissue-engineered constructs that may replace nonfunctional nerves, approaches to influence axonal guidance, limiting of donor-site morbidity, and optimization of functional outcomes. Approaches to muscle transfer continue to evolve, and new technologies allow for electrical nerve stimulation and use of artificial tissues.
  
  
  CONCLUSIONS
  The fields of biomedical engineering and facial reanimation increasingly intersect, with innovative surgical approaches complementing a growing array of tissue engineering tools. The goal of treatment remains the predictable restoration of natural facial movement, with acceptable morbidity and long-term stability. Advances in bioelectrical interfaces and nanotechnology hold promise for widening the window for successful treatment intervention and for restoring both lost neural inputs and muscle function.
authors: aSection of Plastic Surgery, Department of Surgery bDepartment of Biomedical Engineering cDivision of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA *Nicholas B. Langhals and Melanie G. Urbanchek contributed equally to the writing of this article.
authors: Nicholas B
authors: NB
authors: Langhals
authors: Melanie G
authors: MG
authors: Urbanchek
authors: Amrita
authors: A
authors: Ray
authors: Michael J
authors: MJ
authors: Brenner
mesh_terms: D004599:Electric Stimulation Therapy; D005149:Facial Expression; D005158:Facial Paralysis / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D009416:Nerve Regeneration; D016067:Nerve Transfer / Q000379:methods; D009473:Neuronal Plasticity; D023822:Tissue Engineering; D054457:Tissue Scaffolds