FACIAL PARALYSIS REANIMATION
SCHWANNOMA | ACOUSTIC NEUROMA | MOEBIUS SYNDROME | NERVE PALSY
Facial nerve palsy constitutes a serious condition with only a few centres specialising in treating facial paralysis. It’s causes can be from trauma, after tumour resection like schwannoma or acoustic neuroma, congenitally as in Moebius Syndrome or after viral infections. Longstanding facial paralysis can cause ocular problems, feeding and articulation problems and severe cosmetic deformities. The latter caused by the loss of emotional muscle movements in the face.
Treatment depends on the specific cause, type of injury and the location, and important the duration of paralysis.
Primary and secondary repair of the nerves is the first choice if still possible. This can be performed by direct suture or with nerve grafts. If the facial nerve is destroyed or not available we can use other motor nerves. If there is no way to re-innervate facial nerve branches, we can transplant muscle to improve facial movements. The muscle we prefer for free muscle transfer in facial paralysis is the gracilis flap from the thigh.
There are other surgical and non surgical procedures and treatments to support and improve overall outcomes after facial paralysis. This includes static sling procedures and Botulinum toxin injections to increase facial balance and denervation procedures using radiofrequency to suppress over active muscle movement. Botox is frequently used for synkynesis after facial nerve palsy.