Surgery For Facial Nerve Palsy

Surgery For Facial Palsy

What is facial palsy?

The facial nerve, also known as the seventh cranial nerve, is responsible for activating the facial muscles of expression. Each side of the face is subserved by one facial nerve that arises from the brainstem. When the facial nerve is injured due to trauma, tumour, stroke or other disorders, the facial muscles on the same side of the face become paralysed. This is known as facial nerve palsy.

Sometimes, the nerve palsy recovers spontaneously, as in the case of some stroke patients or those whose nerve injury is due to a viral infection (Bell’s palsy). Recovery may or may not be complete.  For those patients who do not show recovery, some steps have to be taken to deal with the problem of incomplete eye closure and an out-turned lower eyelid. The eyebrow may also descend markedly and require a browlift.

What are the treatment options?

For younger patients who do not wish to have the lateral part of the eye opening closed (this surgical procedure is known as lateral tarsorrhaphy), it is possible to consider implanting a gold or platinum weight on the upper eyelid to allow complete closure of the eye. It is important to note that even with the gold weight implanted, frequent application of tear lubricants is still important to keep the cornea healthy.

For older patients in whom cosmesis is not so important, particularly in those who also have poor corneal sensation and experience significant corneal surface breakdown due to the constant exposure, lateral tarsorrhaphy is a good option.

In both age groups, brow lift surgery and ectropion surgery can be performed where appropriate. Find out more about facial palsy treatment or facial paralysis surgery.