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Rehabilitation of Central Facial Paralysis

According to a recently published study performed by the Department of Otolaryngology – Head and Neck Surgery at Stanford University School of Medicine, hypoglossal-facial nerve anastomosis can help reanimate the face in patients with complete nuclear facial nerve palsy.

Facial paralysis occurs when a person is no longer able to move some or all of the muscles on one side of the face. It is almost always caused by damage or swelling of the facial nerve, which carries signals from the brain to the muscles of the face, or damage to the area of the brain that sends signals to the muscles of the face. There are, however, other causes as well, such as infection, Lyme disease, Sarcoidosis, and stroke. With a stroke, other muscles on one side of the body may also be involved.

The study, which involved retrospective case series and took place in a tertiary academic medical center, featured four patients with complete facial nerve paralysis due to lesions of the facial nucleus in the pons, caused by hemorrhage, stroke, cavernous venous malformations, or injury after tumor resection. 

All the patients underwent end-to-end hypoglossal-facial nerve anastomosis to determine if it could help reanimate the face. In order to measure the main outcomes, the researchers used the House-Brackmann scale to measure facial nerve function. They also used the Facial Disability Index to measure physical and social/well-being function.

The study featured three females and one male patient, and the mean age of the patients was 53.3 years. With a minimum of 12 months follow-up after end-to-end hypoglossal-facial anastomosis, 75% of patients regained function to HB grade III/VI, and 25% had HB grade IV/VI.

Average Facial Disability Index scores were 61.25 for physical function and 78 for social/well-being, which is comparable to results from complete hypoglossal-facial anastomosis after peripheral facial nerve palsy after acoustic neuroma resection.

Top of Form In short, the study showed that patients with nuclear facial paralysis who undergo end-to-end hypoglossal-facial nerve anastomosis achieve similar degrees of reanimation compared with those with peripheral facial nerve palsies. This raises the intriguing possibility that reinnervation may also be of benefit in patients who have facial dysfunction as a result of cortical stroke or injury.

If you are suffering from central facial paralysis and are actively considering your treatment options, we encourage you to schedule a consultation with Beverly Hills facial paralysis expert Dr. Babak Azizzadeh by calling (310) 657-2203 today!