Introduction

To help patients who suffer from facial paralysis regain dynamic facial movement, The Facial Paralysis Institute is committed to implementing the most advanced surgical techniques. Dr. Azizzadeh is a world-renowned facial paralysis expert who customizes each patient’s procedure based on his or her individual circumstances. His top priority is to make sure his patients receive unparalleled levels of care. It’s no wonder patients travel from around the world to seek out his expertise.

After discussing the best ways to proceed during your consultation, Dr. Azizzadeh will utilize his team of facial plastic surgeons, otolaryngologists, neuro-otologists, neurosurgeons, head & neck surgeons, ophthalmologists and physical therapists to reach the objectives set forth in your treatment plan. Depending on the severity and longevity of a patient’s facial paralysis, there are a variety of facial nerve reconstruction and facial paralysis surgery options.

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Causes of Facial Paralysis

Facial nerve disorders present with a variety of different functional and aesthetic problems such as facial nerve paralysis, synkinesis, and hemifacial spasm. There are numerous causes of facial nerve paralysis (see table 1). The most common causes include Bell’s palsy, acoustic neuroma, trauma and parotid cancer. In this section you can click on each of the etiologies that you are interested in and get more information.

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Facial Nerve Anatomy

The facial nerve resembles a telephone cable and contains 7,000 individual nerve fibers. Each fiber carries electrical im-pulses to a specific facial muscle. Information passing along the fibers of this nerve allows us to laugh, cry, smile, or frown, hence the name, "the nerve of facial expression."

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House-Brackmann Grading System

Facial paralysis can result from trauma, infection, congenital, metabolic, neoplastic, toxic, iatrogenic, or idiopathic etiologies. Whatever the cause, the consequences for the patient can be devastating depending on the level of facial dysfunction. Several modalities exist to clinically rate the degree of facial function; including the widely used House-Brackman classification.

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Lower Facial Reanimation

The goals of facial paralysis reconstruction include achieving symmetry at rest, dynamic facial movement, and appropriate eyelid function. This chapter aims to address the non-surgical and surgical methods of lower facial reanimation with focus on delineating static and dynamic options.

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