Facial reanimation surgery in facial palsy patients

Abstract

Facial paralysis can cause functional, social, and aesthetic problems, and facial reanimation is challenging in patients with facial paralysis. Facial paralysis is mainly approached by two methods, depending on the paralysis onset and muscle fibrosis degree. Recent-onset facial paralysis without muscle fibrosis is reconstructed by a nerve transfer. If the affected facial nerve is intact on the proximal side, nerve graft can be performed. New nerve sources, including hypoglossal and masseter nerve, are transferred if the affected facial nerve is damaged. In long-standing facial paralysis, wherein facial muscle fibrosis progresses, it is difficult to expect a facial movement even when new nerve signals are transferred. Therefore, it is reanimated by transplanting the muscle flap with new neural input. The free flap is more advantageous for natural restoring facial symmetry or facial movement than the local flap procedure. However, it needs a long operation time and recovery period. There are many ways to reconstruct facial paralysis. Various reconstruction methods have their pros and cons. Since the degree of facial paralysis is very diverse, it is necessary to understand the various reconstruction methods and apply them to the patients. Keywords : Facial paralysis, Bell palsy, Facial nerve injuries, Facial nerve, Free tissue flaps