Facial Nerve Problems and Bell's Palsy

Anatomy of an Ear Infection Slideshow

Medical Revising Author: Standiford Helm II, MD
Medical Revising Editor: Melissa Conrad Stöppler, MD

• What is the facial nerve?
• What are symptoms of a facial nerve problem?
• What conditions affect the facial nerve?
• How are the causes of facial nerve dysfunction diagnosed?
• What is Bell's palsy?
• What are treatment options of facial nerve paralysis?
• What is the treatment for eye problems from facial nerve disorder?
• What surgical reconstruction options are available?
• Facial Nerve Problems and Bell's Palsy At A Glance

What is the facial nerve?

The facial nerve is a nerve which controls the muscles on the side of the face. It allows us to show expression, smile, cry, and wink. Injury to the facial nerve causes a socially and psychologically devastating physical defect; treatment may require extensive rehabilitation or multiple procedures.

The facial nerve is the seventh of the twelve cranial nerves. Everyone has two facial nerves, one for each side of the face. The facial nerve travels with the hearing nerve (the eighth cranial nerve) as it travels in and around the structures of the middle ear. It exits the front of the ear at the stylomastoid foramen (a hole in the skull base), where it then travels through the parotid gland. In the parotid gland it divides into many branches which provide motor function for the various muscles and glands of the head and neck.

What are symptoms of a facial nerve problem?

Facial nerve problems may result in facial muscle paralysis, weakness, or twitching of the face; dryness of the eye or the mouth; or alteration of taste on the affected side. However, the finding of one of these symptoms does not necessarily imply a specific facial nerve problem; your physician needs to make a careful investigation in order to make a precise diagnosis.

What conditions affect the facial nerve?

There are numerous causes of facial nerve disorder:

• Trauma: such as birth trauma, skull base fractures, facial injuries, middle ear injuries, or surgical trauma.

• Nervous system disease: including Opercular syndrome, Millard-Gubler syndrome.

• Infection: of the ear or face, or Herpes Zoster of the facial nerve (Ramsey-Hunt syndrome).

• Metabolic: diabetes mellitus or pregnancy.

• Tumors: acoustic neuroma, schwannoma, cholesteatoma, parotid tumors, glomus tumors.

• Toxins: alcoholism or carbon monoxide poisoning.

• Bell's palsy: Also called idiopathic facial nerve paralysis (see below).

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