Facial Nerve Problems and Bell's Palsy (Bell Palsy)

  • Medical Author:
    Danette C. Taylor, DO, MS, FACN

    Dr. Taylor has a passion for treating patients as individuals. In practice since 1994, she has a wide range of experience in treating patients with many types of movement disorders and dementias. In addition to patient care, she is actively involved in the training of residents and medical students, and has been both primary and secondary investigator in numerous research studies through the years. She is a Clinical Assistant Professor at Michigan State University's College of Osteopathic Medicine (Department of Neurology and Ophthalmology). She graduated with a BS degree from Alma College, and an MS (biomechanics) from Michigan State University. She received her medical degree from Michigan State University College of Osteopathic Medicine. Her internship and residency were completed at Botsford General Hospital. Additionally, she completed a fellowship in movement disorders with Dr. Peter LeWitt. She has been named a fellow of the American College of Neuropsychiatrists. She is board-certified in neurology by the American Osteopathic Board of Neurology and Psychiatry. She has authored several articles and lectured extensively; she continues to write questions for two national medical boards. Dr. Taylor is a member of the Medical and Scientific Advisory Council (MSAC) of the Alzheimer's Association of Michigan, and is a reviewer for the journal Clinical Neuropharmacology.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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What surgical reconstruction options are available?

Reconstructive options for patients with facial muscle weakness or paralysis include one or more of the following:

  • Nerve repair or nerve grafts: Facial nerve regeneration occurs at a rate of one millimeter per day. If a nerve has been cut or removed, direct microscopic repair is the best option.
  • Nerve transposition: Often the tongue nerve (hypoglossal nerve) or the other facial nerve can be connected to the existing facial nerve. For example, the patient can then train themselves to move their face by moving their tongue.
  • Muscle transposition or sling procedures: The temporalis muscle or masseter muscle (some of the only muscles on the face not supplied by the facial nerve), can be moved down and connected to the corner of the mouth to allow movement of the face.
  • Muscle transfers: Free muscles from the leg (gracilis) can be used to provide both muscle bulk and function. Often a cross facial nerve transposition is done to provide similar nerve supply to the donor muscle flap.
  • Ancillary eyelid or oral procedures: In addition to one of the above, often it is necessary to include a brow lift or facelift, partial lip resection, eyelid repositioning, lower eyelid shortening, upper eyelid weights, or eyelid springs in reconstructive surgery following severe facial nerve palsies.

What is the prognosis for facial nerve problems?

The prognosis for facial nerve damage depends on the underlying cause. Many patients who have required surgery to remove tumors may have unavoidable permanent injury to the facial nerve, whereas a majority of persons who experience Bell's palsy will have complete recovery. The best outcomes occur with rapid diagnosis and treatment.

Medically Reviewed by a Doctor on 11/6/2015

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