FACIAL NERVE PALSY

The facial nerve is the seventh cranial nerve and is responsible for innervating the muscles of the face, specifically those around the eye, cheek, and mouth.

In facial nerve palsy, the dysfunction of these muscles causes both functional and aesthetic problems.

Facial nerve palsy can have many causes. In most cases there is no clear cause, a condition known as Bell’s palsy. However, it can be the result of a viral infection, tumors, trauma, and vascular diseases.

In facial palsy, half of the face is affected. The patient experiences a variety of symptoms, such as drooping of the eyebrow, drooping of the lower eyelid and inability to close the eyelids, drooping of the corner of the mouth, as well as muscle weakness on the affected side.

The inability to close the eyelid (lagophthalmos) can lead to severe dry eye syndrome and a persistent foreign body sensation.

Furthermore, the sensitivity of the cornea can be diminished, increasing the risk of corneal ulcers that may permanently threaten vision.

Finally, drooping of the eyebrow (brow ptosis) and the eyelid can cause both aesthetic and functional concerns. A drooping brow can obstruct the superior visual field, while the malposition of the lower eyelid (ectropion) often leads to excessive tearing (epiphora) because the tear drainage system is no longer properly aligned with the eye.

Facial palsy can be treated conservatively with the use of artificial tears, ointments, the use of adhesive tape during sleep, and in some cases botulinum toxin (botox) in order to protect the eye from exposure.

Surgically, the following surgeries can be performed:

• Platinum weight on the upper eyelid: The goal of this surgery is to help the eyelids close better.
• Tarsorrhaphy: This is an emergency operation that aims to protect the cornea from exposure.
• Canthoplasty: It is a surgery performed on the inner side of the eyelids to help with eyelid closure.
• Paralytic ectropion repair: The goal of this surgery is to restore the position of the lower eyelid and treat a watery eye.
• Brow lift and midface lift: to bring the eyebrow and cheek to their correct position, thus offering an aesthetic and functional result.