Management of Facial Nerve Injury

After a complete physical examination is performed in addition to classifying the degree of injury by electrodiagnostic testing, the surgeon is faced with the decision of when and how to proceed with facial reanimation. The complex decision must also include considerations of patient-specific factors such as age, medical status, skin type, motivation for rehabilitation, and likelihood of appropriate

Table 5.5 Common surgical techniques

Surgical treatment options for facial nerve injury

Primary nerve repair

Cross-face grafting

Cable grafting

Regional muscle transposition

Free muscle flaps

Hypoglossal-facial nerve transfer

Static facial procedures: For example, upper lid gold weight, browlift, blepharoplasty, sling, and lower lid procedures

follow-up. Rehabilitation of the patient with facial nerve injury can include a comprehensive program that includes medical management, physiotherapy, psychosocial support, and the possibility of a myriad of surgical procedures available [19, 20] (Table 5.5).

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