Facial Paralysis

UT Southwestern Medical Center offers comprehensive, multidisciplinary treatment for many of the most complex facial paralysis problems. We understand that confronting facial paralysis is very difficult. Our goal is to help. 

There are many causes of facial paralysis, but the signs and symptoms are often similar and include:

• Inability to smile: Smile asymmetry may range from being nearly unnoticeable to severe asymmetries with obvious deformities, even when the face is at rest. In it’s more severe forms patients are unable to create a symmetric smile and the paralyzed side is droopier, even at rest.
  
• Inability to close the eye: Because one of the muscles surrounding the eye assists in eye closure, patients with partial or complete facial nerve paralysis often have difficulty closing the eye. Incomplete closure of the upper eyelid, in combination with decreased production of tears due to facial nerve injury, may expose the eye to dryness and corneal irritation, often resulting in pain (especially after waking), abrasions, ulcerations, and rarely blindness. This condition is also known as exposure keratopathy.
  
• Impaired speech: Due partially to the paralysis of muscles of the lips and those surrounding the mouth, patients frequently complain about impaired speech.
  
• Forehead paralysis: If the frontal branch of the facial nerve is involved, patients lose the ability to raise their forehead. In younger patients it is sometimes less noticeable, but regardless of age, this causes significant impairment in both form and function. Patients lose the ability to lift the eyebrow – an important action of facial expression – and frequently have a droopy brow, which causes both asymmetry, and may cover the eye and interfere with vision.
  
• Inability to clear food from mouth: Due to paralysis of the Buccinator muscle patients may complain about food remaining stuck in the cheek on the paralyzed side. Patients will often have difficulty advancing the food and will commonly use the tongue or fingers to mobilize the food.
  
• Drooling: Often in cases of severe paralysis, drooling of solids or fluids from the corner of the mouth may occur.
  
• Difficulty breathing from the nose: Often the sidewall of the nose is collapsed on the paralyzed side, causing difficult nasal breathing.
  
• Facial Dyskenesias: With Synkinesis, when a person voluntarily moves one muscle, another muscle is also involuntarily and simultaneously moved. It occurs when the facial nerve has degenerated and then partially recovers. Common examples include the closing of the eyes and the simultaneously twitching or partial elevation of the lip or the opening between the upper and lower eyelid when one attempts to smile. With Hyperkinesis, the resting state or activity of the muscle is exaggerated. It is not uncommon that the paralyzed side of the face is contracted or pulled towards the injured side yet cannot produce a functional smile. Very often, even in the resting state, the palpebral fissure is narrower on the paralyzed side in comparison to the normal side and may contribute to asymmetry of the face.
  

Medical attention is needed when facial paralysis only partially recovers or does not recover at all, is progressive, exists from birth, or has been of long-standing duration.

Our facial paralysis specialists not only diagnose and treat complex problems but also do so efficiently and conveniently in one location. Most patients can be evaluated in minimal time, and care is efficiently coordinated if several surgical teams are required for treatment.

Treatments

Our facial paralysis specialists offer treatments for all areas of the face, as well as associated conditions.

Facial paralysis treatments can vary based on the type and location of the paralysis, the elapsed time from when the paralysis occurred to the time of seeking treatment, the patient’s age, and patient preference. Treatment areas and conditions include:

• Forehead
• Eyes
• Smile
• Lower lip
• Abnormal facial motions (Synkinesis)

Postoperative Rehabilitation

UT Southwestern Medical Center's facial paralysis specialists expect you to be committed to your recovery and invest in yourself in order to maximize the results of your treatment.

The importance of pre- and postoperative rehabilitation is paramount.

Prior to surgery you will meet with an experienced therapist who specializes in facial nerve rehabilitation. During this visit, exercises may be prescribed based on the type of reconstruction that’s planned. In certain types of reconstruction, exercise is key to a satisfactory final result and success.

After surgery you will need to come to UT Southwestern every three months for an evaluation during the first year and every six months during the second year. If you are from out of state or country, we will help locate a therapist in your home area.

Working Together

Your meeting with a rehabilitation expert is for initial and continued guidance but is not a substitute for continued work at home or elsewhere – alone or with family and friends.

During the visitation we will decide with you the most appropriate treatment and start the journey of rehabilitation together.

At UT Southwestern, every patient has our commitment and dedication to reach our common goals.