A tumor or infection near the facial nerve or in the area of the brain that controls it can cause paralysis. Rarely, a condition called Guillain-Barre syndrome can also trigger face paralysis.
Treatment for Bell’s palsy includes oral corticosteroids to decrease nerve swelling and speed recovery. Other treatments include physical therapy to improve facial symmetry and muscle strength, and speech therapy to help with swallowing and communication.
If a facial nerve is injured, it can result in the loss of spontaneous movement (the ability to move without conscious effort). Direct repair or grafting usually requires surgery within 72 hours to ensure that the injury doesn’t worsen. The surgical procedure involves removing the damaged muscle and connecting it under the microscope to an intact cranial nerve that will power it. Results are not immediate and may take months to a year for full recovery.
Occasionally, one side of the face will become paralyzed due to swelling of the nerve or damage to the brain that controls it. In these cases, we can sometimes help with in office injections of botulinum toxin or injectable filler that stimulate the nerve and promote muscle movement.
In other cases, the face muscle becomes weak over a period of weeks or months due to a slow growth on or around the seventh cranial nerve. The most common of these is a tumor called a schwannoma that develops inside the skull. Other types of benign or cancerous tumors can also cause this type of nerve damage.
This type of nerve damage can lead to problems with the platysmal muscle in the neck that enables you to tighten your skin as you raise your chin and smile. The muscle is usually active on both sides of the face so when it becomes dysfunctional this can affect both the symmetry of the lower part of your face and the way you speak and eat.
It is important to note that there are many causes of facial paralysis. A traumatic head injury or stroke, infections such as herpes and Lyme disease, tumors that grow on or near the seventh cranial nerve, aging and other factors can all contribute to this condition. Early evaluation with a board certified plastic surgeon with advanced training in this condition can improve recovery rates.
Facial paralysis happens when the facial nerve (cranial nerve #7) becomes damaged, usually resulting in weakness and drooping on one side of the face. It can occur due to injury, surgery, complications of stroke, autoimmune diseases or Bell’s Palsy. The facial nerve transmits signals from the brain to muscles that control facial expression and even carries some taste and ear sensation information. In addition, it sends signals to the lacrimal gland in the eye to produce tears and carries some articulation functions such as speaking, chewing and swallowing.
It is important to know the cause of your facial paralysis in order to determine what type of treatment is best for you. For example, if your facial paralysis is caused by Bell’s Palsy, the condition typically occurs when the facial nerve becomes swollen and inflamed, causing your muscles on that side to become weak or not move at all. It usually comes on suddenly over a 48 to 72 hour period and can be permanent in some cases.
In contrast, if your facial paralysis is due to a brain tumor, it often develops slowly and is more likely to be permanent in some cases. Similarly, if your facial paralysis is due a stroke, it is likely to improve as you recover from the illness, but in some cases it may be permanent.
There are several surgical techniques that can treat facial paralysis to help restore a more normal facial appearance, improve essential function such as speech and the ability to hold food and liquids in the mouth and decrease symptoms such as tongue weakness. For example, a surgical procedure called a nerve graft can be performed when a patient is diagnosed with Bell’s Palsy or other causes of facial paralysis in which the functional branch of the facial nerve is damaged. A small segment of the functional facial nerve is removed and inserted into the damaged branch on the opposite side of the face.
Another surgical technique is known as a selective neurectomy that is used to decrease synkinesis in facial movement and spasming that can occur in Bell’s Palsy or when recovery from a stroke is incomplete. This procedure cuts nerves that stimulate unwanted movements and helps your face to look more natural and decreases muscle tightness or spasming that results from incomplete recovery of your facial nerve.
In some cases, facial paralysis develops slowly and one side of the face loses movement over weeks or months. This may be caused by a slow-growing tumor on the seventh cranial nerve (facial nerve schwannoma) that is putting pressure on the nerve, causing it to become less functional.
It is possible to recover from this condition with surgery. However, the recovery depends on how the nerve is treated, and if other parts of the facial nerve are involved in function. The goal of this surgery is to restore as much facial mimetic function as possible. Patients who are treated with timely nerve repair tend to experience better outcomes. A recent study showed that if the facial nerve is repaired within six to twelve months, most patients will recover smile symmetry, 80% of eye closure without the need for eyelid weights, and 40% of eyebrow elevation.
Another option is to transfer muscle from another location to the area of the paralyzed side of the face. Using a flap of tissue from the inner thigh (fascia), this technique is called a free tissue transfer or a “flap.” The facial nerve provides blood flow and nerve energy to the newly transferred muscle. This procedure is usually performed in combination with a facial lift.
The platysmal muscle is a thin but broad muscle that runs from the lower edge of the jaw bone to the collar bones. It is sometimes affected in Bell’s Palsy and does not normally cause a significant problem. In some people who have Bell’s Palsy that does not resolve fully, this muscle can remain tight and flexed and will demonstrate miscoordination with other parts of the face known as synkinesis.
A thorough history and physical examination are the mainstays of diagnosis for facial paralysis. In addition, certain diagnostic tests will be used depending on the type of paralysis and its underlying cause. For Bell’s Palsy, a complete workup includes MRI and CT scans of the head and neck and bloodwork. When the condition is recurrent, a more extensive workup may be needed including electrodiagnostic studies.
While dynamic procedures are the most important treatment for restoring facial movement, there is also a need to improve the appearance of the face at rest. This is accomplished with static support surgeries that correct the corner of the mouth, nasolabial fold (smile line), and the base of the nose in order to provide more balanced facial symmetry. These surgical techniques are an important addition to the armamentarium of facial paralysis surgeons.
This surgery is commonly performed in combination with dynamic procedures, such as a VII-VII cross facial nerve graft or a masseteric nerve transfer. During this procedure, tissue from the leg (fascia) is removed through a surgical incision in the thigh and is then sewn underneath the skin of the face to hold up the corner of the mouth. This is an effective and relatively quick method of restoring a more symmetric appearance to the face at rest.
A common cause of facial paralysis is tumors that push on or extend into the facial nerve. Some of the most worrisome types of tumors that cause this condition include acoustic neuroma, schwannoma, and cholesteatoma. If these growths are causing facial paralysis, it is important to undergo a detailed assessment by a plastic and reconstructive surgeon with advanced training in facial nerve microsurgery to determine the appropriate course of treatment.
In some cases of paralysis due to tumors, the facial nerve may be completely damaged. This type of injury is often most worrisome, especially if it occurs in the central portion of the face. If a child has this type of facial paralysis, it is important to have them undergo a thorough evaluation by a team of doctors including a neurosurgeon and a neurologist.
If the facial nerve is fully paralyzed, it can be challenging to restore dynamic function. This is why it’s important to discuss treatment options with a board-certified plastic surgeon. Cincinnati Children’s offers state-of-the-art treatment plans and surgical repair for children with facial paralysis.
Static reconstruction can help children with face paralysis look and feel better about themselves. In addition, these procedures can help them with their speech and eating abilities. By addressing these issues, we can make sure your child has the best chance of recovery from facial paralysis caused by trauma or a brain tumor.
Facial paralysis can cause one side of the face to droop or become stiff. It can also interfere with how well you smile or eat. NYU Langone otolaryngologists—ear, nose, and throat doctors—are experts in diagnosing facial nerve paralysis.
Sometimes the seventh cranial nerve becomes inflamed, swollen, or compressed. This is known as Bell’s palsy, and it causes a sudden loss of muscle movement on one side of the face.
The facial nerve carries signals from your brain to the muscles that control your face (and also connects your sense of taste and some sensation in the front of your tongue). Damage or swelling of this nerve can cause weakness, droopiness and lack of movement on one side of your face. This condition is referred to as Bell’s palsy, and it usually improves over time. Sometimes, however, it can be permanent.
The exact cause of Bell’s palsy isn’t known, but it seems to result from inflammation or compression of the seventh cranial nerve. The seventh cranial nerve runs from your brainstem to your jaw and cheek, as well as the outer surface of your nose. It is also involved in the senses of touch and taste.
In 60-75% of cases, paralysis develops on just one side of the face. The symptoms typically appear suddenly and may be preceded by pain behind the ear on that side. The weakness is caused by a temporary reduction in the blood supply to the seventh cranial nerve, and it often recovers within two weeks. In some people, the nerve never recovers, but this is extremely rare.
It’s important to get a diagnosis as soon as possible because the faster you get treatment, the greater your chances of recovering full facial function. Otolaryngologists, who are doctors who specialize in treating the ears, nose and throat, can diagnose the problem. They will ask you when the symptoms began, how quickly they progressed and whether you can move any of your facial muscles on the affected side. They will also ask you if you have any other symptoms, such as hearing loss or tinnitus, which is a ringing in the ears.
A few other conditions can also lead to facial paralysis. For example, tumors inside the skull can push on or extend into a nerve, and infections in the area of the brain that sends signals to the facial nerve can lead to paralysis. Another rare cause is a neurological disorder such as Guillain-Barre syndrome, which occurs when the body’s immune system attacks its own nerve tissue.
Facial paralysis is typically caused by damage to the nerve that controls the muscles in your face. In most cases, the facial nerve becomes weak or completely paralyzed on only one side of your face, although it can affect both sides in some people. In general, this type of paralysis is not permanent and often improves with time. However, it is important to get to a doctor as soon as possible to identify and treat the cause of the problem.
A physician will begin by performing a physical exam and taking your medical history. They will want to know about any recent events that may have led to the weakness in your face. They will also ask if you have had any other problems with your ears, eyes, mouth, or head. They will perform a test that uses electrodes to measure the electrical activity of your face and muscles. The results of this test can help them determine the extent of nerve damage or if your muscle movement is improving.
If the onset of your facial paralysis was sudden, your doctor will likely diagnose you with Bell’s palsy. This condition develops when the seventh cranial nerve that controls your facial muscles becomes inflamed, swollen, or compressed. The symptoms usually develop quickly, within three days, and only affect one side of your face. People who experience Bell’s palsy may also notice other symptoms, such as a drooping eyelid or cheek on the affected side, changes in taste and sensitivity to sound, difficulty blinking, numbness on that same side of their mouth, or trouble closing their eye and breathing through their nose.
If you have a more gradual onset of your face weakness, it may be due to a stroke or brain tumor. In these cases, other muscles on one side of the body are likely to be affected, and you may also have headaches or seizures. Alternatively, your weakness may be due to an autoimmune disease or neurological disorders such as Guillain-Barre syndrome. In these situations, other tests will be necessary to identify the underlying cause of your face weakness.
Facial paralysis affects one side of the face and usually occurs when a nerve (cranial nerve #7) that carries signals from the brain to the muscles becomes damaged, causing weakness or drooping. It can occur suddenly or gradually depending on the cause and can be temporary or permanent.
Bell’s palsy typically develops from swelling of the facial nerve and can be very painful and disabling but is usually not life-threatening. Other causes of facial paralysis can be more serious and may require immediate treatment to prevent worsening.
Neuromuscular facial retraining is a physical therapy technique that can improve the strength and function of the face by helping the patient actively coordinate facial movements. This type of treatment has been shown to reduce recovery time and to improve the ability to smile, close the eye and to speak. Neuromuscular facial retraining is often combined with visual or electromuscular biofeedback, mechanical stimulation and electrical stimulation for optimal results.
The gracilis muscle transplant procedure can restore moving, functional muscle to the face in cases of long-standing facial paralysis. A strip of muscle, including the artery and vein, is surgically removed from the inner thigh through a small incision. The muscle is then connected by microscopic sutures to the gracilis nerve in the neck and to an intact cranial nerve in the face.
Botulinum toxin injections (Botox) can be used to help decrease involuntary twitching that sometimes happens in patients with facial paralysis. This is most useful in treating the early stages of a stroke, but can also be used to treat Bell’s palsy and other types of facial paralysis that are caused by inflammation or nerve damage.
Some people with facial paralysis are able to recover movement on their own as the nerves heal or the problem is reversible and will resolve on its own. Those who don’t recover or who want to improve their quality of life should consider nonsurgical treatment options that include physical therapy, medications, minimally-invasive facial injections and surgery. Duke’s team of experts evaluates each case of facial paralysis to determine the best course of action. Our goal is to restore symmetry and movement to the face so that you can feel confident in your appearance.
The seventh cranial nerve, which controls the movement of your facial muscles, can become weak or damaged for many reasons. When this happens, one side of the face may droop. Rarely, the entire side or both sides of the face can be affected. The weakness can occur in adults and children of all ages. It can come on suddenly, as in Bell’s palsy, or develop gradually over a period of time, as in a stroke or brain tumor.
There are a variety of tests that can help your doctor discover what caused your facial paralysis. They include electromyography, imaging scans and blood tests. These tests can help your doctor see whether a nerve is damaged, or the area of the brain that sends signals to the face is inflamed. Your doctor may also ask you to move your facial muscles and will note the results.
Your doctor will also ask you about your symptoms and when they started. They will want to know if your symptoms are mild, moderate or severe and if they affect only one side of the face or both. They will ask if you have any other problems such as hearing loss or tinnitus (ringing in the ears). Some people with facial nerve paralysis feel their face tighten on the side that’s affected or develop synkinesis, which is the miscoordinated movement of different parts of the face, such as eye closure with mouth movement.
Facial paralysis is not a dangerous condition and usually recovers on its own, but it should never be ignored because it can indicate a serious underlying issue such as a stroke. Follow your health care provider’s instructions and take any medications that are prescribed.
Facial paralysis can be caused by congenital conditions (Moebius syndrome, hemifacial microsomia), stroke, brain tumor or Bell’s palsy. There is a delicate connection between the brain, nerve and muscles that if interrupted will result in facial paralysis.
Surgery can restore symmetry to the face and allow for muscle movement. This is accomplished through several techniques:
In cases of facial paralysis caused by nerve injury or tumor, it is often possible to restore movement in the damaged side of the face using nerve grafts. This procedure involves taking a nerve from the inner thigh and tunneling it through the facial skin to connect to the damaged nerve in the face, which can then send signal to stimulate muscles and bring back movement.
This surgery is performed through limited incisions placed in the natural skin crease directly in front of the ear. The surgeon explores the function of facial nerve branches on both sides of the face, and electrical stimulation is used to verify the absence of motion on the damaged side of the face. The surgeon then maps the function of specific facial nerve branches on the undamaged side, to identify the ideal donor axons.
The surgeon then prepares the facial skin in preparation for graft insertion. This includes protecting the eyes by applying adhesive film dressings or temporary tarsorrhaphy sutures. It is important to make a definitive mark on the patient’s face to avoid intraoperative confusion, and one common method of this is writing “P” on the face and “NP” on the cheek, or marking with a permanent tattoo.
After the axons of the facial nerve have been tunneled through the skin, the surgeon is then ready to place the graft. The graft is positioned and anchored to the jawbone underneath the ear lobe, and to the facial skin with special care to avoid disrupting blood vessels or nerves. The surgeon then closes the graft with a series of small stitches under a high power microscope, and places special nerve sheaths to promote healthy axonal growth.
Once the graft is placed, it will take several months for nerve signals to travel across the nerve graft and activate the damaged face muscles, which can then produce facial movement. This is the primary reason for a wait of about two years to offer this treatment, since it can be difficult to retrain facial muscles after they have been stagnant for so long.
Nerves differ from other tissues in that they operate on electrical impulses and conduction, and other tissues do not. As such, if you injure a nerve and the damage cannot be repaired by simply re-connecting the ends of the damaged nerve, it may be necessary to bridge the gap with a new source of nerve fibers, or a “nerve graft.”
The most common technique for this is to take a functioning, uninjured facial nerve branch from the opposite side of your face, and connect it to the injured nerve and paralyzed muscles. This technique requires some months for the nerve fibers to grow across the bridge and to your muscles, but it is highly effective.
In other cases, if the injury is more extensive and the ends of the nerve can’t be reconnected, a surgery called nerve splicing or neurotransplantation may be needed to bridge the gap. This is also a lengthy procedure, which involves taking an extra nerve from elsewhere in your body, cutting it, and splicing it to the two free ends of your damaged nerve.
This works best when the nerve has been cut cleanly, but is ineffective if the injury was caused by severe stretch or chemical damage (e.g., alcohol or steroid burns). In such cases, the surgeon will usually use a processed nerve allograft to help speed up the healing process and reduce the likelihood of nerve graft rejection by your body.
A new surgical technique may increase the effectiveness of nerve splicing by using a biomimetic approach to mimic nature’s neural tubes. Researchers from the University of Sheffield and the German company Zentrum Hannover Laser have developed a method for applying the polymer polyethylene glycol, or PEG, to the membranes of a large number of nerve cells simultaneously. They applied this to the spinal cord of a guinea pig that had been severed and found that PEG fused the membranes of a significant number of the severed nerve cells together, creating a continuous nerve graft in 100 percent of cases. This is an important advance over previous techniques, such as tendon transfer surgery, where surgeons move a specialized tendon from one part of the body to another, to repair damaged nerves.
A free tissue transfer is a surgical procedure that transplants living tissue from one part of the body to another while retaining its blood supply. During the procedure, surgeons remove a small block of skin, tissue, muscle or bone from one region of your body (the donor site), and then reattach it to a matching artery and vein in another area (the recipient site).
This allows your reconstructive team to create complex structures that wouldn’t be possible with any other technique. The ability to transplant living tissue with a minimal loss of blood supply has opened up many more possibilities in the field of facial reconstruction. This technique is often used in patients with recurrent head and neck cancer who require large reconstructions to protect vital functions. Large series from major microsurgical centers have reported successful flap survival rates ranging from 91% to 99%.
Because of the success and safety of this technique, it has become increasingly popular with surgeons who specialize in head and neck surgery. This has led to a dramatic increase in the use of microsurgical techniques for head and neck reconstruction in the elderly population. Unfortunately, few studies have addressed the comorbidities that may affect free tissue transfer outcomes in this group of patients.
This study retrospectively examined 28 patients with head and neck cancer who underwent microvascular free tissue transfers using radial forearm, fibula, latissimus dorsi, or rectus abdominis flaps. Patients were between 60 and 77 years of age, and almost half were smokers. The majority of head and neck tumors were squamous cell carcinoma.
Results of this study indicate that a high ASA score is associated with increased risk for postoperative complications in head and neck free tissue transfer patients. This finding suggests that a multidisciplinary approach to preoperative assessment is important in this patient group. Additionally, the authors suggest that a preoperative discussion of the pros and cons of free tissue transfer in this patient population is warranted. This will help to minimize postoperative morbidity and improve long-term outcomes. Future research should explore ways to identify perioperative factors that can reduce the incidence of postoperative complications in this patient group, particularly among those who are smokers.
Facial paralysis occurs when the nerves that control your facial muscles become damaged resulting in weakness and drooping on one side of the face. This may be caused by stroke, trauma or an autoimmune disease such as multiple sclerosis. It can be temporary or permanent.
The goal of treatment is to restore the ability to move your face and regain normal facial symmetry. There are several different treatments for this problem that include specialized physical therapy, minimally-invasive injections and surgery. Depending on the cause of your face paralysis the right solution will vary and must be tailored to your situation.
For patients who have lost movement to the entire face, facial reanimation surgery may be necessary. This involves taking muscles from other areas of the body and transplanting them into the area of the face affected by paralysis. This type of surgery is known as a free flap technique. Using this technique facial plastic surgeons can transfer all or parts of existing muscle to the affected area restoring function and improving symmetry.
When a muscle is transferred to the face the surgeon must ensure that it can be activated by the facial nerve. The most common way to do this is to graft a small section of the sural nerve (sensory nerve of the lower leg) to a functional branch of the facial nerve. The surgeon then tunnels this nerve underneath the skin to the paralyzed area of the face (often within the upper lip). The goal is that when the functional side of the face moves the signal will be transmitted to the paralyzed side, triggering movement there as well.
This technique can also be used to target specific facial movements by connecting the muscle to a single point on the face that needs to be stimulated. For example, a temporalis tendon that connects the temple to the jaw can be transferred to the corner of the mouth to improve its movement and help keep the lips closed. This can be useful in patients who have had other surgeries involving the face that have changed its shape, such as a necklift or chin implant.
For your face to move normally there needs to be an intact connection between brain, nerve and muscle much like a table lamp only works when it is plugged into a working outlet. When the facial nerve is injured the connection is broken.
One-sided facial paralysis can be the result of Bell’s palsy or other conditions including a stroke, a tumor or an autoimmune disease. NYU Langone otolaryngologists can help restore movement to your face.
The neck is home to many muscles that help you move your head, spine, and torso. Two of these muscles, the sternocleidomastoid and trapezius, form the outermost layer of neck muscle (figure 2). Another set of muscle in the front of your neck is called the platysma. When this muscle is not working properly with facial paralysis, it can cause the skin on the side of your neck to feel tight or “heavy.” This tightness can contribute to a sagging appearance in the lower part of the face and neck on the affected side (figure 2).
The next set of neck muscles are the scalene muscles, which attach to the cervical vertebrae and support neck movement. There are three main scalene muscles: the anterior scalene, posterior scalene, and lateral scalene. The anterior scalene muscle is responsible for flexing the neck forward and backward. The posterior scalene muscle is responsible for bending the neck to the opposite side, or ipsilateral flexion. The lateral scalene muscle pulls the jawbone downward and toward the chest.
Facial nerve paralysis can be caused by problems with any of these muscles or by damage to the nerve that controls them. The most common cause of facial nerve paralysis is Bell’s palsy, which usually develops suddenly and affects one side of the face. In most cases, Bell’s palsy is due to swelling of the facial nerve, which temporarily restricts its blood supply. However, a variety of other conditions can also cause paralysis of the facial nerve, including infections, tumors, autoimmune disorders, and neurologic disorders like Guillain-Barre syndrome.
If you have facial paralysis, doctors can use several diagnostic tests to find out what is causing your symptoms. One test is an electromyogram, which measures the electrical impulses transmitted along nerves and muscle tissue. During the electromyogram, your doctor inserts needle electrodes into the skin and into muscles that correspond to specific nerves. Then, he or she asks you to move these muscles if you can. The results of this test can indicate which nerves are involved and whether they are weak or functioning normally. In some cases, a doctor may conduct this test several times over the weeks following diagnosis to see if a nerve is recovering.
There are several muscles in the nose that perform a variety of functions. The nasalis muscle (Latin: musculus nasalis) is one of them. It is a paired muscle with a transverse and alar part. The transverse portion compresses the nasal cartilages and widens the nostrils, while the alar part dilates the nostrils. This muscle is innervated by the facial nerve (CN VII). If the facial nerve is damaged, this can cause a loss of function in the nose muscles. In addition, the nasalis muscle can contribute to the drooping of the forehead and eyebrows that is often seen in patients with facial paralysis.
People who have a weakening of the facial nerve on one side may experience trouble closing their eyelids, which can lead to dry eyes and even corneal ulcerations. Inability to open the mouth completely, as well as the ability to eat or breathe through the nose, can also be a problem when the chin or lip muscles become weak.
Forehead paralysis can result in a droopy brow that can cover the eye or interfere with vision and, in older people, can cause the face to droop on one side. It can also make it harder to raise the eyebrow, which is an important action for expression. It is common for people with paralysis of the frontal branch to complain that food gets stuck in their cheek on the paralyzed side.
If you have a weakness in the muscles of your face on one side, NYU Langone doctors will conduct diagnostic tests to determine the cause of your paralysis. These include a physical exam to look for signs of injury or damage to your nerves and muscle tissue, such as a numbness in the affected area. We also use a special test called an electromyogram (EMG) to measure the electrical activity of your muscles and nerves. For this test, we insert small needle electrodes into your skin and ask you to move the muscles that correspond to them. The signals that are recorded indicate whether the nerves or muscles are working properly.
The mouth muscles receive facial nerve signals to move, but sometimes those messages don’t get through. When this happens, the facial muscles on one side of your face can’t move properly and may look weak or droopy. This can cause problems with speech, eating and eye closure. It can also lead to a crooked smile or difficulty keeping food in your mouth to prevent drooling.
There are three main types of facial paralysis: congenital, acute and chronic. Congenital paralysis occurs at birth and is usually permanent, although some cases of congenital facial paralysis improve with age. Acute facial paralysis typically happens in less than three days and affects just one side of the face. This type of facial paralysis can be caused by Bell’s palsy, stroke or injury. Chronic facial paralysis occurs over a longer period of time and tends to worsen with age. This can be caused by a tumor or other growth pressing on the facial nerve, a stroke or other trauma and even certain cancers of the head and neck.
If you have Bell’s palsy, the quickest way to restore function to your mouth muscles is to receive Botox injections. But some people need more than that, and for them, facial nerve surgery might be the answer. In this procedure, select branches of the facial nerve on the functional side of your face are cut and connected to a nerve graft from the lower leg (known as a cross facial facial nerve graft). The new nerve is then passed under the skin to the paralyzed side of the face and connected to the damaged nerve.
Another option for restoring the movement of your mouth muscles is to transfer a muscle from the inside of your inner thigh to the paralyzed side of your face. The most common choice for this is the gracilis muscle, which is removed through a small incision and sewn to the corner of your mouth to the cheek bone in a position that matches the smile movement of the natural facial muscles on the opposite side of your face. The grafted gracilis muscle is then connected with microscopic sutures to an artery and vein in the neck to provide blood flow and a nerve to power it.
The eyes are surrounded by six muscles that attach to the eye socket (orbit) and work to move the eyes up, down, side to side, and rotate them. They also work in teams to move the eye in and out of focus as needed. For example, when looking upwards, the inferior oblique muscle contracts while its antagonist, the superior rectus muscle, relaxes. This movement of the eyes is controlled by three cranial motor nuclei that send signals to these eye muscles.
The facial nerve, which carries signals from the brain to the muscles of the face, can become damaged in some people with a condition called Bell’s palsy. This happens when the area of the nerve that supplies the facial muscles with blood becomes swollen for unknown reasons, and this interferes with its ability to send messages to those muscles. The symptoms of Bell’s palsy include weakness or droopiness of one side of the face. It is the most common cause of face paralysis and can occur suddenly for no apparent reason.
If you are experiencing the symptoms of Bell’s palsy, it is important to get treatment within a few days of when the symptoms first started. This is because the earlier you start treatment, the more likely it is that your symptoms will improve with time.
Acupuncture and physiotherapy are the most common treatments for Bell’s palsy and other types of face paralysis. These can help restore movement to the affected muscles, and they can also improve the overall function of your facial muscles and your ability to smile and speak clearly.
If you are suffering from face paralysis, the best way to treat it is to see a doctor who specializes in treating this condition. They will be able to diagnose the cause of your facial paralysis and recommend the best treatment for you. There are many different treatments available, including nerve repair, surgery, and physiotherapy. The sooner you begin treatment, the more likely it is that your face will return to its normal movement and you will be able to smile again.