Facial Nerve Surgery

Facial weakness is also called facial palsy (complete lack of motion) or facial paresis (a weakness in facial movement).  It is either a congenital deformity from birth or an acquired deformity that causes complete or partial paralysis of facial motion.  It can originate in the brain, along the facial nerve or in the muscles of the face, usually affecting one side of the face.  Facial nerve weakness can be seen as twitching, paralysis, weakness, inability to close an eye and even numbness in part of the face.  The underlying causes of these symptoms include infection, injury, circulatory disturbance or tumors. 

Depending on the underlying cause of facial nerve dysfunction, surgery on the facial nerve may be indicated.  Tumors, infection, and trauma of the facial nerve are all indications for facial nerve surgery.  Generally, a hospital admission is required.  Different surgical approaches may be indicated depending on the specific pathology.  Access to the long and curved course of the facial nerve is provided by Middle Fossa Approach, Transmastoid Approach or approach to the nerve outside the temporal bone in the tissue of the upper neck under the ear. 

Therapeutic interventions may include removal of the boney covering of the nerve (decompression), removal of tumors, and grafting of the facial nerve with a donor nerve (sensory branch to the ear) from the neck which allows the nerve to re-grow to the facial muscles achieving movement of the face.  If necessary, a Hypoglossal-Facial Nerve anastomosis is performed.  This is accomplished by transferring a portion of the hypoglossal nerve (nerve to the tongue) to the facial nerve in order to provide muscle tone and movement to the face.