Which is the Best Treatment in Facial Palsy?

Arianna Di Stadio*

Which is the Best Treatment in Facial Palsy?

We can choose either free muscle transfer, associated with nerve transfers, or cross-face nerve grafting. After a skull base schwannoma, which is the best choice? An immediate facial nerve repair using a nerve graft will be a longer procedure, but it will be the only one needed. But what if this is not possible?

I prefer to perform multiple small surgeries to reach symmetry. This is done using either static suspension, which is sometimes obsolete in my opinion, or myotomies2 on the healthy side. But why create damage to correct damage?

The best choice is most likely a transfer of associated small muscles to temporal or masseteric muscle with corrective surgery for the superior and inferior eyelid. In this way, movement and symmetry can be restored at the same time.

“My patient refuses any type of surgery.” When I have a case like this, I use suspension needles/wires commonly used in aesthetic procedures. It is a non-invasive method that is probably not the best, but it is a means to reach static symmetry for those who refuse traditional surgery.

Which is the best choice: treat facial palsy as a functional disease using major surgery
or treat it like an aesthetic procedure for those looking for less invasive solutions? I leave the answer to my colleagues. Hopefully, at the end of our discussion, we will reach the idea that function and aesthetics have the same value in facial surgery.

Otolaryngol Open J. 2016; SE(2): Se1-Se2. doi:10.17140/OTLOJ-SE-2-e001