General Editor: Daniel Buchbinder

Authors: Damir Matic, John Yoo

Facial nerve

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Glossary

Reversible paralysis

Please select a treatment option:
Treatment Main indication Skill Equipment
Observation When return of function is likely or during the course of recovery (e.g. Bell's palsy, post-surgical trauma) Basic surgical experience, no specialized skills Basic equipment only
Lateral tarsorrhaphy Corneal exposure Basic surgical experience, no specialized skills Basic equipment only
Direct nerve repair When a tension free coaptation is possible. This applies to the main trunk or the distal branches Basic surgical experience, no specialized skills Simple surgical and imaging resources
Interpositional nerve graft Tension free direct repair not possible Basic surgical experience, no specialized skills Simple surgical and imaging resources
Reinnervation with masseteric nerve transposition Proximal facial nerve not available. Functioning masseteric nerve Some specialized surgical experience Simple surgical and imaging resources
Reinnervation with hypoglossal nerve Proximal facial nerve not available. Functioning hypoglossal nerve Some specialized surgical experience Simple surgical and imaging resources
Selective reinnervation with proximal facial nerve and masseteric nerve To limit synkinesis by separating eye closure and smile movements when proximal nerve available Some specialized surgical experience Simple surgical and imaging resources
Reinnervation with cross facial nerve graft Proximal facial nerve not available Highly experienced and skilled surgeon Simple surgical and imaging resources
Selective reinnervation with contralateral facial nerve and masseteric nerve To limit synkinesis by separating eye closure and smile movements. When the ipsilateral proximal facial nerve is not available Some specialized surgical experience Simple surgical and imaging resources
Static suspension with tendons Augmentation of reinnervation procedures Some specialized surgical experience Simple surgical and imaging resources

Irreversible paralysis, eye complex

Please select a treatment option:
Treatment Main indication Skill Equipment
Lateral tarsorrhaphy Corneal exposure Basic surgical experience, no specialized skills Basic equipment only
Direct brow lift Brow ptosis Basic surgical experience, no specialized skills Basic equipment only
Upper eyelid weight Symptomatic incomplete upper eyelid closure Basic surgical experience, no specialized skills Basic equipment only
Lower eyelid - Lateral strip canthopexy Lateral lower lid laxity Some specialized surgical experience Basic equipment only
Lower eyelid - Tendon sling Medial and lateral lower lid laxity Highly experienced and skilled surgeon Simple surgical and imaging resources

Irreversible paralysis, midface and mouth

Please select a treatment option:
Treatment Main indication Skill Equipment
Static suspension with tendons When dynamic reconstruction is not possible Some specialized surgical experience Simple surgical and imaging resources
Masseter muscle transposition When the situation is not appropriate for a free vascularized muscle transfer Some specialized surgical experience Basic equipment only
Temporalis muscle (antidromic) mini-sling Reconstruction of the upper portion of the nasolabial fold Some specialized surgical experience Basic equipment only
Temporalis muscle transposition When the situation is not appropriate for a free vascularized muscle transfer Some specialized surgical experience Basic equipment only
Innervated free muscle transfer (Gracilis) Preferred option for dynamic, voluntary movement Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Irreversible paralysis, mouth - Lower lip

Please select a treatment option:
Treatment Main indication Skill Equipment
Horizontal shortening Prolonged irreversible paralysis of the lower lip Basic surgical experience, no specialized skills Basic equipment only
Contralateral depressor angularis muscle excision Unilateral irreversible paralysis of the lower lip causing asymmetry Some specialized surgical experience Basic equipment only
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources