Facial Nerve Palsy

What is Facial Nerve Palsy?
Facial Nerve Palsy, also known as seventh cranial nerve palsy, mononeuropathy VII, facial nerve paralysis or facial neuropathy, occurs when the seventh cranial (facial) nerve, responsible for controlling muscle movements of the face, is damaged.  Damage to the seventh cranial nerve may also affect the sense of taste and feeling within the ear canal.  A common form of facial nerve palsy is Bell's palsy which can lead to temporary or permanent paralysis of usually one side of the face.  

What are the symptoms of Facial Nerve and Bell's Palsy?
When facial nerve palsy or Bell's palsy occurs, the following symptoms, among others, may exist:
- Facial droop
- Paralysis on one side of the face
- Difficulty closing the eye on the affected side
- Droopy eyelid and/or mouth
- Droopy brow
- Dry eye
- Excessive tearing
- Difficulty producing facial expressions
- Difficulty eating and drinking
- Impaired sense of taste
- Sensitivity to sound

What causes Facial Nerve and Bell's Palsy?
The cause of Bell's palsy is unknown, but facial nerve palsy can occur as a result of:
- Tumors that put pressure on the seventh cranial nerve
- Facial trauma or surgery
- Infections such as Lyme disease, HIV, tuberculosis, mononucleosis, and mumps, and other viral infections such as herpes simplex virus
- Diabetes
- Neurological disorders such as multiple sclerosis or myasthenia gravis

What functional and aesthetic changes occur with Facial Nerve and Bell's Palsy?
The extent of functional and aesthetic changes depends upon the severity of the facial paralysis.  In the eye area of the affected side, often the eyebrow droops and an inability to close the eyelid known as lagophthalmos or lid lag exists, which may lead to dry eye symptoms and corneal damage if not treated.   Also, an outward turning and drooping of the lower eyelid called ectropion may occur. Other facial changes such as brow droop, facial asymmetry, mid-face droop, a lop-sided smile and lower lip droop may occur.  

What are my options to correct the functional and aesthetic effects of Facial Nerve and Bell's Palsy?
Any of the following procedures may be recommended for symptoms associated with facial nerve and Bell's palsy:
- Eyebrow droop: a browlift to reposition the eyebrows and recreate symmetry
- Inability to close the eyelid: a gold or platinum weight implanted under the muscle in the upper eyelid to help with upper eyelid closure
- Ectropion: tightening and repositioning of the lower eyelid 
- Mid-face droop: mid-face lift to re-create facial symmetry 
- Lop-sided smile: static or dynamic sling or re-animation procedures

Treatment of facial nerve and Bell's palsy often takes a multi-specialty team approach.  As an ophthalmologist and oculofacial surgeon, Dr. Elahi has special expertise in managing the ophthalmic symptoms as well as the facial surgery needs that may exist.  He also works closely with a team of highly specialized otolaryngologists, neurologists and physical therapists to manage other functional and aesthetic challenges of facial nerve and Bell's palsy.