Cranial Maxillofac Trauma Reconstruction 2015; 08(01): 001-013
DOI: 10.1055/s-0034-1372522
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Facial Nerve Trauma: Evaluation and Considerations in Management

Eli Gordin
4  Department of Otolaryngology–Head and Neck Surgery, SUNY Downstate Medical Center, Brooklyn, New York
,
Thomas S. Lee
2  Department of Otolaryngology–Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia
,
Yadranko Ducic
1  Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
3  Department of Otolaryngology–Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
,
Demetri Arnaoutakis
3  Department of Otolaryngology–Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
› Author Affiliations
Further Information

Publication History

Publication Date:
08 December 2014 (online)

Abstract

The management of facial paralysis continues to evolve. Understanding the facial nerve anatomy and the different methods of evaluating the degree of facial nerve injury are crucial for successful management. When the facial nerve is transected, direct coaptation leads to the best outcome, followed by interpositional nerve grafting. In cases where motor end plates are still intact but a primary repair or graft is not feasible, a nerve transfer should be employed. When complete muscle atrophy has occurred, regional muscle transfer or free flap reconstruction is an option. When dynamic reanimation cannot be undertaken, static procedures offer some benefit. Adjunctive tools such as botulinum toxin injection and biofeedback can be helpful. Several new treatment modalities lie on the horizon which hold potential to alter the current treatment algorithm.