October 4, 2023

(TNS) Mayo Clinic Information Community

DEAR MAYO CLINIC: My husband and I not too long ago seen our 5-year-old daughter was having issue blinking and consuming, and one facet of her face was drooping. The pediatrician referred us to a plastic surgeon who recognized her with facial paralysis. What’s facial paralysis and what are the remedy choices? Will this require surgical procedure?

ANSWER: Facial paralysis happens whenever you can’t transfer some or all the facial muscular tissues. It may well have an effect on one or each side of the face. Facial paralysis can disrupt eye closure, the smile and decrease lip motion. It may well trigger asymmetrical facial muscle tone leading to a sagging face. Although many individuals consider facial drooping as an indication of stroke, it may be among the many first indicators of facial paralysis, which is uncommon amongst youngsters. When facial paralysis happens in youngsters, it impairs a toddler’s potential to maneuver their facial muscular tissues and present facial features.

It’s important to judge facial paralysis promptly as the reason for the paralysis informs the remedy method. Whereas some youngsters are born with facial paralysis due to a developmental or congenital drawback, it additionally may result from trauma, a tumor or one other problem.

To diagnose the underlying motive for the paralysis, sufferers bear a complete workup, together with scientific examinations and imaging. Electromyography (EMG) is a kind of imaging used to substantiate the presence of nerve injury and decide its severity. An MRI or CT scan could also be carried out to rule out whether or not there are sources of strain on the facial nerve, similar to a tumor or cranium fracture, that may very well be inflicting the paralysis.


A remedy plan is developed primarily based on the prognosis and the kid’s age. Treating facial paralysis doesn’t at all times contain surgical procedure and might vary from providing bodily remedy to injecting Botox to weaken different components of the face to attain symmetry. If surgical procedure is one of the best remedy choice for a affected person, there are a couple of progressive approaches your plastic surgeon could take into account.

Facial paralysis surgical procedure additionally known as facial reanimation surgical procedure and includes utilizing muscular tissues or nerves from different components of the physique to revive movement within the face.

Two commonplace procedures utilizing muscular tissues are known as gracilis muscle switch and temporalis muscle switch. Utilizing reconstructive microsurgery strategies, a surgeon transplants muscle from both the inside thigh (the gracilis muscle) or the temple (the temporalis muscle) beneath the facial pores and skin and connects it to facial nerves to recreate a smile. The gracilis muscle switch is the favored method to revive a symmetric, spontaneous smile and normally is carried out in two phases. The primary stage includes utilizing among the nerves from the opposite facet of the face, known as cross-face nerve grafting, and the second stage includes gracilis muscle switch. This surgical procedure goals to allow the working facet of the face to manage the paralyzed facet, which is crucial for facial concord or spontaneity.

One other type of facial asymmetry can happen as a result of irregular regrowth of nerve fibers after trauma or Bell’s palsy. This may increasingly lead to involuntary contractions of particular muscular tissues whenever you’re making an attempt to maneuver different muscular tissues, known as synkinesis. For instance, whenever you smile, the attention on the affected facet could shut. Remedy of this asymmetry within the face consists of bodily remedy, Botox injections and sometimes selective neurectomy, a surgical procedure that helps obtain a extra balanced and symmetrical motion of the face.

If surgical procedure is required, sufferers can anticipate to remain within the hospital one to 5 days, relying on the process carried out.

When confronted with facial paralysis, it’s important to hunt remedy from a cosmetic surgery workforce targeted on facial paralysis and reanimation. At Mayo Clinic we’re skilled in pediatric facial reanimation surgical procedure and microsurgery. These delicate operations require specialised experience and data, particularly when treating the littlest sufferers.

The multidisciplinary workforce at Mayo Clinic, which incorporates pediatric plastic and oculoplastic surgeons, neurologists, optometrists, and bodily therapists, makes use of a long time of data to create particular person remedy plans to assist your baby regain facial perform and high quality of life. — Dr. Samir Mardini , Plastic Surgical procedure, Mayo Clinic, Rochester, Minnesota


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