Facial Paralysis
Advanced reconstructive surgery for facial nerve palsy
What is Facial Paralysis?
Facial paralysis (facial nerve palsy) is a dysfunction of the seventh cranial nerve (facial nerve). This nerve is responsible for controlling the muscles of facial expression on one side of the face.
A loss of this nerve's function leads not only to severe visual asymmetry but also to massive functional and psychological problems:
- Incomplete eye closure (risk of corneal drying)
- Difficulties with eating, drinking, and speaking
- Loss of emotional expression
Crucial Timing: The Early Phase
Dr. Megerle has more than 15 years of experience in the surgical treatment of facial paralysis. When choosing the right therapeutic strategy, timing is absolutely crucial.
If the paralysis has been present for less than 12 months, reanimation of the original facial muscles is often still possible. This is typically achieved through nerve transfers.
Most commonly, we use a branch of the motor nerve to the chewing muscles (masseteric nerve) for this purpose. This healthy nerve is microsurgically redirected and connected to the paralyzed facial nerve to restore muscle function and a smile as quickly as possible, before the muscles atrophy irreversibly.
Muscle Transfer & Dual Innervation
For long-standing paralysis (over 12 months), where the facial muscles have already irreversibly deteriorated, we utilize a classic, highly complex concept: A cross-face nerve graft (nerve transfer from the healthy side of the face) combined with the transplantation of a muscle from the thigh (gracilis muscle).
A highly innovative concept is dual innervation. Here, both techniques are combined—the transplanted muscle is connected to both the masseteric nerve and the cross-face nerve to achieve an even stronger and more spontaneous smile.
A frequent complication with spontaneous recoveries is synkinesia. These involuntary associated movements (for example, the eye closing automatically when the patient smiles) are a very common complication that can occur after a spontaneous but misdirected recovery of the nerve.
Frequently Asked Questions
How long does recovery take for facial paralysis?
The recovery time depends heavily on the cause and severity of the paralysis. In mild cases, the nerve may regenerate within a few weeks. Following surgical reconstruction, it can take several months to a year before the final results are fully visible.
Does health insurance cover the cost of the surgery?
Yes, because the treatment of facial paralysis is a medically necessary procedure to restore function (e.g., eye closure), the costs are typically covered by both statutory and private health insurances.
Are there non-surgical treatment options to improve symmetry?
Yes. In addition to surgical reconstruction, we successfully use Botulinum toxin (Botox). This allows us to dampen overactivity on the healthy side of the face to create a more symmetrical resting appearance, or to treat involuntary movements (synkinesia) on the affected side.
Are the scars very noticeable after facial paralysis surgery?
For nerve and muscle transfers, the necessary incisions are placed as optimally as possible into natural skin folds (for example, in front of the ear, similar to a facelift, or in fine neck creases) so that they are barely visible once fully healed.