The Effective Treatment for Incomplete Recovery after Facial Nerve Paralysis / 대한이비인후과학회지

ABSTRACT

The facial nerve coursing through the temporal bone provides a challenge to the otologic surgeon. Advances in surgical instrumentation and refinements of surgical strategies enable the otologist to uncover the entire course of the facial nerve safely from brainstem to its exit from temporal bone. The most common cause of facial nerve paralysis is Bell's palsy, followed by traumatic facial paralysis, herpes zoster oticus, and intratemporal tumorous lesion. The surgical approaches to the injured facial nerve depend on its causes. In consideration of selecting surgical technique of facial nerve paralysis reconstruction, clinician must find out thecause, degree and duration of paralysis for the appropriate technique. Although preventing synkinesis is more effective than treating an established one, it has been shown that when patients inevitably has facial sequelae, there is no effective intervention modalities. Numerous facial rehabilitation techniques for such facial problems after facial palsy have been developed to improve cosmesis and function. Recently botulinum toxin A chemical neurectomy has been considered as a best approach in treating facial sequelae. Botulinum toxin injection has shown remarkable results in the disappearance of facial synkinesis within a few days. This procedure helps the patients to recover from lower self-esteem and better quality of life than before.