FACIAL PASLY SURGERY IN DELHI
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Facial Palsy
Facial Palsy is a condition characterized by weakness or paralysis of the muscles in the face, typically on one side, due to damage or inflammation of the facial nerve (cranial nerve VII). This nerve controls facial movements, including expressions, blinking, and functions related to speech and eating.
It can be congenital (since birth) and can involve one side or both side or can be partial .
Sometimes there can be lower nerve involvement resulting in loss of lower lip movement in one side.
Types of Facial Palsy
The most common cause of facial palsy, believed to be due to viral infections (like herpes simplex) causing inflammation of the facial nerve. It usually resolves on its own within weeks or months.
Caused by reduced blood supply to the brain, which can affect the facial nerve. This type of palsy often affects only the lower half of the face.
Caused by injury to the facial nerve, often due to surgery, accidents, or fractures.
Tumors in or near the facial nerve (e.g., acoustic neuromas) can compress the nerve and cause palsy.
Conditions such as Lyme disease, otitis media, or Ramsay Hunt syndrome (caused by varicella-zoster virus) can lead to facial nerve dysfunction.
Congenital-it is rare but can present in any form ,Unilateral or bilateral or part
Diagnosis of Facial Palsy
The diagnosis of facial palsy involves clinical evaluation and, in some cases, additional testing to determine the underlying cause:
- Physical Examination: The healthcare provider examines facial symmetry both in resting phase and dynamic phase this way we can clearly see the difference in movement, muscle strength, and sensory functions.
- Imaging Studies: MRI or CT scans may be performed to check for tumors, stroke, or trauma-related causes.
- Blood Tests: Used to rule out infections or other systemic causes like Lyme disease.
- Electromyography (EMG): Measures the electrical activity of the facial muscles to assess nerve function this way we can compare both side.
Treatment
Early presentation within days
- Medications:
- Corticosteroids: Used in cases like Bell’s palsy to reduce inflammation of the facial nerve.
- Antiviral Drugs like acyclovir is given for viral infection (e.g., herpes simplex) is suspected.
- Antibiotics: For bacterial infections like Lyme disease.
- Analgesics: Pain relievers to manage discomfort.
- Post bells palsy as the recovery takes 2 to 3 months so
- Physical Therapy:
- Exercises to help maintain muscle tone and function in the affected side of the face.
- Techniques like facial massage or electrical stimulation may also help with recovery.
- Early diagnosis with infection or tumors, otitis media or cholestotoma Will require Surgical Interventions:Like Decompression Surgery: In rare cases, surgery may be needed to relieve pressure on the facial nerve.
- Indication for surgery intervention
- If patient is not recovered in 4-5 months after bells palsy. Then is the right time of surgery and if you delay it then chances of recovery is reduced.
- If there is complete transection of nerve due to tumor or direct injury then best possible time is as soon as possible i.e within 2 months.
- The possibility of nerve repair, or nerve grafting or nerve transfer.
- Nerve transfer can be masseteric nerve transfer or cross face nerve transfer or both.
- If patient has come very late more than 18 months after facial nerve paralysis then the only options remain is the muscle transfer.
- Muscle transfer can be local like masseteric or temporalis.
- It can be Free functional muscle transfer like gracilis with cross face nerve graft.
- Eye Care: Since facial palsy can affect the ability to blink, eye protection (such as lubricating drops or wearing an eye patch) may be necessary to prevent drying and injury to the cornea. If there is repeated eye infection or irritation then gold weight or temporalis sling is an option.
- Botox Injections: Used to reduce unwanted muscle movements (synkinesis )on the unaffected side or to relax overly tight muscles on the affected side.
Prognosis
- Most people with Bell’s palsy experience full recovery within three to six months.
- The prognosis depends on the underlying cause; cases due to stroke or trauma may have varying outcomes based on severity and the timing of treatment.
- Early diagnosis and treatment are key to improving outcomes, especially in conditions where nerve damage may be reversible.
Contact us to know more about Facial Palsy and book an appointment with one of our surgical specialists today.