What is Facial Paralysis?
Facial paralysis has many causes including prior surgery, tumors, trauma, infection, and inflammatory conditions. When no known etiology is found, it is labeled Bell’s palsy. Bell’s palsy is a temporary or permanent weakness or paralysis of the facial nerve (7th nerve). The facial nerve innervates the facial muscles, which are responsible for various facial movements including eyelid closure and blinking, smiling, raising brows, frowning, among others. If the facial nerve is affected, then one is unable to close the eyelids (lagophthalmos) and the lower eyelid turns out (ectropion) unable to pump the tears normally resulting in tearing and eye redness and significant irritation (exposure keratopathy).
Treatment For Facial Paralysis
The most important treatment is frequent and aggressive ocular lubrication to protect the eye since the eyelids cannot close. The eyelids should be taped at night. Punctal plugs can also be used to reduce tear drainage. Eyelid surgeon Dr. Taban in Santa Barbara has written a textbook chapter entitled “Periocular rehabilitation in facial nerve palsy”, discussing various eye treatment options and techniques for facial paralysis.
Read Article Published by Los Angeles' Dr. Taban about Eyelid Facial ParalysisClick to Read
Surgical Options For Facial Paralysis
Due to the many different options of reconstructive eye treatment for the various types of causes for face paralysis, it’s important to speak with a board certified ocular plastic surgeon in Los Angeles in order to learn more about which eye treatment option may be best for you and your specific needs.
Upper Eyelid Gold Weight
A small gold plate can be inserted in the top eye crease to increase its weight and assist it in closing and blinking.
Upper Eyelid Hyaluronic Gel Injection
Temporary fillers (Restylane, Juvederm) can be injected into the upper eye to increase the weight of the upper eye fold and assist in closing and blinking.
Read Article Published by Los Angeles' Dr. Taban about Upper Eyelid HA FillersClick to Read
Tarsorrhaphy is a temporary or permanent procedure that “pinches” the lateral corner of the eye, thereby making the eye smaller and allowing better closure of the eye.
The brow is paralytic and cannot be raised causing heavy top eyelid and inability to see properly. The brow can be lifted via various techniques (see section on brow lift).
Lower Eyelid Ectropion
A paralytic lower eyelid rolls out, causing eye irritation and tearing. Surgery treatment can be performed to tighten the area.
For more information on treatment for Facial Paralysis please visit WebMD.com.
Next read about congenital/pediatric oculoplastics.
Before (left) 70+ year old male with left facial/eyelid paralysis from Bells palsy with paralytic left lower eyelid ectropion. After (right) underwent left lower eyelid ectropion surgery with skin graft.