Extra-temporal Facial Nerve Reconstruction

Facial nerve denervation and paralysis imposes significant psychological and functional impairment. Facial paralysis can inhibit and mar facial expression, communication, symmetrical smile, eye protection, and oral competence. The physician must accurately evaluate and examine the patient and determine the etiology, duration, and the scale of the paralysis. Regardless of the technique employed for facial nerve repair or reconstruction, the return of function after a facial nerve transection injury is a slow process affecting many aspects of facial function and aesthetics. This chapter describes the surgical anatomy and applied physiology relevant to the facial nerve. It also addresses the etiology and diagnosis of facial nerve paralysis, and discusses the indications, contraindications, techniques, prognosis, and complications of facial nerve reconstruction.