Facial nerve disorders
Facial nerve disorders is a broad term referring to problems with the facial nerve that result in absent or abnormal movement of facial muscles. Facial nerve problems may be due to Bell’s Palsy, Ramsay-Hunt Syndrome, infections, tumors, trauma, pregnancy, surgery, or unknown factors. Some people can’t move the affected side of the face at all (paralysis), some have partial movement (paresis), and others have abnormal or hyperactive movements (synkinesis). Facial retraining, also known as “facial physical therapy,” is an important part of recovery and living with facial nerve disorders. There is a spectrum of both nonsurgical and surgical options to improve facial function, symmetry and quality of life.
Dr. Longino has specialized training in both non-surgical and surgical treatments for facial nerve problems, and she has written numerous research papers in prestigious journals on this topic.
Non-surgical treatments
Non-surgical procedures are most commonly used in patients with facial synkinesis - unusual, hyperactive or inappropriate facial movements and facial tightness. Dr. Longino may use neuromodulators (ex: Botox) to improve facial function and symmetry. Some patients may also benefit from fillers to improve facial function and symmetry. Each patient with a facial nerve disorder is unique, and sometimes it can take several treatment sessions to find the ideal regimen that meets your goals. Dr. Longino creates a custom treatment plan for each patient and constantly seeks ways to improve bothersome facial nerve symptoms at every visit.
Surgical procedures
Patients with facial nerve disorders may be candidates for various surgical procedures to improve facial function. Depending on the timing and cause of the facial nerve injury, surgery may be a consideration early in your treatment journey, or after several months to years of non-surgical treatments. There are some minor procedures that can be done in the office, and others may be performed in the operating room.
There are both “static” and “dynamic” procedures. Static procedures improve facial drooping and symmetry at rest, but do not restore facial movement. The goal of dynamic procedures is to restore movement to the face. Examples of static procedures include brow lift, upper eyelid weight placement, lower lid tightening, facial sling, and facelift. Examples of dynamic procedures include nerve transfer, nerve grafting, temporalis tendon transfer, and gracilis free muscle transfer. Other procedures are designed to improve synkinesis (abnormal facial movements) by addressing “problem” nerves or muscles, called selective neurectomy or myectomy.
Sometimes several procedures are performed at the same time to achieve an optimal result, and the selection of procedures varies with each patient.