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HEAD AND NECK
Facial palsy is one of the topics of special interest for Mr. João Nunes da Costa, and our team can provide a wide range of treatments adapted to the reality and needs of each patient.
Facial palsy is a problem that affects the patient's quality of life because the face is our most visible feature, and even small changes in expression may compromise the way we communicate. On the other hand, function is also affected, namely the inability to close the eyes (which can lead to serious problems and even blindness), difficulty in feeding (chewing, drinking) and even relation may be affected, especially kissing.
We can classify facial palsy according to several methods, but in a simplistic way we can take into account the age (child/adult/ elderly), severity (complete/incomplete facial palsy), and cause (congenital, facial trauma, surgery to the ear or skull, stroke).
Depending on the age, severity and cause, we can offer one or more of the following therapeutic options:
- Nerve surgery, including procedures that provide nerve stimulation from unaffected nerves (from mastication or tongue) to the facial nerve, suturing of nerves cut by traumatic face and cross-facial nerve graft (transfer of nerve stimulus from the healthy side’s facial nerve to the affected nerve)
- Surgery to restore smile, with procedures that restore movement by bringing in a new muscle source to power a smile, especially temporal muscle flap or transfer of the gracilis muscle of the thigh (free flap technique)
- Static procedures of face suspension in minor cases or in patients where effective recovery of movement is not predictable
- Placing gold weight on the upper eyelid to allow closure
- Lower eyelid canthoplasty to correct lid drooping (lower lid ptosis)
- Reduction of eyebrow sagging with suspension or redundant skin excision
- Symmetrisation of the face, especially at the forehead and lower lip, using toxin injections
- Treatment of synkinesis (anomalous movements of the face, e.g., closing the eye with a smile, or vice versa) with toxin injections
- Adjuvant procedures such as creation or deepening of the smile groove (nasogenian sulcus), fat grafting (lipofilling)
All these treatments are only effective if coupled with careful and long-lasting physiotherapy.
