Facial Paralysis & Reanimation Surgery

Advanced Expertise in the Diagnosis and Treatment of Facial Paralysis

Facial paralysis or dysfunction can occur when there is damage or trauma to the facial nerve, which controls the muscles involved in facial expression, taste sensations and tear production. Depending on the cause and location of the nerve damage, it can lead to an inability to move the muscles of the face making it difficult or impossible to speak, blink, swallow or smile.


Your health is important. Don’t delay care.

If you experience any symptoms of facial paralysis, you should immediately seek medical help. To schedule an in-person consultation with a UH facial paralysis expert, call 216-844-3223.
Virtual appointments are also available.

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Diagram of facial muscles

What is the facial nerve?

Every person has twelve cranial nerves that connect the brain to different parts of the body. The facial nerve is one of these twelve – specifically, it is known as the seventh cranial nerve.

The facial nerve originates in the brain stem (base of the brain) and exits the skull through an opening located near the base of the ear. It then travels through the parotid gland – a salivary gland that sits just in front the ears on each side of the head. Within the parotid gland, the nerve splits into five distinct branches. Each branch then exits the parotid gland and travels to the area of the face which it controls. The five branches of the facial nerve are as follows:

  • Temporal or frontal: Controls the muscles of the forehead and eyebrows. When not functioning correctly, the eyebrow can droop and potentially obscure vision.
  • Zygomatic: Controls the muscles around the eyelids that allow the eye to close completely. When not functioning correctly, it can cause dry eye and potentially damage the cornea if untreated.
  • Buccal: Controls the muscles used to move the nostrils and upper lip. When not functioning correctly, there can be difficulties with smiling, speech, eating/drinking and spontaneous eye blinking.
  • Marginal mandibular: Controls the muscles of the lower lip. When damaged it can cause a conspicuous, asymmetric smile and problems with eating and drinking.
  • Cervical: Controls the lower chin muscle. Damage to this facial nerve branch may result in an asymmetric smile.
Sketch of facial paralysis

What causes facial paralysis or dysfunction?

Facial paralysis is almost always caused by some type of damage to or deformity of the facial nerve. The damage can be present at birth (congenital) or can be caused by:

  • Infections, including middle ear infections (otitis media), herpes simplex, herpes zoster (shingles) and Lyme disease
  • Traumatic injury including temporal bone fracture, birth trauma or any head injury that damages the facial nerve
  • Stroke – a stroke in the brainstem may cause long-term, debilitating facial paralysis.
  • Brain tumors, tumors of the inner ear (acoustic neuroma)
  • Parotid gland tumors and malignancies (cancer) can invade the facial nerve.
  • Surgery to remove head and neck tumors can sometimes lead to facial nerve damage.
  • Ramsay Hunt Syndrome – a complication of shingles that can damage the facial nerve.

In some cases, the cause is idiopathic (unknown). The most common cause of idiopathic facial muscle weakness or paralysis is Bell’s palsy. This disorder typically has a sudden onset with symptoms worsening over the next 48 hours, and often resembling those of a stroke. This type of facial palsy usually occurs on only one side of the face but in rare cases can affect both sides. Bell’s palsy is usually a temporary condition that resolves within three months.

Advanced Treatments for Facial Paralysis

It is very important to consult with an ENT specialist as soon as you experience symptoms of facial paralysis to ensure the appropriate treatment is started promptly. Some conditions, such as Bell’s palsy, may resolve on their own, while others may be successfully treated with medications, physical therapy or other conservative measures. Treatments may include:

Surgery May Be a Treatment Option for Some Patients

When facial paralysis or dysfunction does not resolve on its own or respond to the conservative treatments listed above, there are several facial reanimation surgical procedures that may be recommended to improve facial symmetry and restore movement.

Learn more

Your health is important. Don’t delay care.

If you experience any symptoms of facial paralysis, you should immediately seek medical help. To schedule an in-person consultation with a UH facial paralysis expert, call 216-844-3223.

Virtual appointments are also available.