An incomprehensible episode of facial paralysis or muscle weakness is known as Bell’s palsy. There is a sudden onset of this condition, which usually worsens over 48 hours. It is induced by damage to the facial nerve where the patient feels pain and discomfort on one side of the face/head. It can happen to anyone at any age. However, pregnant women, people with diabetes, influenza, or other upper respiratory ailment are more prone to Bell’s palsy. Both men and women between the ages of 15-60 can be affected equally.(1)
Is There A Surgery For Bell’s Palsy?
Most of the time, Bell’s palsy is cured without any treatment. Although, it takes several weeks or months for the muscles on the face to retrieve their normal health. In extreme cases, an individual requires a surgical operation.
Decompression Surgery For Bell’s Palsy
Earlier, physicians used decompression surgery to alleviate the stress on the facial nerve. It includes the transmastoid approach, middle fossa approach, and translabyrinthine approach. When the trauma is specifically restricted to the mastoid or tympanic segment, the nerve is decompressed at 180 degrees of its circumference, and the incus is removed & restored as an intervention graft to achieve the decompression of the facial nerve. When the injury is spread to the labyrinthine segment, the middle fossa approach is adopted. The translabyrinthine approach enables the decompression of the entire intratemporal course of the facial nerve when the cochleovestibular function is missing or destroyed by the trauma.
However, considering the possible side effects, such as permanent hearing loss and facial nerve injury, it is not recommended anymore.(2)(3)
Plastic Surgery For Bell’s Palsy
Plastic surgery can help in fixing the facial nerves and re-establishing facial movement. Common examples include nerve grafts, facial implants, eyelid lift, and eyebrow lift.(2)
Facial Nerve Repair For Bell’s Palsy
Primary Nerve Repair: This surgery is the choicest way to restore the facial nerve function. It is tension-free and compels mobilization or aversion of the adjacent facial nerve segment. Electrical stimulation is used to recognize the distal nerve segments for up to 72 hours after the injury. However, most surgeons recommend epineurial repair as the other ways may bother the axons.
Cable Grafting: When the primary nerve repair isn’t feasible, cable nerve grafting is employed to correct the facial nerve. In this technique, a graft is harvested behind the lateral malleolus. The medial and lateral antebrachial cutaneous nerves, sural nerve, and great auricular nerve are ideal choices for donor nerve graft.(3)
Nerve Transfers And Cross-Facial Nerve Grafting For Bell’s Palsy
Two standard nerve transfer techniques include Masseteric Muscle Transfer and Hypoglossal Nerve Transfer. In the former method, one branch of the muscle that helps in chewing is rerouted to the new area in the face, and in the latter technique, a portion of the facial nerve that moves the tongue is relocated to a spot that enables facial movement. In cross-facial nerve grafting, the surgeon moves a nerve from one side of the face to the other to supply a reconditioned muscle with the ability to adjust.(3)
Life Expectancy For Individuals With Bells’ Palsy
Those suffering from this condition get treated without any complexities. Different individuals have different intensities of this condition, and thus, doctors may recommend physical therapy or medications to expedite the recovery. In some cases, individuals have extreme dryness in eyes leading to an eye infection. Some may also suffer from synkinesis where one body part causes another to move involuntarily.
To conclude, we can say that Bell’s palsy is not a critical life-threatening condition. We cannot consider this condition to be permanent, but in rare cases, it lives forever. In most cases, people suffering from it restore full facial health and expression. If you opt for facial reconstructive surgery, it is essential to consider all your options before going under the knife. Any operation on the face can leave a significant impact on your overall look and appearance.
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