Facial Nerve Palsy


Some people may develop facial nerve palsy during his/ her life, be it due to Bell’s palsy, brain tumour or surgery or viral infection.   Many left with distorted asymmetrical face, droopy brow and  eyelid, inability to close the eyes and lower eyelid everting out ( ectropion).

Patient not able to close the eye

  • Patient not able to close the eye

Left facial nerve palsy secondary to brain tumor.  Patient is not able to close left eye.

right brow drooping

right lower eyelid ectropion (eyelid everting out)

  • right brow drooping

  • right lower eyelid ectropion (eyelid everting out)

Patient with right facial nerve palsy.  Note right brow drooping, right lower eyelid ectropion (everting out) and marked facial asymmetry.

Provided Physiotherapies

Treatment

Depending on the duration and potential recovery of disease, there is a variety of options which can be adopted to treat this condition.  Protecting the eye is the top priority.  The options range from the use of lubricants, nocturnal taping, botulinum toxin to surgery such as tarsorrhaohy, upper eyelid loading with platinum weight, lower eyelid lifting, ectropion correction and brow lift.  The aim is to protect the eyes, treat watery eyes and reduce facial asymmetry and thus increase social acceptance.

Pre op:  This patient has brain tumor and subsequently has it removed.  She developed inability to close her left eye.   Due to lack of lubrication, her left eye develop scarring and not able to see well.  She has to tape her eye close every night.

Post op:  Patient has platinum plate inserted.  Platinum plate is compact and hence is not that visible externally.  She said she is able to sleep well now.

 

Pre op: This patient has right facial nerve palsy.  The brow in the right eye is dropping.  The lower eyelid also evert out causing water to come out.  The face look asymmetrical

one week post op with remarkably reduced left swelling

Pre op:  This man has brain tumor removed leaving him unable to close left eye.

Post op: immediately post op, left eye is able to close now.

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