Facial paralysis

Facial movements (lip, cheek, eyebrows, eye zone) are implemented with the help of facial nerve. It ensures the execution of any exercise transmitting movement impulses to facial nerve and facial muscles from brain. If some diseases in brain or facial nerve break this transmission, then facial paralysis occurs and facial exercises disappear partially or completely. It is medically called facial paralysis.

Facial paralysis can arise in relation to many diseases between bridge and pons Varolii till to facial muscles with pons Varolii. The reason for facial muscle between brain – pons Varolii can be brain hemorrhage and neurological disease. Facial paralysis occurring for this reason is called central facial paralysis. And facial paralysis emerging from facial nerve diseases after pons Varolii is called peripheral facial paralysis. There are many factors that cause facial paralysis:

Bell paralysis: It is one of the most common reasons. The etiology is not known exactly. Cold and wind have an impact. The main symptom is the loss of nerve function. There is no other neurological symptom. It is basically fully cured.

Ramsay-hunt syndrome: The main reason is viruses. In addition to signs in Bell paralysis, there is pain and wound in outer ear canal. Recovery is lower than Bell paralysis.

Middle ear infections: Acute middle ear infections in children and chronic middle ear infections in adults melting bones or passing through existing openness to facial nerve, can cause to facial paralysis.

Systematic diseases: Diabetes mellitus, hypertension, neuritis, vitamin deficiency etc.

Tumor diseases: Tissues of facial nerve or tumors in the region where it passes can cause. These tumors can be benign and malignant. Ear salivary gland tumors can also cause.

Traumas: Traumas around ear or face can create facial paralysis damaging facial nerve.

Surgeries: Intracranial, surgeries in ear or salivary gland.

Symptoms: There can be decrease in facial movements, in addition to wound in the outer ear, middle ear infections and other neurological signs. If there is no middle ear infection (otitis media) or tumor in the middle ear, examination of ear seems to be normal.

Diagnosis: It is diagnosed with the violation of facial movements. The main thing is to examine the reason. For this, analysis should be conducted in accordance with suspicious circumstances and if any disease is revealed, treatment apprropriate for it should be carried out. If only the signs of facial paralysis are revealed in the first examination, then blood pressure and diabetes being measured, treatment should start thinking that there is Bell paralysis.  Other analysis, including CT or MRT can be conducted when it is incurable with drugs or in recurring cases.

Treatment: It is based on etiology. Treatment in Bell paralysis is drug treatment. If there are no other diseases (blood pressure, diabetes, stomach problems) in the patient, corticosteroids are appointed. In addition, medicines for stomach, tear and antibiotic creams for the prevention of eye dryness are given. The patient should pay attention to - massage in the muscles of the face, warm application, chewing gum in order to move facial muscles. In addition to RAMSAY–HUNT syndrome, medicine is given against virus. If any other reason is revealed, this disease should be treated with medicine or surgery. For example, if the surgery in the facial paralysis related to tumors of inner ear or middle ear infections is associated with the acute middle ear infections, it is treated by scratching and opening of eardrum and with antibiotics.

Is there a need for surgery?

There is a need for surgery in some reasons for facial paralysis. The decision for surgery is made according to the effectiveness of medicine, the degree of facial paralysis, the result of electrophysiological tests and period from the beginning. The decision about patients surgical operation is made by doctor.