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Evaluation and Management of the Patient With Postoperative Facial Paralysis

Tessa Hadlock, MD
Arch Otolaryngol Head Neck Surg. 2012;138(5):505-508. doi:10.1001/archoto.2012.632.
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Postoperative facial paralysis comprises a spectrum of injuries ranging from mild, temporary weakness to severe, permanent paralysis, affecting as little as one muscle group to as much as the full hemiface. Herein is presented an introductory review of iatrogenic facial paralysis, from initial evaluation and decision making to the full range of conservative and operative management.

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Figure 1. Eyelid-stretching technique. The patient grasps the upper eyelid lashes and pulls the lid downward while offering countertraction in the center of the upper eyelid, in the zone corresponding to the levator palpebrae superioris. This stretch is held for 60 seconds and is repeated every 8 hours.

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Graphic Jump Location

Figure 2. Typical map for the administration of botulinum toxin to the facial musculature. Dose symbols (representing number of international units) are dragged to the appropriate locations on the map after administration.

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