Current Concepts, State of the Art Treatment of Facial Paralysis

Patrick J. Byrne, MD, FACS

It is my distinct honor to serve as guest editor of this Issue of Facial Plastic Surgery devoted to the management of facial paralysis. Our intention was to produce a very practical, valuable resource. I would like to share how I chose the contributors and the topics.

First, we invited the contributors. Each author is an experienced leader in the field, and each sees atypically high volumes of patients with facial paralysis. You can know that the views presented here are thoughtful and based on personal experience.

Next, we chose the topics. The decision was made to focus only on topics that matter. That is, scenarios that are both common and require you to make difficult decisions. Therefore, you will not find an exhaustive review of the causes of facial paralysis (many of which you will never encounter), nor will we present the current recommended management of Bell palsy upon presentation. You can look these up elsewhere. We do instead try to provide insight into how you may want to make decisions about management. These can be difficult. What will you offer the patient with a history of Bell palsy 2 years ago who has tone but wants to smile more (see Hadlock's article)? What do you tell the acoustic neuroma patient who presents with a 3-month history of complete paralysis, and who informs you that his neurosurgeon told him to wait a year because the nerve may regain function (see Boahene's article)? Should the patient with long-standing facial paralysis be offered a temporalis transfer or a gracilis free flap? Or something else?

I hope that you will find guidance in this issue for these and many other practical problems that you face in your practice.