Treatment of facial nerve palsy at Marienhospital Stuttgart

Facial nerve palsy is very stressful for those who are affected. Besides the visual impairment, the functional disorder is drastic. The ability to close the eyelid completely is eliminated, which leads to chronic conjunctivitis and dryness of the eye. Furthermore, the paralysis of the mimic muscles and the resulting impaired mobility of the corner of the mouth leads to an asymmetry of rest, loss of oral continence and, through compensatory activation of the healthy side, to grotesque dynamic asymmetry. In the following we would like to present our operative therapy concept for the treatment of facial nerve palsy.

The patients treated in the Marienhospital Stuttgart over the last 30 years (1990 – 2019) were summarized and analyzed. It is shown that an operative therapy concept in 3 steps, adapted to the initial situation including secondary diseases, age and the patient's wish, often leads to impressive results and a significant improvement of quality of life.

1. Reconstruction of eyelid closure, starting with ectropion correction followed by upper eyelid loading in two separate steps. 

2. Reconstruction of the nasolabial fold by implantation of a cartilage anchor. This also serves as a structure for suspending the upper and lower lip and the corner of the mouth.

3. After a healing phase of 3 months, static or dynamic reconstruction follows.

Our follow-up examinations showed the necessity of various "touch-up" operations, e.g. to compensate volume deficits and to treat synkinesia.

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Artikel online veröffentlicht:
24. Mai 2022