الفهرس 
A-IntroductionOnly 14 pages are availabe for public view
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Abstract
The facial nerve has a complex anatomy and function that renders it susceptible to multiple neurologic disorders based upon the location of the lesion . The possible causes of facial nerve palsy are many and may be congenital, infectious, neoplastic, traumatic, or idiopathic Approximately one-half of all cases qualify for the label ”Bell’s palsy,” defined as an acute facial nerve palsy of unknown cause. Other important causes include otitis media, herpes simplex viral infection, Lyme disease, Ramsay Hunt syndrome, and HIV infection. Patients with facial nerve palsy typically present with the sudden onset (usually over hours) of unilateral facial paralysis. Common findings include sagging of the eyebrow, inability to close the eye, disappearance of the nasolabial fold, and drawing of the mouth to the unaffected side. Decreased tearing, hyperacusis, and/or loss of taste sensation on the anterior two-thirds of the tongue may also occur. The diagnosis of idiopathic (Bell’s) facial nerve palsy is based upon the following criteria : •A diffuse involvement of all of the distal branches of the facial nerve is present. •Onset is acute, over a day or two; the course is progressive, reaching maximal clinical weakness/paralysis within three weeks or less from the first day of visible weakness; recovery of some degree of function usually occurs within six months. •Associated prodrome, ear pain, or dysacusis may be reported. The prognosis of individual cases of facial paralysis is based upon the underlying cause :
•Congenital facial palsies, including Moebius syndrome, have a poor prognosis for recovery of function because of insufficient development of the facial nerve, or canal. •Traumatic facial paralysis in the perinatal period has an excellent prognosis, with 100 percent of patients showing some degree of improvement of function on the affected side. •Most children with Bell’s palsy recover with minimal, if any, dysfunction The patient with facial paralysis presents a daunting challenge to the reconstructive surgeon. A thorough evaluation, including complete history and careful physical examination, directs the surgeon to the appropriate treatment modality. Dynamic reanimation involves nerve repair, nerve transfer, regional muscle transfer, or free-muscle transfer. None of the procedures can restore all of the complex vectors and balance of facial movement and expression. However, dynamic reconstructive techniques can yield improved facial symmetry, spontaneous and symmetrical smile, eye closure and protection, and oral competence, all of which refurbish patients’ emotional, psychological, and cosmetic state and disabilities. A range of therapies are used in the management and treatment of patients with facial paralysis. A therapist can help in many ways, depending on the type and cause of facial paralysis. The basis of physical rehabilitation is physical therapy, the physical therapist should teach the patient how to innervate the facial muscle efficiently after nerve transfer and grafting. Also, the patient should be encouraged to exercise the facial musculature to gain maximum strength of muscle pull. Nerve stimulation can be used postoperatively;
however, electrical stimulation does not constantly demonstrate evident improvements. The type of therapy you receive will depend on the cause of your facial palsy. It will also depend on how long you have had your facial palsy and the type of damage to your facial nerve. Facial rehabilitation therapy services vary across the country. You may be referred to a physiotherapist or a speech and language therapist for assessment and treatment of your facial palsy.