Facial nerve paralysis or Bells Palsy affects all the structures around the eye; the eyebrow, upper eyelid, lower eyelid and midface. Treatment is directed at fixing the structural and functional problems in these areas.
Bell’s Palsy is the most common cause of temporary facial nerve injury causing weakness on one side of the face. Facial nerve paralysis is also called facial palsy and can be temporary or permanent. Facial skin cancer spreading along the facial nerve is another cause of facial weakness.
The facial nerve is the most important nerve in the face as it controls all the muscles that are responsible for facial function (eyelid and mouth closure) and facial expressions. Inability to close the eyelid exposes the cornea and increases the risk of dryness, irritation, infection and vision loss. Protecting the cornea is the first step.
Common Non-Surgical Methods to protect the cornea:
• Regular use of artificial tears
• Eye ointment
• Taping the eyes shut at night
• Use of glasses with side protection when going outdoors
Common Surgical Procedures to protect the Cornea:
• Suture Tarsorraphy (using a stitch to bring the eyelids together)
• Lid Resection and Tarsorraphy
The upper eyelid is unable to close and protect the eye. The Lower eyelid droops causing an unsightly look and excess tearing.
The following operations help:
• Upper Eyelid loading with a gold weight – is effective in most cases
Bell’s Palsy causes the eyebrow and midface to descend. The eyebrow slides down on the upper eyelid further frustrating the patient. For maximum results upper and lower eyelid surgery are combined with brow and midface surgery.
The eyebrow can be lifted and stabilised by one of these methods:
• Direct brow lift
• Open lateral brow lift
• Endoscopic brow lift
• Internal browpexy
• Midface lift