Overview

We understand the challenges

When you have facial nerve paralysis, one side of your face droops. On very rare occasions it can happen on both sides of your face. It may make it hard to smile or close your eyes and can change the way your body produces saliva and tears. It can also cause pain in your ear and make it more sensitive to sound. The paralysis can change your sense of taste on one side of your tongue and make it hard to speak as well.

At UW Health, we understand the challenges facial nerve paralysis brings. At our Facial Nerve Clinic, our extensive team of specialists is ready to help. We offer advanced surgical and nonsurgical treatments. We also offer emotional and psychological support.

Meet our team

Our specialists can help

At UW Health, we have specialists in ear, nose and throat surgery, facial plastic surgery, and head and neck surgery. They’re joined by neurosurgeons and surgeons who specialize in disorders of the eyelids, tear ducts and face. Our team also includes health psychologists and physical therapists who focus on facial nerve paralysis.

Known around the world, focused on you

Ear, Nose and Throat Services

Treatments and research

The right treatment at the right time

Treatment depends on your condition and when it developed.

There can be many causes of facial nerve weakness or paralysis. An accurate diagnosis is important for getting you the exact help you need.

Doctors don’t always find a definite cause for a person’s facial drooping. Many times, symptoms will resolve on their own within three months. Whether your paralysis is new or long-term, the Facial Nerve Clinic can help you.

Eye care

Getting eye care as soon as you notice any facial drooping is extremely important. If you can’t close your eyes, they may become dry and scratched. Without proper care, the damage may be permanent. Your doctor can advise you on how to care for your eyes and may refer you to a specialist.

These home-care tips can help:

  • Use a moisture chamber at night.

  • Use an eye patch or eye taping when sleeping after discussing this with your eye doctor.

  • Use eye drops such as “artificial tears” frequently during the day.

  • Use over-the-counter eye ointment at night. Within seven to 10 days of starting the ointment, be sure to see an eye doctor.

  • Wear wraparound sunglasses when outside.

Treatment options

This treatment involves surgery to relieve pressure on your facial nerve. Pressure can occur if your nerve becomes swollen. If it’s been less than two weeks after paralysis has set in, our ear surgeons can do a special test to see if you’re a good candidate for this treatment.

Some people with facial drooping have a lot of trouble closing one eye. In certain cases, we do surgery to place a small metallic weight in your eyelid. It may help your eye close better. After you recover, we remove the weight.

If you’re having trouble completely closing an eye, botulism (Botox) injections may help. In most cases, we recommend other steps to protect your eyes first. Botox injections, which help relax muscles, may be an option if you’re still having trouble after three months.

Botox injections may also help with synkinesis. This is a long-term condition that sometimes occurs when you lose all muscle tone and facial movement. When symptoms start to improve, facial muscles might “over-correct.” As a result, one eye may appear smaller than the other. Or the crease between the side of your nose and the corner of your mouth may seem deeper on the affected side of your face. Sometimes, as you move one muscle, another may move on its own. For example, your eye may close when you smile. Or your cheek might pull up when you close your eye.

Facial retraining uses specific exercises to improve the way your facial muscles work. The goal is to retrain your brain and nerves. A specially trained physical therapist guides you through the exercises.

Working with our speech therapists may be helpful if your paralysis is affecting your speech or swallowing.

If you’ve had facial paralysis for one to two years, your muscles begin to break down. Movement won’t return on its own. Static procedures lift sagging or drooping parts of your face and restore a more natural appearance. We also do surgeries to raise drooping eyelids.

We may use dynamic procedures when you’ve had paralysis for a long time. After a while, your muscles won’t be able to move on their own. These procedures involve moving muscles and nerves from other parts of your body to your face and connecting them with a new blood supply there.

Nerve transfer surgery

Nerve transfer surgery involves using a healthy nerve to take over part of the role of the paralyzed facial nerve.

A procedure that involves the sural nerve from your lower leg. We use that nerve to wire new connections between branches of the facial nerve on the working side of your face and nerve branches of facial muscles on your paralyzed side. Surgeons tunnel the nerve across your face under your nose.

A procedure involving a nerve that normally helps you move your tongue. The transfer involves “borrowing” part of this nerve from the side of your paralysis. We connect it to your facial nerve to stimulate facial nerve muscles.

A procedure often used to restore your smile. It involves connecting your masseteric nerve to your paralyzed facial nerve. The procedure limits the function of one of the muscles involved in chewing. However, this doesn’t cause significant problems.

Tumor- and trauma-related surgery

Nerve paralysis can be a result of trauma to your facial nerve. Certain tumors can lead to facial nerve paralysis as well. We offer several treatments in these cases:

Reattaches the damaged nerve. It can take six months for the nerve to regenerate and improve muscle movement. Synkinesis (abnormal movement) might result, but facial retraining can help.

An option when we can’t reattach a severed nerve without causing too much tension on the nerve. The procedure involves taking a graft from a different nerve and placing it between the two segments of severed facial nerve. This can also take up to six months to work and may cause synkinesis.

A treatment for cancer patients who have large portions of facial tissue removed during surgery. It involves moving muscle and other tissue to the area in addition to fixing the damaged nerve. The surgery gives shape and volume to your face.

Patient support and services

Getting ready for your visit

The following resources can help you better understand your condition and prepare you for your visit to the Facial Nerve Clinic.

Frequently asked questions

Location

How to find us

If you have facial paralysis, schedule an appointment at our convenient location today.

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  • University Hospital - Facial Nerve Clinic
    • 600 Highland Ave. / Madison, WI
    • (608) 263-6190
    • Open now
    • We provide a unique approach bringing together experts from multiple medical specialties including.This combined expertise provides the highest level of facial reconstruction and helps remove confusion about which specialists to see.

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