Congenital Facial Paralysis
Finding out your baby has been born with facial paralysis can be incredibly challenging for families. Congenital facial paralysis (facial paralysis present at birth) can have many causes. And sometimes we never know the cause.
But with facial reanimation surgery, we can help your child improve their facial symmetry and motion.
What Is Congenital Facial Paralysis?
Sometimes referred to as facial palsy, facial paralysis means that part of your child’s face isn’t able to move.
Bilateral or Unilateral
Often, facial paralysis only affects 1 side, or is unilateral. But in other instances, it is bilateral and affects both sides of the face.
What Causes It?
It’s important to understand that sometimes an exact cause is never found for congenital facial paralysis. When this happens it’s referred to as ‘idiopathic.’ This can be hard for many families who want to find a root cause, but it doesn’t change the treatment options or success.
We can fully understand the problem without knowing what caused it. By diagnosing which nerves and muscles are affected, we can create a treatment plan that is specific to your child’s condition.
If we suspect an underlying genetic condition, we may recommend testing. Your decision on genetic testing will not affect our ability to treat your child.
Some causes include:
- Absent or underdeveloped nerves
- Genetic conditions like Moebius syndrome, CHARGE, or hemifacial microsomia
- Absent or underdeveloped facial muscles
- Changes during fetal development during pregnancy
- Heath factors or injury during birth
Diagnosing Congenital Facial Paralysis
Children with severe congenital facial paralysis are often diagnosed at birth. This is especially true if the paralysis is severe, affects both sides of their face, or interferes with eating.
Milder cases may go undetected until your baby starts to smile.
While the facial paralysis itself may be obvious, the underlying cause is also important. We recommend coming to see our facial nerve experts early. Even though we usually can’t begin treatment until they’re older, we can determine which nerves and muscles are affected and begin to plan out our approach.
Facial Nerve Expertise
Our facial nerve center provides unique expertise in the full range of treatments for facial nerve conditions, including congenital facial paralysis. Through multidisciplinary care, we provide state of the art care with a small center feel.
Gracilis Muscle Flap Surgery
For children born with facial paralysis or children whose facial paralysis has been long lasting, often there isn’t healthy facial muscle to reconnect. By using muscle fibers from the inner thigh, surgeons can create the facial muscle needed for natural movement. This microscopic surgery includes connecting the blood vessels and nerves so the new facial muscles will have the nutrients and power they need to work. This surgery may be performed in 1 or 2 stages, and your surgeon will help you determine which approach is best for your child. It typically takes several months after surgery before motion begins, and the smile motion will continue to improve over the first few years after surgery.
Temporalis Tendon Transfer Surgery
An alternative to Gracilis muscle surgery is to use the temporalis muscle to help elevate the corner of the mouth and produce smile movement. This surgery does not rely on microscopic nerve and blood vessels connection, so the motion is seen sooner and recovery is quicker. The amount of smile movement seen with temporalis tendon transfer is often smaller than the Gracilis flap surgery, however, so our surgeons will help you determine which approach might be best for your child’s situation.
Continuing Follow-Up
After surgical treatment to create facial movement, physical therapy is a critical part of recovery. During the months following surgery, we’ll check in to see how your child’s progress is going. It can take a year or longer to fully see improvements, but we’ll be there for your family through this recovery process. Our specially trained physical therapist has extensive experience treating people with facial paralysis of all ages and will help your child get the best possible outcome after surgery.
Life After Congenital Facial Paralysis
After facial reanimation, most children with facial paralysis go on to lead healthy lives.. Surgical repair tends to be long-lasting, with little need for lifelong follow-up. If your child begins experiencing new problems or concerns related to their repair, we’re here to help support their lifelong health.