The surgical management of facial nerve injury

The surgical management of facial nerve injuries is dependent upon a thorough understanding of facial nerve anatomy, nerve physiology, and microsurgical techniques. Timely repair with primary neurorrhaphy, when indicated, usually provides the best results; nerve grafts, nerve transfers, regional muscle transfers, free tissue transfers, and static procedures can also be performed when indicated. Meticulous technique, selection of the appropriate surgical management, and aggressive physiotherapy with motor reeducation are critical to obtaining a functionally and aesthetically acceptable result with minimal synkinesis and facial asymmetry.