A small nerve is taken, usually from the foot, and joined from an intact branch of the facial nerve on the other side to the paralysed nerve on the affected side. If it works, the intact nerve supplies motor power to the muscles of both sides.
A further refinement is to graft small muscles from the foot on to the paralysed muscles as well as a cross-facial nerve graft.
These intricate procedures have developed with micro-surgery. It may take nine months to assess if these complicated procedures are going to be successful.
Another approach is to do the simpler static sling as well as the complicated procedure. In this way the appearance is improved immediately and, should the complicated graft not take, a reasonable result is achieved.
Those who develop Bell’s palsy can take heart from statistics. Almost nine out of 10 will get completely better. Those unfortunate enough to have persistent paralysis can call on the skill of the plastic surgeon to improve their appearance and, perhaps, restore function to the facial muscles.
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