Common Causes and Treatments for Facial Nerve Damage

Facial nerve specialist, Dr. Douglas Henstrom, speaks with Reagan Leadbetter on Good Things Utah about the common causes and treatments for facial nerve damage.

Reagan: Whether you’re in the chronic or acute stages of facial nerve damage, Utah Facial Plastics has treatment options for both. Dr. Henstrom joins me now to explain the causes and the treatments. He does all the good stuff, the facelifts, the eyelifts, the Botox, the fillers, all that stuff but we’re talking about facial nerve damage. Why are we talking about that today?

Dr. Henstrom: It’s a good point. Dr. Thompson and I come on here frequently and we talk about aesthetic options for people with face and neck concerns. One of our passions in the reconstructive options that we offer patients with different concerns about their face and neck. And one of the things that I have a passion for and have specialty training. Quite frankly, there’s not a lot of people in the country that comprehensively treat patients with facial paralysis. This is a patient group that sometimes gets neglected because there aren’t a lot of known treatment options out there but I’m here to tell you that there are and we offer a lot at Utah Facial Plastics. I have a lot of training and expertise and interest in helping these patients.

Reagan: What causes facial nerve damage?

Dr. Henstrom: Great question. If you open up a textbook you’d see a lot of causes listed. But the most common things that are going to cause facial paralysis that people are most familiar with are fiber mediated diseases like Bells Palsy, Ramsey-Hunt disease, people have surgery on their parotid gland right here and their facial nerve may get damaged because of that, intracranial problems, trauma, things from accidents that may cause facial nerve damage, intracranial tumors. When I did a study on the facial reanimations that we did on kids back in Boston, we found that the kids who were getting facial reanimation treatment were most commonly effected by brain tumors. They have surgery and then they have radiation and it knocks out the facial nerve so lots of different causes.

Reagan: You also have acute and chronic facial nerve damage. What’s acute nerve damage?

Dr. Henstrom: In the early stages of facial nerve damage you may be worried about certain factors. Most patients who get facial nerve damage will actually heal up and do fine in the end. But a percentage of those patients won’t heal up. So in the acute stages patients can see their primary care doctor, neurologist, their ear, nose, and throat doctor and get treated with steroid medication, anti-viral medication to help the swelling on the nerve to help decrease the long-term ramifications of this nerve damage.

Sometimes in the acute stage we might do other things. We’re really concerned about people’s eyes because they don’t close well when patients have facial nerve damage. We might actual put a weight in the eye to help close it.

Reagan: And then what about the chronic nerve damage?

Dr. Henstrom: So chronic options, here’s a picture of a gentleman who had facial nerve damage and one of the things that we offer are facial reanimation procedures so you can see a lot of focus is on the smile. Here’s a person who can’t smile and after what we call a temporalis tendon procedure he can smile. Here’s another patient who has a neurofibrosis type 1, can’t smile that left facial nerve is completely out. We put single stage gracilis muscle transfer to help him smile and reanimate.

Reagan: How life changing. Does that feel so good to help these patients out?

Dr. Henstrom: Absolutely, this is so rewarding. Here’s a couple of examples. We actually used Botox for this patient whose eye unvoluntarily closes when she smiles. If we use Botox in the right place and in the right amount we can open up that eye, she can see better and can talk better. Here’s a young man who was actually born with moebius syndrome, which is very rare but causes the facial nerve not to develop. So he can’t smile at all. That before picture is actual of him tempting to smile. So we do a bilateral surgery in two different stages to put a muscle up there, hook it into a nerve, hook it into an artery to keep it alive and give him a smile.

The differences are not just what you see but how they feel because the non-verbal communication in facial paralysis is a big part of what effects them long-term. So helping them be able to do this helps them with their non-verbal communication. It can help how they talk, eat and drink. In public if you think about how that might be a real detriment to go out. And just their self-confidence.

Reagan: I love that you have the expertise to be able to do it. Visit for more information or call (801) 776-2220.

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