Offering multidisciplinary treatment for children and adults with facial nerve disorders

The OHSU Facial Nerve Center offers treatment for children and adults with facial nerve disorders. Our doctors and therapists understand the challenges for people who are unable to move muscles in their face due to trauma or other conditions such as Bell's Palsey. With our expertise, we create an individualized plan for each person to improve your ability to blink, smile, speak look better and help overall well-being. People with sudden new facial weakness or long-standing facial paralysis are treated at the clinic. We offer many different types of therapies, including rehabilitation, retraining and surgical treatments.

Central hub for peripheral nerve dysfunction

The Facial Nerve Center is part of the OHSU Nerve Center, which is unique on the West Coast for our multidisciplinary approach to nerve disorders. We bring the collective expertise of neurology, neurosurgery, ophthalmology, orthopedics, otolaryngology/head and neck surgery, physical medicine and plastic surgery to bear on determining the right treatment options for each patient. Additionally, we have support systems for patients in the OHSU Rehabilitation Services, OHSU Comprehensive Pain Center and OHSU Neurology.

Smiling again

Following a stroke in 2015, Jarmila "Jarm" Hawes was left with one side of her face severely paralyzed. Dr. Loyo Li at OHSU was able to transfer nerves from one side of Hawes' face and tongue to the other, which eventually allowed her to regain the ability to smile. Read the article: Grinning big: Facial reanimation returns the gift of a smile.

Common symptoms

Facial nerve disorders mean that people can't control muscles in their faces on one or both sides. This can lead to the inability to move muscles, facial spasms, inability to smile and facial drooping. Combined, these symptoms can affect how we communicate, express emotions and how others perceive us. 

Facial paralysis affects different parts of the face. Common symptoms include: 

Eyelid and brow region

• Droopy eyebrow and eyelid 
• Inability to completely close the eye 
• Dry eye and excessive tearing
• Involuntary eye closure 
• Corneal scarring 
• Red eye 
• Blurry vision
• Pain or discomfort 

Mouth and smile

• Inability to smile
• Difficulty with speech and eating 
• Frequent biting of the lips or inside cheek 
• Drooling 
• Inability to keep food in mouth 

Midface

• Droopy cheek
• Nasal obstruction 

Neck

• Neck spasms 

Common conditions

The Facial Nerve Center at OHSU treats patients with different conditions that affect muscle movement in the face and the facial nerve. Here are the conditions we treat:

Conditions that affect the facial nerve and are treated at the center include: 

• Bell's palsy (including incomplete recovery) 
• Facial synkinesis and hemifacial spasms 
• Involuntary blinking
• Facial nerve tumors 
• Facial paralysis from vestibular schwannomas (also called acoustic neuroma tumors) 
• Facial paralysis from head and neck cancers (including skin cancer and salivary gland cancer) 
• Facial paralysis from trauma 
• Facial paralysis from brain tumors and facial spasms from vascular tumors 
• Congenital facial paralysis (such as Mobius syndrome or congenital unilateral lip palsy (CULP)
• Facial paralysis after surgery 
• Facial paralysis from ear disease or ear surgery 
• Facial paralysis from viral infection (including Ramsay Hunt Syndrome) 
• Facial paralysis from a stroke

Treatment

Treatment options we offer include: 

• Rehabilitation services including mirror therapy and massage therapy, exercise, pain control, meditation and motor control therapy. 
• Surgery for brow and eyelid paralysis including brow lift surgery, eyelid weight placement eyelid sagging correction.  
• Neuromodulation with botulinum toxin (also known as Botox). 
• Nerve transfers and selective surgical neurolysis (Gracilis free muscle transfer). 
• Regional muscle transfer and static suspension.
• Neuro glide stretching. 
• Scleral contact lenses.  

Pediatric facial paralysis

Although facial paralysis is rare in children, our group has dedicated doctors who specialize in treating children with facial paralysis. There are surgeries that can help make facial movement better and recreate a smile. 

Facial paralysis can be congenital (present at birth) or happen later – both of which can be treated. It is important to see a specialist right away as soon as paralysis happens for the best chance of success. Treatment for facial paralysis may include surgery where nerves or muscles are taken from other parts of the face, and it is even an option in cases of incomplete paralysis. 

Common causes of paralysis in children

• Hemifacial/craniofacial microsomia
• Mobius syndrome and other congenital abnormalities
• Intracranial tumors
• Craniofacial trauma
• Post-surgical injury
• Bell’s palsy

Resources

• American Academy of Ophthalmology
• American Society of Ophthalmic Plastic and Reconstructive Surgery
• Bell's Palsy & Facial Paralysis Support Group on Facebook
• Ear, Nose and Throat
• Facial Palsy UK Foundation
• Facial Paralysis and Bell's Palsy Foundation support groups in Portland and online
• Information on Bell's Palsy from the American Academy of Otolaryngology 
• Moebius Syndrome Foundation 
• Oculofacial Plastic and Reconstructive Surgery
• Support group in Portland and central Oregon with Acoustic Neuroma Association