Smile Restoration for Permanent Facial Paralysis

The loss of facial expression and the disfigurement of facial paralysis have serious implications for a patient’s physical and psychological well being [1]. Numerous aetiologies of facial paralysis exist but once nerve recovery has been static for two years, interventional surgery is required to improve the situation [2]. Facial paralysis is often treated as an aesthetic problem but can also have real physical and psychological problems. These include difficulty with speech, low self-esteem, poor social interaction, oral incontinence, and dental problems; caries may develop due to the lack of food progression through the oral cavity and repeated trauma and ulceration caused by biting of the inside of the paralysed cheek. Poor understanding of the treatment modalities available and an element of ‘postcode lottery’ have an impact on the service a patient may receive in the UK. This was highlighted in a recent communication from the British AssoCONTINUING MEDICAL EDUCATION