Bell's Palsy can also lead to residual facial paralysis, as can viral infections. Children may have paralysis as the result of a congenital birth defect. The first step in treating isolated facial paralysis involves electrodiagnostic testing to determine whether damage to the nerve is only temporary or permanent. These tests determine conclusively if the injury will heal itself or result in a permanent functional loss. By comparing the undamaged side of the face and its nerve activity levels, Chu explained, outcome can be estimated.
Age is often the determining factor in deciding which option is best for a particular patient.
For this population, Bartlett frequently performs a number of static lift and sling procedures that elevate and suspend the structure of the face. Cheek tone, an important aspect of speech, is also improved. Bartlett cautioned that these and other reconstructive procedures would not be appropriate for stroke patients, in whom facial paralysis is a result of brain damage, not nerve damage. For these patients, Bartlett actually removes nerves in order to induce partial paralysis of the non-affected side. The result, said Bartlett, is improved facial balance at rest.