1 Facial Nerve Anatomy and Mastoid Surgery in the Management of Facial Nerve Disorders Frank M. Warren   Introduction Essential to the proper management of facial nerve disorders is a detailed knowledge of facial nerve anatomy. Knowledge of the intricate anatomy and the relationship of the facial nerve to associated structures are critical in the diagnosis and management of patients facial paralysis. In this chapter, we review the embryology of the various components of the facial nerve and then -- 2 Facial Nerve Paresis and Paralysis: History, Etiology, and Testing Steven B. Cannady and Oren Friedman   History Peripheral facial injury was a known entity to the Egyptians, Greeks, Romans, Incas, and other native cultures in Pre-Columbian America as evidenced by preserved artistic renderings.1 Facial nerve weakness has captivated cultures and clinicians while conjuring reactions and a search for explanation over thousands of years. Early medical descriptions date back to Hippocrates -- a later -- 3 Complications of Facial Paralysis Mark K. Wax and Steven B. Cannady   Introduction Facial paralysis from whatever etiology is a devastating process. The facial nerve is not only responsible for physiologic functions in the head and neck, but is of paramount importance in the patients' perception of themselves and what they present to the outside community. The facial nerve is responsible for normal and atomic functioning of the forehead, upper and lower eyelid complex, nasal passage facilitati.

4 Medical Management of Facial Paralysis Jessica J. Peck and Mark K. Wax   Introduction Treatment of facial nerve palsy presents special problems for both the practitioner and the patient. There are many surgical procedures that can improve the outcome when the time course of the palsy is known. In cases of known permanent palsy, intervention can be initiated at the time of the original facial nerve sacrifice or within the week. This will prevent many of the sequelae of the process. When the pot -- 5 Management of the Facial Nerve Joshua D. Rosenberg and Eric M. Genden   Introduction Facial paralysis results in a myriad of functional and cosmetic deficits including loss of spontaneous blink, oral incompetence, and facial asymmetry. If not corrected there is a risk of corneal injury, impairments in speech and swallowing, and social isolation. Affected patients identify themselves as not effective in expressing basic emotional states.1 Significant social impairment and psychological distress -- 6 Nerve Substitutions in Facial Reconstruction Cheryl C. Nocon and Alexander Langerman   Introduction Direct repair of the facial nerve is the most effective method of reanimating the paralyzed face. When this is not possible the use of motor nerve substitution is an excellent alternative. The general principle behind this technique is to reestablish neural continuity with the distal facial nerve and reanimate the facial muscles by using adjacent motor nerves. In this procedure, the substitute m.

7 Management of the Paralyzed Brow Fred Fedok, Parker Velargo, Frank Garritano, and Irina Chaikhoutdinov   Historical Aspects of Brow Management Individuals with unilateral brow ptosis secondary to facial nerve paralysis have numerous treatment options in this current age of facial reconstructive surgery. While management of the ocular disturbances secondary to facial paralysis takes priority, the brow should not be neglected. The brow plays a very important aesthetic role in framing the face, d -- 8 Management of the Upper Eyelid Complex Erika McCarty Walsh and Eben L. Rosenthal   Introduction The upper eyelid complex is an essential component in the structure and function of the eye. The primary function of the upper eye complex is to protect the orbital contents. The upper eye fulfills its protective function by first acting as a physical barrier and then secondarily gently washing the external eye with lacrimal fluid. By protecting and lubricating the cornea and sclera the upper eyelid -- 9 Management of the Lower Eyelid Amy L. Pittman and John D. Ng   Anatomy of the Lower Eyelid In order to fully comprehend the impact that facial paralysis has on the lower eyelid, a solid understanding of the anatomy and physiology of the lower lid is necessary. Similar to the upper lid, the lower lid functions to close the eye, thus lending protection to the cornea. It also shields the globe from foreign bodies and helps to provide lubrication by circulating the tear film. The muscular componen.

10 Management of the Nasal Valve Mark K. Wax and Jessica J. Peck   Introduction Human beings are obligate nasal breathers. Although there are a minority of individuals who are obligate oral breathers, the majority of individuals not only like to, but are required to breathe through their nose. Not being able to breathe through one's nose can be quite distressing and physiologically incapacitating. The nose provides many important physiologic and functional aspects to the individual. It is essent -- 11 Management of the Midface and Lips in the Paralyzed Face Kristine A. Smith, Melynda Barnes, and Tom D. Wang   Introduction Facial nerve paralysis is a relatively common and complex reconstructive issue. In general, paralysis of the facial nerve equally affects males and females. The average age at presentation, which is largely dependent on the cause, is approximately 45 years.1-3 Clinical severity of the facial nerve paralysis is most often classified according to the House-Brackmann grading -- 12 Facial Reanimation With Free Tissue Transfer Satyen Undavia and Babak Azizzadeh   Introduction Facial expression plays an integral role in the way humans communicate. Because of this, the diagnosis of facial nerve paralysis has a significant impact on a patient's quality of life. In addition to the cosmetic deformity, there are a significant number of functional deficits that occur. Paralysis of the upper third of the face results in brow ptosis, lagophthalmos, and ectropion that can lead to.

13 Management of the Soft Tissue Defect Following Parotidectomy Christine G. Gourin and Mark K. Wax   Introduction The concave deformity resulting from parotidectomy is a significant source of cosmetic morbidity and postoperative dissatisfaction.1 The extent of parotid surgery correlates with the incidence of Frey's syndrome, sensory impairment, and aesthetic outcome, with limited parotid resection associated with fewer sequela and better patient satisfaction than more extensive parotidectomy su.