Facial Nerve Disorders Program|Loyola Medicine

Facial Nerve Disorders Program

Overview and Facts about Facial Nerve Disorders

Loyola Medicine has been a Facial Nerve Center for Chicago and the nation for over two decades with experience in the workup, management, and the compassionate treatment of facial nerve paralysis. The loss of facial movement can have a significant effect on your speech, eating and drinking, as well as cause pain, excessive tearing or twitching. Causes of facial nerve paralysis include head trauma, infection or inflammation of the facial nerve, parotid tumors, head or neck cancers, or stroke. Facial paralysis can come on suddenly or gradually depending on its cause.

Loyola’s doctors have expertise in the treatment of various types of facial paralysis, including Bell’s palsy, which occurs when a virus infects the facial nerve and leads to acute paralysis on one side of the face. While most cases of Bell's palsy recover on their own or with medication, some require surgical intervention. If you have facial paralysis resulting from an accident or from tumors of the ear and salivary gland, your Loyola specialist may recommend surgery to repair the damage caused to your facial nerve. 

We treat a large volume of complex cases, and we provide second opinion services for patients who have been turned away from other centers for recent, delayed, or long-standing facial paralysis.

Why Choose Loyola for Facial Nerve Disorders?

Experience matters. The Facial Nerve Center was started over 25 years ago by John Leonetti, MD, through the development of an extensive lateral skull base practice, which has managed over 2,000 patients with facial nerve disorders and tumors. With careful recruitment of additional skull base surgeons, audiologists, facial nerve physical therapists, facial plastics surgeons, speech therapists and nurses, the team today offers a unique approach to patient care. The multidisciplinary Facial Nerve team at Loyola provides a collaborative approach to treating children and adults with facial nerve paralysis and disorders. We understand how the loss of facial movement due to nerve damage can have a significant effect on a patient’s speech, eating, drinking and ability to express emotion. We work together to deliver individualized treatment plans suitable for each patient’s specific condition or issue through retraining, medication and surgery when appropriate.

Symptoms and Signs of Facial Nerve Disorders

Facial paralysis can happen suddenly or over a period of time. The signs of facial nerve paralysis include drooping mouth and the inability to close one eye. Other signs include:

  • Facial asymmetry
  • Difficulty making facial expressions, such as smiling or closing your eye
  • Drooling
  • Decrease in saliva production
  • Change in tear production
  • Pain around the jaw or ear of the affected side
  • Decreased ability to taste
  • Increased sensitivity to affected side
  • Involuntary movement of facial muscles
  • Lump or swelling on the affected side of your face
  • Numbness
  • Difficulty swallowing
  • Sensitivity to loud sounds
  • Trouble opening your mouth widely
  • Weakness on one side of the face

If you notice any of the above symptoms, it is important to see your doctor for accurate diagnosis and the start of a customized treatment plan right away.

Causes of Facial Nerve Disorders

The most common causes of facial nerve paralysis are:

  • Viral (Bell’s palsy)
  • Facial damage as the result of a previous surgery
  • Congenital facial paralysis
  • Head trauma
  • Ear infection
  • Ramsay Hunt syndrome
  • Lyme disease
  • Head or neck, ear, skull base or salivary gland tumor
  • Stroke
  • Vascular malformations 

Tests and Diagnosis of Facial Nerve Disorders

Your doctor will conduct a thorough medical exam to determine the extent of your facial nerve issue. He/she will look at your face and ask you to move your facial muscles by closing your eyes, lifting your brow, showing your teeth and frowning, among other movements.

If the cause of your facial nerve paralysis or disorder is unknown, your doctor may recommend additional tests, including:

  • Electromyography (EMG): An EMG measures a muscle’s electrical activity when stimulated and how fast the muscle responds. This test is used to confirm nerve damage and determine its severity.
  • CT or MRI scans: These tests can help determine other causes of facial nerve damage, such as a fracture, infection, or tumors in the head or neck area. 

Treatment and Care for Facial Nerve Disorders

Facial nerve paralysis without an identifiable cause may go away on its own, but it does require careful monitoring by you and your healthcare provider. Loyola offers a wide range of medical and surgical treatment options for facial paralysis, including:

  • Oral steroids
  • Facial nerve decompression with electrical stimulation surgery
  • Physical therapy
  • Nerve repair or nerve grafts
  • Nerve transposition
  • Gold weight placement and eyelid surgery
  • Cosmetic surgery
  • Botulinum toxin injections for the management of synkinesis
  • Gracilis muscle free tissue transfer for facial reanimation

Together, you and your Loyola doctor will determine the best course of treatment for your condition. Your doctor is primarily concerned with improving your quality of life so that you may return to your normal activities. At Loyola, you have access to the most advanced treatments available for facial paralysis.

Facial Retraining

Facial nerve physical therapists at Loyola work with you to develop customized movement patterns that help you re-coordinate the muscles of your face after paralysis. Facial retraining is a non-surgical approach to rehabilitation in which you and a therapist identify the facial muscles that are functioning incorrectly and create strategies to re-establish normal function as much as possible.

Facial Reanimation

For paralysis that recovers partially, or not at all, there are a wide variety of treatments, both medical and surgical, that are aimed at dealing with existing paralysis. The goals of reanimation include the restoration of symmetry, movement and function. Treatments are tailored toward the patient, with careful consideration of the etiology (cause) and also the patient’s long-term outcome goals. The procedures offered at Loyola include gold weights, eyelid surgery, nasal surgery, facial suspension, nerve grafts and gracilis muscle and nerve transfers.