facial nerve injuries


Summary: Traumatic injuries to the facial nerve. This may result in FACIAL PARALYSIS, decreased lacrimation and salivation, and loss of taste sensation in the anterior tongue. The nerve may regenerate and reform its original pattern of innervation, or regenerate aberrantly, resulting in inappropriate lacrimation in response to gustatory stimuli (e.g., "crocodile tears") and other syndromes.

Top Publications

  1. Zujovic V, Luo D, Baker H, Lopez M, Miller K, Streit W, et al. The facial motor nucleus transcriptional program in response to peripheral nerve injury identifies Hn1 as a regeneration-associated gene. J Neurosci Res. 2005;82:581-91 pubmed
    ..These findings identify Hn1 as a gene associated with nervous system development and nerve regeneration. ..
  2. Humphrey C, Kriet J. Nerve repair and cable grafting for facial paralysis. Facial Plast Surg. 2008;24:170-6 pubmed publisher
    ..Proficient anastomotic technique and, when necessary, selection of an appropriate interposition graft will optimize patient outcomes. Promising research is under way that will enhance future nerve repair and grafting efforts. ..
  3. Angelov D, Ceynowa M, Guntinas Lichius O, Streppel M, Grosheva M, Kiryakova S, et al. Mechanical stimulation of paralyzed vibrissal muscles following facial nerve injury in adult rat promotes full recovery of whisking. Neurobiol Dis. 2007;26:229-42 pubmed
    ..Our findings indicate the potential of use-specific training to enhance appropriate functional outcome after peripheral nerve injury and may be useful in a clinical rehabilitation setting. ..
  4. Streppel M, Azzolin N, Dohm S, Guntinas Lichius O, Haas C, Grothe C, et al. Focal application of neutralizing antibodies to soluble neurotrophic factors reduces collateral axonal branching after peripheral nerve lesion. Eur J Neurosci. 2002;15:1327-42 pubmed
  5. VanSwearingen J, Brach J. Changes in facial movement and synkinesis with facial neuromuscular reeducation. Plast Reconstr Surg. 2003;111:2370-5 pubmed
  6. Guntinas Lichius O, Irintchev A, Streppel M, Lenzen M, Grosheva M, Wewetzer K, et al. Factors limiting motor recovery after facial nerve transection in the rat: combined structural and functional analyses. Eur J Neurosci. 2005;21:391-402 pubmed
    ..Because polyneuronal innervation of muscle fibres is activity-dependent and can be manipulated, the present findings raise hopes that clinically feasible and effective therapies could be soon designed and tested. ..
  7. Moran L, Graeber M. The facial nerve axotomy model. Brain Res Brain Res Rev. 2004;44:154-78 pubmed
    ..The medical implications of these findings are significant. Also, the facial nerve system of rats and mice has become the best studied and most widely used test system for the evaluation of neurotrophic factors. ..
  8. Raivich G, Bohatschek M, Da Costa C, Iwata O, Galiano M, Hristova M, et al. The AP-1 transcription factor c-Jun is required for efficient axonal regeneration. Neuron. 2004;43:57-67 pubmed
    ..Taken together, our results identify c-Jun as an important regulator of axonal regeneration in the injured central nervous system. ..
  9. Hadlock T, Heaton J, Cheney M, Mackinnon S. Functional recovery after facial and sciatic nerve crush injury in the rat. Arch Facial Plast Surg. 2005;7:17-20 pubmed
    ..These quantitative measures will be useful for future facial nerve manipulation studies. ..

More Information


  1. Werner A, Willem M, Jones L, Kreutzberg G, Mayer U, Raivich G. Impaired axonal regeneration in alpha7 integrin-deficient mice. J Neurosci. 2000;20:1822-30 pubmed
    ..The associated delay in the reinnervation of the whiskerpad, a peripheral target of the facial motor neurons, points to an important role for this integrin in the successful execution of axonal regeneration. ..
  2. Tomov T, Guntinas Lichius O, Grosheva M, Streppel M, Schraermeyer U, Neiss W, et al. An example of neural plasticity evoked by putative behavioral demand and early use of vibrissal hairs after facial nerve transection. Exp Neurol. 2002;178:207-18 pubmed
  3. Al Moraissi E, Louvrier A, Colletti G, Wolford L, Biglioli F, Ragaey M, et al. Does the surgical approach for treating mandibular condylar fractures affect the rate of seventh cranial nerve injuries? A systematic review and meta-analysis based on a new classification for surgical approaches. J Craniomaxillofac Surg. 2018;46:398-412 pubmed publisher
    ..The inclusion criteria were all clinical trials, with the aim of assessing the rate of facial nerve injuries when (ORIF) of mandibular condylar fractures was performed using different surgical approaches...
  4. Iversen R, Illum P. Cervicofacial nontuberculous mycobacterial lymphadenitis in children. Dan Med J. 2012;59:A4349 pubmed
    ..Although the lymph nodes may persist for months, spontaneous regression may occur and the children remain systemically well. not relevant. not relevant. ..
  5. Beretta F, Hemida S, Andaluz N, Zuccarello M, Keller J. Exposure of the cervical internal carotid artery: surgical steps to the cranial base and morphometric study. Neurosurgery. 2006;59:ONS25-34; discussion ONS25-34 pubmed
    ..The number of steps required varies depending on the level of lesion. Complete understanding of the surgical anatomy is essential to minimize surgical morbidity and to develop surgical expertise. ..
  6. Hastan D, Vandenbroucke J, van der Mey A. A meta-analysis of surgical treatment for vestibular schwannoma: is hospital volume related to preservation of facial function?. Otol Neurotol. 2009;30:975-80 pubmed publisher
    ..Prospective and nationwide registration of surgical results might contribute to more definitive conclusions regarding outcome of vestibular schwannoma surgery. ..
  7. Gerganov V, Klinge P, Nouri M, Stieglitz L, Samii M, Samii A. Prognostic clinical and radiological parameters for immediate facial nerve function following vestibular schwannoma surgery. Acta Neurochir (Wien). 2009;151:581-7; discussion 587 pubmed publisher
    ..Our data suggests that the analysis of the radiological and neurological patient data prior to surgery could give reliable clues regarding the immediate post-operative facial nerve function. ..
  8. Kalinin P, Sharipov O, Kutin M, Fomichev D, Gavrjushin A, Polev G, et al. Amygdalohippocampectomy via the Lateral Extended Transsphenoidal Endoscopic Approach Through the Pterygopalatine Fossa: An Anatomic Study. World Neurosurg. 2017;103:457-464 pubmed publisher
    ..Disadvantages that limit application of LETEA include risk of cerebrospinal fluid leak and skills needed for manipulation in a narrow and deep surgical field with angled 30° and 45° endoscopes. ..
  9. Knopf A, Szyper M, Mansour N, Sonnenberg J, Hofauer B, Niedermeyer H. A critical review of 20 years of parotid gland surgery. Acta Otolaryngol. 2016;136:711-6 pubmed publisher
    ..Extended surgery was associated with post-operative facial nerve alteration. Extracapsular dissection and superficial parotidectomy did not show differences in the facial palsy rate. ..
  10. Ikeda K, Aoki M, Kawazoe Y, Sakamoto T, Hayashi Y, Ishigaki A, et al. Motoneuron degeneration after facial nerve avulsion is exacerbated in presymptomatic transgenic rats expressing human mutant Cu/Zn superoxide dismutase. J Neurosci Res. 2005;82:63-70 pubmed
    ..The present data indicate the increased vulnerability of injured motoneurons after avulsion in the presymptomatic mutant SOD1-tg rats. ..
  11. Kim J, Han S, Shin D, Lee W, Choi J. Subthreshold continuous electrical stimulation facilitates functional recovery of facial nerve after crush injury in rabbit. Muscle Nerve. 2011;43:251-8 pubmed publisher
    ..This study shows that subthreshold, continuous, low-frequency ES immediately after a crush injury of the facial nerve results in earlier recovery of facial function and shorter overall recovery time. ..
  12. Ha G, Huang Z, Petitto J. Prior facial motor neuron injury elicits endogenous T cell memory: relation to neuroregeneration. J Neuroimmunol. 2007;183:111-7 pubmed
    ..Measures of microglial responsiveness did not differ between the groups. Further study is needed to delineate the role of endogenous T cell memory in neuronal injury and regeneration. ..
  13. Oschipok L, Teh J, McPhail L, Tetzlaff W. Expression of Semaphorin3C in axotomized rodent facial and rubrospinal neurons. Neurosci Lett. 2008;434:113-8 pubmed publisher
    ..This demonstrates that increased Sema3C mRNA levels in axotomized rubrospinal neurons is common to both mouse and rat injury models. ..
  14. Wang A, Wang J, Dexter M, Da Cruz M. The vestibular schwannoma surgery learning curve mapped by the cumulative summation test for learning curve. Otol Neurotol. 2013;34:1469-75 pubmed publisher
    ..Position along the learning curve, tumor size, and familiarity with a preferred surgical approach are the factors, which dominated facial nerve outcome. We recommend the use of LC-CUSUM test for learning curve analysis. ..
  15. Lu X, Cai Z, Yu G, Peng X. [Surgical treatment of transected peripheral facial nerve injury]. Beijing Da Xue Xue Bao Yi Xue Ban. 2011;43:106-11 pubmed
    ..The site and range of facial nerve injury, the time post onset until repair, and the age of patient are factors that influence the clinical outcomes. ..
  16. Skouras E, Ozsoy U, Sarikcioglu L, Angelov D. Intrinsic and therapeutic factors determining the recovery of motor function after peripheral nerve transection. Ann Anat. 2011;193:286-303 pubmed publisher
    ..All these findings raise hopes that clinically feasible and effective therapies could be soon designed and tested. ..
  17. Marin P, Pouliot D, Fradet G. Facial nerve outcome with a peroperative stimulation threshold under 0.05 mA. Laryngoscope. 2011;121:2295-8 pubmed publisher
    ..01). A proximal ST of <0.05 mA is a better predictor of facial nerve function immediately postoperatively. ..
  18. Cerón J, Troncoso J. [Facial nerve injuries cause changes in central nervous system microglial cells]. Biomedica. 2016;36:619-631 pubmed publisher
    ..These modifications could be involved in the generation of morphological and electrophysiological changes previously described in the pyramidal neurons of primary motor cortex that command facial movements. ..
  19. Rabie A, Ibrahim A, Kim P, Medina M, Upton J, Lee B, et al. Dynamic rehabilitation of facial nerve injury: a review of the literature. J Reconstr Microsurg. 2013;29:283-96 pubmed publisher
    ..Outcomes are improving. Ultimately, the approach depends on the surgeon's experience. ..
  20. Huang Y, Xing Y, Wang H, Chen L, Li S. Differences in pharmacodynamic responses to rocuronium in normal or injured orbicularis oris are associated with expression of acetylcholine receptor subunits. Sci Rep. 2017;7:3238 pubmed publisher
    ..Facial nerve injury caused the resistance to neuromuscular blockers and reduced twitch tension, which was related to qualitative, quantitative, and locational changes in nAChR subunits. ..
  21. Har Shai Y, Metanes I, Badarny S, Cuzin P, Gil T, Mayblum S, et al. Lengthening temporalis myoplasty for facial palsy reanimation. Isr Med Assoc J. 2007;9:123-4 pubmed
  22. Hetzler L, Sharma N, Tanzer L, Wurster R, Leonetti J, Marzo S, et al. Accelerating functional recovery after rat facial nerve injury: Effects of gonadal steroids and electrical stimulation. Otolaryngol Head Neck Surg. 2008;139:62-7 pubmed publisher
    ..By targeting different stages of neural regeneration, the synergy of electrical stimulation and testosterone appears to have promise as a neurotherapeutic strategy for facial nerve injury. ..
  23. Sasaki R, Aoki S, Yamato M, Uchiyama H, Wada K, Okano T, et al. Tubulation with dental pulp cells promotes facial nerve regeneration in rats. Tissue Eng Part A. 2008;14:1141-7 pubmed publisher
    ..These results suggest that the transplanted dental pulp cells formed blood vessels and myelinating tissue and contributed to the promotion of normal nerve regeneration. ..
  24. Ohno K, Kato H, Funahashi S, Hasegawa T, Sato K. Characterization of CLP36/Elfin/PDLIM1 in the nervous system. J Neurochem. 2009;111:790-800 pubmed publisher
    ..These findings suggest that CLP36 serves as a scaffold to form a multiprotein complex that regulates actin cytoskeleton dynamics and plays a role in controlling neurite outgrowth. ..
  25. Canh M, Serpe C, Sanders V, Jones K. CD4(+) T cell-mediated facial motoneuron survival after injury: Distribution pattern of cell death and rescue throughout the extent of the facial motor nucleus. J Neuroimmunol. 2006;181:93-9 pubmed
    ..These data are discussed in context of recent work in amyotrophic lateral sclerosis, a fatal motoneuron disease. ..
  26. Al Hayani A. Anatomical localisation of the marginal mandibular branch of the facial nerve. Folia Morphol (Warsz). 2007;66:307-13 pubmed
    ..It is concluded that the lower border of the mandible can serve as an important landmark to help avoid injury to the nerve; above it a subplatysmal flap is satisfactory but below it a subfascial flap is much safer. ..
  27. Enomoto K, Nishimura H, Inohara H, Murata J, Horii A, Doi K, et al. A rare case of a glass foreign body in the parapharyngeal space: pre-operative assessment by contrast-enhanced CT and three-dimensional CT images. Dentomaxillofac Radiol. 2009;38:112-5 pubmed publisher
    ..We emphasise the usefulness of contrast-enhanced CT and three-dimensional CT images for pre-operative evaluation of the locational relationship between the foreign body and great vessels in the parapharyngeal space. ..
  28. Haas D. Articaine and paresthesia: epidemiological studies. J Am Coll Dent. 2006;73:5-10 pubmed
    ..This article reviews the epidemiological evidence regarding articaine and paresthesia...
  29. Mandl E, Vandertop W, Meijer O, Peerdeman S. Imaging-documented repeated intratumoral hemorrhage in vestibular schwannoma: a case report. Acta Neurochir (Wien). 2009;151:1325-7 pubmed publisher
    ..To our knowledge, repeated hemorrhage in vestibular schwannoma with radiological confirmation has not been reported before. ..
  30. Marchesi M, Biffoni M, Trinchi S, Turriziani V, Campana F. Facial nerve function after parotidectomy for neoplasms with deep localization. Surg Today. 2006;36:308-11 pubmed
    ..To determine whether the deep location of a parotid gland neoplasm is specific risk factor for facial nerve paralysis after parotidectomy...
  31. Wang Y, Wang D, Nie X, Lei D, Liu Y, Zhang Y, et al. The role of bone morphogenetic protein-2 in vivo in regeneration of peripheral nerves. Br J Oral Maxillofac Surg. 2007;45:197-202 pubmed
    ..These findings suggest that BMP-2 might be involved in the regeneration of facial nerves, and might function as a potential neurotrophic factor. ..
  32. Toledo R, Borin A, Cruz O, Ho P, Testa J, Fukuda Y. The action of topical basic fibroblast growth factor in facial nerve regeneration. Otol Neurotol. 2010;31:498-505 pubmed publisher
    ..This study showed that the regeneration of the facial nerve occurred earlier and resulted in significantly more myelinated nerve fibers in the animals that received topical bFGF. ..
  33. Melle C, Ernst G, Grosheva M, Angelov D, Irintchev A, Guntinas Lichius O, et al. Proteomic analysis of microdissected facial nuclei of the rat following facial nerve injury. J Neurosci Methods. 2009;185:23-8 pubmed publisher
    ..This proteomic analysis with ultra high sensitivity paired with potential for a spatial resolution is a promising methodology for peripheral nerve regeneration studies. ..
  34. Watabe K, Hayashi Y, Kawazoe Y. Peripheral nerve avulsion injuries as experimental models for adult motoneuron degeneration. Neuropathology. 2005;25:371-80 pubmed
    ..These results indicate that the gene transfer of GDNF, BDNF, TGFbeta2, and GIF and oral administration of T-588 may prevent the degeneration of motoneurons in adult humans with motoneuron injury and motor neuron diseases. ..
  35. Murphy M, McCutcheon B, Kerezoudis P, Porter A, Rinaldo L, Shepherd D, et al. Morbid obesity increases risk of morbidity and reoperation in resection of benign cranial nerve neoplasms. Clin Neurol Neurosurg. 2016;148:105-9 pubmed publisher
    ..5-25. Obesity is an independent and important risk factor for composite morbidity in resection of benign cranial nerve neoplasms, and as such, merits discussion during preoperative counseling. ..
  36. Costa H, Bento R, Salomone R, Azzi Nogueira D, Zanatta D, Paulino Costa M, et al. Mesenchymal bone marrow stem cells within polyglycolic acid tube observed in vivo after six weeks enhance facial nerve regeneration. Brain Res. 2013;1510:10-21 pubmed publisher
    ..Accordingly, groups D and E had BMSC integrated in neural tissue with maintenance of former cell phenotype for six weeks. ..
  37. Joseph S, Joseph A, Douglas R, Massry G. Periocular Reconstruction in Patients with Facial Paralysis. Otolaryngol Clin North Am. 2016;49:475-87 pubmed publisher
    ..Current reconstructive procedures are most commonly intended to improve coverage of the eye but cannot restore blink. ..
  38. Lehtivuori T, Palonen R, Mussalo Rauhamaa H, Holi T, Henriksson M, Aaltonen L. Otorhinolaryngological patient injuries in Finland. Laryngoscope. 2013;123:2397-400 pubmed publisher
    ..Patient injuries in ORL are seldom severe and are strongly associated with surgery. A typical compensated injury was one that occurred in a central hospital during working hours. N/A. ..
  39. Seol H, Kim C, Park C, Kim C, Kim D, Chung Y, et al. Optimal extent of resection in vestibular schwannoma surgery: relationship to recurrence and facial nerve preservation. Neurol Med Chir (Tokyo). 2006;46:176-80; discussion 180-1 pubmed
    ..227). GTR is the ideal surgical treatment for vestibular schwannoma, but NTR is a good option, with better facial nerve function preservation than GTR without significantly increasing the risk of recurrence. ..
  40. Múnera A, Cuestas D, Troncoso J. Peripheral facial nerve lesions induce changes in the firing properties of primary motor cortex layer 5 pyramidal cells. Neuroscience. 2012;223:140-51 pubmed publisher
    ..Taken together, such changes demonstrate that peripheral facial nerve lesions induce robust and sustained changes of layer 5 pyramidal neurons in vibrissal motor cortex. ..
  41. Bacciu A, Falcioni M, Pasanisi E, Di Lella F, Lauda L, Flanagan S, et al. Intracranial facial nerve grafting after removal of vestibular schwannoma. Am J Otolaryngol. 2009;30:83-8 pubmed publisher
    ..However, the technique of FN repair by means of fibrin glue is technically simple, less time-consuming, and imparts less trauma on the nerve than does the traditional suture method. ..
  42. Heeremans E, Mastboom W. [Subtotal parotidectomy for a parotid gland tumour in two players of wind instruments, with preservation of facial nerve function]. Ned Tijdschr Geneeskd. 2007;151:543-7 pubmed
    ..A few weeks after the operations, both musicians could resume playing; subtotal parotidectomy can apparently be safely performed in players of wind instruments. ..
  43. Makeieff M, Pelliccia P, Letois F, Mercier G, Arnaud S, César C, et al. Recurrent pleomorphic adenoma: results of surgical treatment. Ann Surg Oncol. 2010;17:3308-13 pubmed publisher
    ..Nevertheless, a definitive facial paralysis ? grade III rate of 11.3% is reported after multiple nerve dissection. New recurrence after surgery is less frequent if the initial treatment for pleomorphic adenoma is total parotidectomy. ..
  44. Shuto T, Inomori S, Matsunaga S, Fujino H. Microsurgery for vestibular schwannoma after gamma knife radiosurgery. Acta Neurochir (Wien). 2008;150:229-34; discussion 234 pubmed publisher
    ..Dissection of the tumour from the facial nerve or brain stem is likely to be difficult. We recommend subtotal resection without dissection of the facial nerve and tumour, because growth of the residual tumour was rare in our series. ..
  45. Olvera Caballero C, Hidalgo Monroy P. Neurovascular musculocutaneous latissimus dorsi free-flap transfer for reconstruction of a major cheek defect with facial palsy in a 14-month-old child. Microsurgery. 2005;25:373-7 pubmed
    ..Consequently, a free musculocutaneous neurovascular latissimus dorsi free flap was proposed to restore the volume, shape, and function of the left half of the face. We present the surgical technique and the results 3.5 years later. ..
  46. Fakhry N, Herve J, Michel J, Santini L, Piller P, Giovanni A. [Giant pleomorphic adenoma of the deep lobe of the parotid gland: role of MRI and nerve monitoring in facial nerve localization]. Rev Laryngol Otol Rhinol (Bord). 2011;132:233-5 pubmed
    ..A careful search of facial nerve during surgical procedure is always necessary to avoid accidental injury of the nerve. In difficult cases, nerve monitoring is an important technical assistance. ..
  47. Arcuri F, Brucoli M, Benech A. Analysis of the retroauricular transmeatal approach: a novel transfacial access to the mandibular skeleton. Br J Oral Maxillofac Surg. 2012;50:e22-6 pubmed publisher
    ..We think that further prospective clinical trials are needed better to assess and eventually develop this approach. ..
  48. Zhang L, Wang H, Fan Z, Han Y, Xu L, Zhang H. [Changes in facial nerve function, morphology and neurotrophic factor III expression following three types of facial nerve injury]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011;25:78-81 pubmed
    ..The fibres' degeneration occurs not only dispersed throughout the injury site but also occurred throught the length of the nerve. NT-3 immunoreactivity increased in activated fibers after partial transection. ..
  49. Gaszyńska E, Kozakiewicz M. [Complications of surgical treatment of mandibular prognathism]. Pol Merkur Lekarski. 2008;25:27-31 pubmed
    ..The choice of sagittal split ramus osteotomy is related to higher probability of paraesthesia within lower lip immediately after surgery, but the early risk of facial nerve paralysis is greater after extraoral vertical ramus osteotomy. ..
  50. Myrseth E, Pedersen P, Møller P, Lund Johansen M. Treatment of vestibular schwannomas. Why, when and how?. Acta Neurochir (Wien). 2007;149:647-60; discussion 660 pubmed
    ..Furthermore, we review the literature concerning quality of life in patients with VS. Finally, we present our experience with a management strategy applied to more than 300 cases since 2001...
  51. Gurgel R, Theodosopoulos P, Jackler R. Subtotal/near-total treatment of vestibular schwannomas. Curr Opin Otolaryngol Head Neck Surg. 2012;20:380-4 pubmed publisher
    ..Whereas facial nerve outcomes are more favorable in partial resections, the risk of recurrence increases and is proportional to the volume of residual tumor. ..
  52. Wang H, Fang F, Yi J, Xiang Z, Sun M, Jiang H. Establishment and assessment of the perinatal mouse facial nerve axotomy model via a subauricular incision approach. Exp Biol Med (Maywood). 2012;237:1249-55 pubmed publisher
  53. Tetzlaff J, Tanzer L, Jones K. Exogenous androgen treatment delays the stress response following hamster facial nerve injury. J Neuroendocrinol. 2007;19:383-9 pubmed