How is congenital facial paralysis treated?

Updated: Jan 07, 2019
  • Author: Alan D Bruns, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Immediate medical treatment of congenital facial paralysis requires attention to eye care. Instill artificial tears in the eyes of a child every hour while the child is awake. Use ointment when the child is sleeping. Care must be taken when taping the eye and using patches to prevent the eyelashes from abrading the cornea. Frequent ophthalmologic evaluations are indicated to evaluate for corneal abrasions, epiphora, and entropion. [40]

Some have recommended treating traumatic facial paralysis in the newborn with observation and corticosteroids. [2] This approach is similar to treatment of adult acute facial paralysis. No prospective randomized studies are available that evaluate the efficacy of steroid use in the newborn with facial paralysis caused by birth trauma. Steroids can be considered during the 5-week observation period before decompression or exploration of the nerve is undertaken. A recent recommendation is that corticosteroid treatment or surgery should be withheld in neonates who present with uncomplicated facial nerve resulting from forceps trauma. [41] As the child ages, speech impediments may become more obvious because of difficulty with oromotor tone; therefore, speech therapy should be considered.


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