Peripheral Facial Paralysis: Reanimation Techniques. An Overview

Peripheral facial paralysis represents a disabling condition with serious psychological and social impact. Patients with peripheral facial paralysis have a disfigurement of the face with loss of harmony and symmetry, and difficulties in everyday facial functions such as speaking, drinking, laughing, and closing their eyes, with impairment of their quality of life. This paralysis leads to impairment of facial expression that represents one of the first means of communication, an important aspect of human interaction. This review aims to explore the reanimation techniques for managing peripheral facial paralysis. An analysis of static and dynamic techniques for facial reanimation is provided, including muscle flaps, nerve grafting techniques, and bioengineering solutions. Dynamic techniques, when feasible, enable better outcomes in terms of facial motility, although the long-term rehabilitation and the long learning curve. Static techniques, while less invasive, provide limited functional recovery and should be combined with dynamic strategies for good results. Each technique showed its benefits and drawbacks; despite several options for facial reanimation, no technique has been detected as the gold standard. Therefore, each patient must be evaluated on an individual basis, considering his medical history, age, expectations, and treatment goals to find the best and most fitting treatment for him.