Long term results of idiopathic hemifacial palsy: Orthodontic and surgical multidisciplinary management

Idiopathic facial palsy is the most common cause of unilateral neurologic disorders of the cranial nerves. It can result from congenital, due to delivery traumas, and genetic or malformative diseases, or acquired due to infective, inflammatory, neoplastic, traumatic or iatrogenic causes. In the great majority of cases its causes are unknown. A careful differential diagnosis is recommended in paediatric patients, in order to establish the most appropriate treatment as the therapeutic approach differs in relation to the aetiology. Controversy exists regarding treatment options. The primary concern in the treatment is to restore the aesthetics, function and comfort. Facial palsy may result in a multitude of conditions such as: affected salivation, taste and lachrymation, depending on the topography of the facial nerve affection, and patients may also refer auditory hipersesitivity which may result in noise intolerance. In this paper a case of a child with unilateral facial palsy is described. The patient was treated by orthopaedic appliances and surgical facial reanimation. At the end of therapy good aesthetic and functional results were obtained. Oral functions as well as facial expression were partially recovered and symmetry was almost completely restored. Children with idiopathic facial palsy have a better prognosis if the diagnosis is early and treatment is multidisciplinary.