What is Congenital Facial Paralysis?
Congenital facial paralysis is a rare form of facial palsy affecting children at birth. To make a diagnosis, extensive testing, including physical examinations, is necessary to exclude other conditions. When a child is born with congenital facial paralysis, it’s somewhat common for other disorders to be present, including microtia, cleft palate, deformed extremities, and other muscle paralysis.
Congenital facial paralysis is organized into several different classifications, including:
- Unilateral or Bilateral
- Traumatic or Developmental
- Complete or Incomplete
Difficulties that are present immediately after birth include eye closure and nursing issues. If congenital facial paralysis is not treated early, and does not resolve later in life, it may affect the child’s future development in relation to speech and emotional expression.
Treating Congenital Facial Paralysis
Treatment protocol for patients with congenital facial palsy is rapidly changing. Historically, patients would not be treated until they reached adulthood. Due to advancements in microsurgical techniques over the past decade, we have begun to treat children at an earlier age to help them get a head start in blending in psychosocially.
It’s extremely integral for treatment to be tailored to the patient and their particular disorder. Patients with CULLP (congenital unilateral lower lip palsy) have limited issues and can be treated successfully with Botox to the opposite side of the face as teenagers and adults without the need for complex surgery. Patients with mobius or bilateral facial paralysis require gracilis muscle flaps that are attached and controlled by the masseteric nerve as early as age 5. Patients with unilateral facial paralysis can potentially be treated with a combination of the masseteric to facial nerve transfer in with a cross facial nerve grafts or gracilis free flaps as early as age 2.
One of the most important factors of treating a younger patient dealing with facial palsy is the development of a completely safe and customized treatment plan, as this will allow for the best results in regards to improved facial reanimation and facial symmetry possible.