How to treat facial nerve paralysis? Surgery is effective

For diseases like facial nerve paralysis, we can use drug therapy to treat it during the acute and recovery periods. In addition, surgical treatment is also very effective. If you need it, you must choose a regular hospital for surgery.

1. The acute phase begins within 1 to 2 weeks. The main focus of this stage is to control inflammatory edema, improve local blood circulation, and reduce nerve compression. Commonly used drugs are:

(1) Use corticosterone drugs to reduce facial nerve edema. Starting from the day of onset, take prednisone tablets orally, 3 times a day, with a daily dose of 45-60 mg. After 3 days, gradually reduce the dose within 10 days. Dexamethasone 10 mg can also be used by intravenous drip, once a day.

(2) Vasodilators: Oral niacin tablets, 100 mg, 3 times a day; or oral dimethoate tablets, 20-30 mg, 3 times a day.

(3) Aspirin tablets: Oral, 0.5-1g, twice a day.

(4) Vitamin B1 100 mg, intramuscular injection, once a day; Vitamin B12 1,000 μg, intramuscular injection, once a day.

(5) Antiviral drugs such as isatis root, morphine, acyclovir (ribavirin) etc. may be given as appropriate.

2. Recovery period: 2 weeks to 2 years after onset. The treatment at this stage is mainly to restore nerve conduction function and strengthen muscle contraction as quickly as possible. In addition to continuing to give vitamin B1 and vitamin B12, the following measures can be taken:

(1) Galantamine: 2.5 mg intramuscular injection, once a day; or neostigmine tablets, 60 mg orally, 3 times a day.

(2) Physical therapy: electrical stimulation, electric massage, etc.

(3) Acupuncture: Dicang, Yifeng, Taiyang, Fengchi, Hegu, Zusanli and other acupoints.

(4) Pay attention to eye protection: such as wearing glasses, using sterile liquid paraffin eye drops, eye drops and antibiotic eye ointment, etc.

(5) Some people advocate that if facial paralysis shows no signs of recovery after one month, facial nerve canal decompression surgery should be considered, but this is only effective for patients whose lesions are located within the facial nerve canal.

3. Surgery

Mainly for late-stage facial paralysis. Surgical treatment can be divided into static treatment and dynamic treatment. Static treatment mainly involves transplanting the fascia lata in strips to the face. After treatment, the facial expressions on both sides are symmetrical in static conditions, but the affected side cannot move with the healthy side in dynamic conditions. Dynamic treatment is generally divided into two stages. The first stage is to anastomose the nerve removed from the patient's calf with the nerve on the healthy side, and place the transplanted nerve end on the affected side. After 6 months to 1 year, the nerve grows from the healthy side to the affected side. The second stage of surgery is performed, which is to transplant muscles with vascular nerves. The muscles selected can be the rectus femoris, gracilis, latissimus dorsi, etc. After 3 months to 1 year of treatment, the symmetry of bilateral expressions can be achieved in both static and dynamic states.