bell’s palsy/Facial nerve palsy

bell’s palsy/Facial nerve palsy

bell’s palsy/Facial nerve palsy

bell’s palsy/Facial nerve palsy

Bell’s Palsy/Facial Nerve Palsy

Did you know that oculoplastic surgery can help treat Bell's palsy? Dr. Amy Kulak has years of experience treating this condition and can help alleviate some symptoms related to Bell’s Palsy. Symptoms include tearing, facial and eyelid spasms, facial asymmetry, and ocular irritation as a result of poor eyelid closure. If you're suffering from Bell's palsy, don't hesitate to contact our office for a consultation!

What is Bell’s Palsy or Facial Nerve Palsy?

Bell’s palsy is a common cause of facial paralysis where the muscles on one side of the face weaken or become paralyzed. This paralysis typically presents itself as a droop in the eyebrow, a sagging lower eyelid, and a weakness in the corner of the mouth. The eyelid on the affected side will resist closing. Patients will have excessive tearing from the weakness of the eyelid muscles.

The cause of Bell’s palsy is unknown, but it's believed to be due to inflammation of the facial nerve on the affected side of the face. Inflammation is caused by a reaction that occurs after a viral infection.​​​​​​

Bell’s palsy can occur suddenly and without warning. The paralysis can last for a few days or weeks; it usually improves significantly after six months. A small number of people may have some of Bell’s palsy symptoms for life.

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Why you need treatment

Bell’s palsy can cause feelings of discomfort and other complications. Facial paralysis causes complications with closing one’s eyes (known as lagophthalmos) which can threaten the eye's health. Patients who are unable to blink and completely close their eyes are at risk of dry eye and damage to the cornea from exposure (keratopathy).

Some additional symptoms include:

  • Drooling

  • Headaches

  • Increased sensitivity to sound on one side of your face

  • Loss of taste

Another potential consequence of Bell's palsy is social isolation. People with the condition may find that their communication abilities are compromised, which can lead to difficulties in forming and maintaining relationships. Also, some may feel self-conscious about their appearance and avoid public spaces. These social consequences can lead to depression and anxiety.

Treatment process

Treatment for Bell’s palsy focuses on relieving symptoms and preventing complications. There is no cure for Bell’s palsy, but most people recover fully within a few weeks or months. However, if there is no resolution in nerve function, surgery may be necessary to protect the eye and restore function.

Some of these treatments include:

Eye lubrication
- It is essential to increase the frequency of using lubricating eye drops throughout the day to prevent the cornea from drying and the eye from becoming painful. Prolonged corneal exposure (exposure keratopathy) due to the eyelid not closing completely can lead to permanent vision changes and possible scarring if left untreated. Most often, we recommend adding a lubricating ointment for nighttime protection in addition to artificial tears during the day.

Botox eyelid and facial spasms
- After recovering from Bell’s palsy, sometimes there can be some “miswiring” of the nerves leading to overactive muscle contractions around the eyes and mouth. This could lead to one eye appearing smaller than the unaffected eye and for some a pulling sensation near the corners of the mouth. Some patients will also notice an eye spasm or twitch. Botox works by relaxing the affected overactive muscles and can improve asymmetries of the face and eyelids from Bell’s palsy. Botox can vary in how long it lasts and most patients need injections a few times a year to keep symptoms well controlled. During your evaluation, Dr. Kulak will assess the muscles of your face and discuss a treatment plan.

Ectropion repair
- Ectropion is a “turning out” of the lower eyelid; in Bell’s palsy, this can occur due to paralysis of the facial nerve, which causes muscle weakness around the eyes. When the eyelid losses its muscle tone, the lower eyelid can droop and become red and irritated. Ectropion repair is a short outpatient surgical procedure that tightens and restores the lower eyelid to its normal position. This can significantly improve tearing and comfort to the eye. In severe cases, this procedure may be recommended urgently to prevent vision changes due to dry eyes and exposure to the cornea.

Upper eyelid surgery (Gold or Platinum weight placement)
- The eyelids can resist closing due to Bell’s palsy. When the eyelids can’t completely close, the cornea of the eye will become dry and scarring can occur. Lubrications and ointments are applied to protect the eye, but sometimes surgery is warranted. Depending on which problem you have, various procedures are facilitated to repair your eyelid’s functionality in this procedure, a gold or platinum weight is placed inside the eyelid to help assist in closing the eyelid. These procedures are performed in an outpatient surgery center, typically under mild sedation. Although healing may vary from patient to patient, recovery is commonly between 2-3 weeks. This procedure is sometimes performed in conjunction with lower eyelid ectropion repair (see above).

Eyebrow lift
– The eyebrow can descend from its normal position, known as brow ptosis. This can be corrected with either a direct brow lift or an endoscopic brow lift. An endoscopic eyebrow lift restores the eyebrow’s normal position through small incisions hidden in the hairline. A direct brow lift can lift a severely paralytic brow through an incision placed right above the brow hairs or hidden in a forehead crease. Dr. Kulak will discuss both procedures during your consultation to help determine which procedure is right for you.

Contact us for Bell’s palsy treatment

Bell’s palsy can be a very disabling condition, but fortunately, there are treatment options available. If you or someone you know is suffering from Bell’s palsy, please contact our office today. We offer a wide range of cosmetic surgery options that can help relieve your symptoms and improve your quality of life. Contact us today at 904-775-5275 or, we would be happy to help!

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