Advances in Facial Nerve Paralysis: Surgical Innovation, Tissue Engineering, and Emerging Technology

Facial nerve paralysis profoundly impairs an individual’s quality of life, physical health, and self-image. Dynamic surgical correction of facial paralysis seeks to restore symmetry and tone, thereby achieving voluntary movement and expression. The selection of technique is dictated by anatomy and timing of the injury. Reinnervation techniques, including primary surgical repair, nerve grafts, tissue-engineered constructs, and nerve transfers, are feasible within 1–2 years, while neuromuscular junctions are viable. More chronic injuries require reanimation techniques such as free muscle transfers and regional muscle transfers or static approaches. Emerging research and technology include advances in nerve regeneration as well as bioelectrical interfaces. These innovative approaches hold promise for enhancing the existing therapeutic arsenal for rehabilitating injury and restoring facial nerve function after facial palsy.