What We Offer You for Facial Nerve Care
- Specialized expertise in restoring both form and function to individuals with facial paralysis. Go to Conditions Treated
- Advanced treatment strategies, including facial reanimation surgery, surgical treatment of synkinesis, rehabilitation, and eye care and surgery. Go to Treatments
- Team-based care that brings together facial plastic surgeons, neurologists, ophthalmologists, rehabilitation specialists, and others. Go to Your Care Team
- Complete support services to help you focus on your total health and wellness. Go to Support Services
- Easy access to a broad range of facial nerve specialties and support services at one convenient location. Go to Accessing Care
At Stanford Health Care’s Facial Nerve Center, our team has extensive experience in diagnosing, treating, and rehabilitating all types of facial nerve conditions. Our experts provide comprehensive care and support for facial paralysis, tumors (including facial neuroma and acoustic neuroma), injuries, muscle contractions or spasms, and other facial nerve issues. We treat a wide range of facial nerve conditions, including:
- Acute facial nerve injury
- Bell’s palsy, temporary weakness on one side of your face
- Complete facial paralysis
- Facial neuroma, a tumor on the facial nerve
- Facial symptoms of acoustic neuroma (noncancerous brain tumor)
- Ramsay Hunt syndrome, facial paralysis caused by an outbreak of shingles
- Synkinesis, unintentional movement in one part of your face while attempting to move another (such as your eyes closing when you smile); a “faulty re-wiring” of the facial nerve that occurs after injury and recovery
Nerve to Masseter Transfer
Dual Nerve Transfer
Facial Nerve Treatments
At Stanford Health Care’s Facial Nerve Center, our specialists work with you to develop a treatment plan that’s right for your needs. Every member of our team is devoted to offering you the most effective care based on the latest scientific evidence. Depending on your condition, we provide surgical, nonsurgical, and behavioral care to treat your condition and improve your symptoms.
PROGRAM HIGHLIGHTS
We bring together specialists across many disciplines for seamless, coordinated care. Every situation is different, so we customize a diagnostic and treatment roadmap specifically for you. Highlights of what we offer include:
- Multispecialty coordinated care from a team of experts, including otolaryngologists (ear, nose, throat, and head and neck specialists), facial plastic surgeons, neurologists (nerve specialists), ophthalmologists (eye specialists), specially trained nurses, and rehabilitation specialists. Our providers work side by side to ensure you get complete care for any facial nerve disorder.
- Diagnostic tests including blood tests and minimally invasive neurodiagnostic tools, such as electroneuronography (ENoG) and electromyography (EMG), which test nerve function
- A monthly Facial Nerve Conference held by our multidisciplinary team. We invite doctors from around the nation to submit cases for our evaluation. We offer recommendations for treatment and, if needed, further diagnostic testing. This increases our knowledge base, allowing us to provide you with better care.
- The Pepper Lab, Stanford Health Care Facial Nerve Center's scientific arm, which has pioneered the development of new microsurgical techniques, such as dual nerve transfer, to treat facial paralysis
To help restore movement in your face, we offer surgical facial reanimation treatments such as:
- Free muscle (gracilis) transfer surgery: We connect the gracilis muscle from your thigh, along with its nerve and blood vessels, to your facial muscles and nerves to help restore movement. It’s typically used for patients who have had facial paralysis for one year or longer.
- Nerve transfer surgery: We connect a nerve from another part of your face or body to a facial nerve to restore facial symmetry and movement. It is typically offered within one year of complete paralysis.
- Selective neurectomy: We use face lift-type incisions to cut nerves to enhance facial symmetry. It “turns off” nerves that activate unwanted facial muscle contractions.
- Muscle division (myectomy) procedures: Muscles that are showing signs of spasm may be surgically treated to relax them and improve facial movement.
- Tendon transfer surgery: We connect tendon and bone from the side of your face to the muscles at the corner of your mouth. This procedure helps improve your ability to speak, eat, and smile.
- Static sling surgery: We lift skin at the corner of your mouth using tissue from your thigh. This helps improve the symmetry of your mouth, but it doesn’t restore movement.
To help improve facial symmetry in patients with facial paralysis and synkinesis, we offer surgical facial refinement treatments such as:
- Brow lift: We treat drooping eyebrows to improve eyebrow symmetry and treat obstructed vision.
- Face lift: We raise the skin and soft tissue near your jawline and neckline to improve face symmetry.
- Fat grafting: We remove fat from your stomach or thighs and inject it into your face to improve facial volume and symmetry. This minimally invasive procedure is typically performed after facial reanimation surgery.
To help improve symptoms of facial paralysis and synkinesis, we offer nonsurgical facial refinement treatments such as:
- Injectable drugs, such as Botox® (botulinum toxin), to increase facial symmetry and treat unwanted facial movement in synkinesis
- Injectable hyaluronic acid (HA) fillers, to help improve speech and the ability to close your lips
Facial neuromuscular retraining (FNMR) is a specialized form of rehabilitation often used along with both surgical and nonsurgical facial nerve paralysis treatments. Specialized therapists teach you appropriate exercises and give you a treatment regimen to maximize your desired facial movement.
FNMR is often the first treatment for synkinesis. A speech therapist performs all FNMR evaluations and treatments at the Stanford Facial Nerve Center.
If you have facial paralysis, it’s critically important to protect the health of your eye on the paralyzed side of your face. Your eye may be especially vulnerable to problems such as:
- Decreased tear production, which causes dry eye
- Inability to close or blink your eye, which can lead to corneal irritation (exposure keratopathy)
Your cornea is the transparent outer layer of your eye. When your eye can’t close properly, it leaves the cornea exposed, causing redness, burning or eye pain, and feeling like there’s a foreign object in your eye. If left untreated, exposure keratopathy may result in:
- Decreased vision or blindness
- Infection
- Loss of your eye
- Scarring
- Ulcers on your eye
Our team includes ophthalmologists with extensive experience treating eye disease related to facial nerve disorders. We may first suggest continuous lubrication of your eye, using eye drops, ointment, and moisture chambers (eyewear to protect the eye while you sleep). Other treatments we offer include:
- Brow lift
- Devices inserted into your tear ducts (punctal plugs), to keep fluid in your eyes
- Eyelid weights
- Lower eyelid surgery, to help your eye close better
- Temporary sutures (tarsorrhaphy), to keep your eyelids closed
We care about maximizing your overall wellness, and your total health plays a role in the success of your treatment. We offer a range of support services to promote healing and improve your quality of life. These services include financial counseling, lifestyle modification support, and spiritual care.
Innovation Through Clinical Research
As a leading academic and research institution, we are always striving to find new techniques and apply the latest and best technology to your treatment. Specialists at the Stanford Health Care Facial Nerve Center work with each other and with teams across the nation to spark groundbreaking research. We are committed to bringing you clinical trials that test new and better ways to diagnose, treat, and manage facial paralysis and related conditions. Participating in a trial may give you access to the latest therapies before they are widely available.
A diagnosis of facial paralysis or a facial nerve disorder can disrupt your life. We are here to guide you through every challenge using our Circle of Care approach. You have a team supporting you and placing your needs at the center of every decision. Our multispecialty team works together to tailor treatments to your needs. Depending on your condition, you will be cared for by our facial nerve specialists, surgeons, neurologists, and advanced practice providers. Together, we prioritize your overall health and give you renewed hope for a better quality of life.
Through teamwork, our doctors continually advance our approach to diagnosis and treatment and improve the care experience. At weekly review meetings, experts from multiple disciplines review cases that require more complex recommendations.
Our extended care team embodies the same cooperative spirit to provide support for all your individual physical, emotional, and daily living needs. Our goal is to maximize treatment success while minimizing the impact that facial nerve conditions and facial paralysis disorders can have on your life.
Your Doctors
Facial Nerve Specialist
Facial plastic and reconstructive surgeons specialize in surgical procedures to restore facial form and function.
View All {0} Facial Plastic Surgeons »Advanced Practice Provider
Our skilled advanced practice providers (APPs) specialize in diagnosing and treating facial nerve conditions and facial paralysis disorders. They see patients independently and occasionally alongside your doctor. APPs can give you a thorough exam, write prescriptions, and help prevent or treat any issues. Our APPs meet weekly to discuss patient needs.
View All {0} Advanced Practice Provider Doctors »Extended Care Team
Otologic and Neurotologic Surgeon
Doctors in the field of otology-neurotology specialize in problems affecting your ears, skull, and brain. Otologic and neurotologic surgeons have expertise in treating these conditions with techniques such as microsurgery and implantable hearing devices.
View All {0} Otology And Neurotology Specialists »Neurologist
Neurologists specialize in diagnosis and treatment of conditions affecting the nervous system.
View All {0} Neurologists »Ophthalmologic Surgeon
Ophthalmologic and oculoplastic surgeons specialize in diagnosis and treatment of conditions affecting the eyes.
View All {0} Ophthalmologic Surgeons »Facial Rehabilitation and Speech Therapists
Rehabilitation and speech therapists focus on helping you improve the function of the nerves and muscles in your face.
»Nurses and Nurse Coordinators (RNs)
Nurses and nurse coordinators are registered nurses who coordinate your care with your facial nerve team. They guide you from your first contact through follow-up care and help you find counseling, financial assistance, and other support services.
»Care Coordinators
Care coordinators provide you with information and assistance before and during your appointment.
- Medical Assistant: Medical assistants work with our team to help provide care. They may prepare you for an examination, assist your doctor, or take your vital signs before your appointment.
- Patient Care Coordinator: Our patient care coordinators help you with scheduling appointments and accessing your lab results. They are your first line of contact before you see your provider and will guide you during your facial nerve care.
- Patient Access Representative: Patient access representatives can answer your questions about health insurance coverage, help you apply for health insurance, and refer you to our financial counselors.
Research Coordinators
Doctors at Stanford Health Care’s Facial Nerve Center participate in research efforts to advance the understanding and treatment of facial nerve conditions and facial paralysis disorders. Research coordinators help screen candidates for possible participation in clinical research trials.
»Support Services
We take care of the details, so you can focus on your health and wellness. Our facial paralysis specialists work as a team to coordinate every aspect of your care. We also offer a wide range of support services to promote healing and improve your quality of life, including:
We make access to care as simple as possible. We anticipate what you need and provide support when you need it. Our network of locations puts our services within your reach. User-friendly digital health tools help you stay connected with your care team. We accept most insurance plans and offer discounted transportation, short-stay options, and international travel and translation services. We help make sense of the details, so you can make decisions that are right for you.
Facial nerve care is accessible and convenient at Stanford Health Care. Our scheduling staff can coordinate your appointments if needed, so that you can see multiple providers during a single trip.
For Referring Physicians
PHYSICIAN HELPLINE
Phone: 1-866-742-4811
Fax: 650-320-9443
Monday – Friday, 8 a.m. – 5 p.m.
Stanford Health Care provides comprehensive services to refer and track patients, as well as the latest information and news for physicians and office staff. For help with all referral needs and questions, visit Referring Physicians.
HOW TO REFER
Email or fax a facial nerve program referral form with supporting documentation to ReferralCenter@stanfordhealthcare.org or 650-320-9443.
