Unilateral total facial palsy is a debilitating condition that can affect an individual's physical, social and emotional wellbeing. When this occurs bilaterally, the severity of impact is extreme, with significant cosmetic disfigurement and functional morbidity. A variety of facial reanimation techniques have been used for unilateral facial weakness of varying House–Brackmann grades, and these are also applicable in bilateral cases. In bilateral cases, it is difficult to gauge successful improvement in comparison to the contralateral side, which also is afflicted.
This paper presents our experience with a bilateral facial paralysis patient who had a complex otological history. The patient, who presented with bilateral debilitating grade VI facial palsy, achieved a good result from bilateral facial reanimation with sequential hypoglossal–facial anastomosis. This is considered a reasonable option in cases of bilateral facial paralysis.
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