Facial paralysis, etiology and surgical treatment in a tertiary care center in plastic and reconstructive surgery in Mexico.

[BACKGROUND] Facial paralysis is a frequent disabling entity that causes a negative impact on the cosmetic, functional, social, psychological and economic aspects of the patient. Surgical treatment aims to restore the patient to her previous life with the fewest possible sequelae.

[OBJECTIVE] Describe the experience of surgical management and propose a treatment algorithm.

[METHOD] A retrospective study was carried out from 2017 to 2019 of the records of patients with facial nerve involvement. The variables were age, sex, etiology, affected side and procedures performed.

[RESULTS] 108 patients were obtained. The most frequent cause was development facial paralysis (41,8%), followed by resection of intracranial tumors (29%). A total of 225 procedures were performed, average per patient of 2.7. The most performed dynamic procedure was the gracilis-free flap (59%). The most frequent static procedures were the placement of a gold weight (24%) and the recreation of the nasogenian sulcus (13%).

[CONCLUSIONS] The surgical treatment algorithm will depend on the evolution time, etiology, donor nerves and state of the facial musculature. The gracilis-free flap continues to be the gold standard procedure in facial paralysis reconstruction. Static procedures are additionally required to achieve a satisfactory aesthetic and functional result.