Etiologies, periocular manifestations and surgeries for congenital and childhood acquired facial nerve palsy

Facial nerve palsy (FNP) is a common disease that may lead to a significant impairment and an impact on patients and family members, especially in the pediatric cases. Regardless of age at presentation, FNP leads to weakness of facial muscles causing difficulty in verbal communication and interaction, impaired taste and ocular surface protection [1]. Ocular manifestations of FNP vary. They include poor or incomplete blink, brow ptosis, lagophthalmos, and diminished tear production [2]. These manifestations may cause ocular surface dysfunction, leading to exposure keratitis, corneal abrasion, ulceration and finally, visual impairment [3]. The incidence of peripheral facial palsy in children ranges from 5 to 40:100,000/year [1], [4], [5], [6]. The mean age in the pediatric population ranges between 5 and 11 years with no significant difference between females and males [4], [7], [8]. The most common cause of unilateral facial palsy is Bell's palsy, also known as idiopathic facial palsy [9], [10], [11]. Toddlers and pre-teenagers may be at higher risk for facial nerve paralysis due to infectious and traumatic causes [12].

Even though the etiologies, manifestations and therapies of peripheral facial palsy (PFP) differ among children and adults, few studies have focused on children, describing the etiology of FNP in children [12], [13], [14], [15]. Limited literature is present regarding the ophthalmic findings and periocular surgery in children with FNP. The current study reports the ophthalmic findings and periocular surgeries performed for patients with congenital and childhood acquires FNP.

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