New Treatment of Facial Paralysis by

Microsurgery with NTL (Viterbo Technique)

Facial paralysis is a disfiguring disorder with significant psychological impact, emotional and family, leading to these suicidal patients, because these patients are marginalized in their families, work and their social environment ...






New Treatment of Facial Paralysis by Microsurgery with NTL (Technical Viterbo)

Facial paralysis is a disfiguring disorder with important implications for psychological, emotional and family, leading these patients to the brink of suicide, because these patients are marginalized within their families, work and social environment. This condition is characterized a complex combination of axonal degeneration and muscle.

Today with advances in technology, the best results are achieved in combination with microsurgery by facial nerve graft (Cross Face Graft Nerv with NTL) achieving a harmonious and symmetrical smile on his facie. Note that the microsurgical treatment of this pathology previously performed in the United States, France, Brazil, Taiwan, Japan and available today in Ecuador.

This condition was discovered by Charles Bell in 1821, being called Bell syndrome. Currently, according to studies by Murakami, Ko JY, Sheen TS, Hsu MM and other authors, I conclude that the causal agent of this pathology is the herpes simplex virus and Herpes Zoster in 79% of the cases studied in 1996 -2000, other causes are for facial nerve tumors and / or parotid gland, trauma, congenital (moebius syndrome), infections by proximity (otitis media with effusion), fractures of the skull base and others. It has an incidence of 20-30 cases per 100 000 inhabitants, is more common in women aged 10-20 years and men over 40 years.

The clinical picture has a sudden onset and progressive during the first 14 days with pain pre and / or post-auricular, hypoesthesia in the hemi-face involved, 10% of cases are bilateral in 60-80% of cases has a full recovery and 7% is recurrent.

Clinical Treatment:
The use of corticosteroids to reduce edema of the facial nerve.

Retrovirals to reduce viral loads-zoster herpes simplex. Eye drops and eye ointments to keep the eye lubricated, preventing the formation of ulcers in the cornea and the most severe loss of the eye.

The electro-physiotherapy to keep the facial muscle trophism.

Surgical Treatment:
It is addressed to those who have no improvement or spontaneous regression of facial movements during the first 3 months, and in whom permanent sequelae of facial paralysis several years of evolution. It should be noted that the technique of Viterbo, for its efficiency, is considered among the best 3 results of facial paralysis in the world.

The aim of microsurgical treatment start from 4 months, is for the purpose of avoiding facial muscle atrophy.


Figure A. Patients with facial paralysis. B. Results obtained after microsurgery.










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Guayaquil - Ecuador