As a rule, the initial assessment of facial nerve paralysis is carried out by the Clinic for Ear, Nose, Throat and Facial Surgery. The aim is to first rule out a stroke or other brain diseases. The assessment begins with a detailed medical history and a physical examination, during which the face and ears are inspected, other cranial nerves are tested and further physical examinations are carried out. If a stroke or a cause in the brain stem has been ruled out, further tests are carried out to determine the cause, depending on the severity and progression of the facial nerve paralysis.
At our clinic, we carry out various tests to determine the cause of facial nerve paralysis. A throat ultrasound examination is an important part of the investigation, as the parotid gland may be a possible cause. With the help of ultrasound, we can assess the size and structure of the parotid gland and rule out inflammation or a tumor. In addition, we use electroneurography (ENG) to measure the electrical signals of the facial nerve. By applying an electrode to the skin in the area of the facial nerve and measuring the electrical signals during various facial muscle movements, we can determine the degree of damage to the facial nerve. Magnetic resonance imaging (MRI) allows us to produce detailed images of the body and to rule out or confirm possible causes such as tumors or inflammation in the facial nerve area. We also carry out a taste test to determine whether the taste buds are affected and an otoscopy to detect possible inflammation or blisters in the ear. A hearing test and an impedance measurement to check the intact stapedius reflex are also part of our examination methods.
Individual treatment recommendations
After clarifying the cause, we will recommend a suitable therapy. Depending on the cause and severity of the facial nerve palsy, this may include drug therapy, physiotherapy or even surgery. In the case of facial nerve paralysis of unknown cause, treatment with cortisone tablets over a few days is often effective. If the eye closure is affected, it is important to protect the eye from drying out, for example by applying drops, ointments and, if necessary, a bandage at night. Further therapies are usually carried out interprofessionally with other clinics and physiotherapy in order to achieve the best possible results.