Contemporary Surgical Techniques for Facial Paralysis: A Review of the Chang Gung Experience

Facial paralysis can cause profound functional and psychological impact. Management strategies have evolved significantly, with advances in understanding facial nerve anatomy, nerve physiology, and microsurgical techniques. This review provides a comprehensive overview of surgical strategies for both acute and chronic facial paralysis, highlighting contributions from Chang Gung Memorial Hospital that have shaped contemporary practice. Indications, timing, and selection of interventions-including nerve grafting, nerve transfers, and free functioning muscle transplantations-are examined with emphasis on techniques that restore facial symmetry. Recent developments in the management of acute facial paralysis following oncologic resection and in eyelid reanimation are also discussed. By integrating evidence from published research and institutional experience, this review aims to guide the selection of surgical strategies to enhance facial movement and symmetry.