摘要

Objectives: • Highlight the long-term consequences of facial nerve palsy. • Present the role of botulinum toxin in restoring facial symmetry, minimizing synkinesis, and improving muscle relaxation. • Provide practical botulinum therapy protocols for various cases of irreversible consequences of facial nerve palsy, enabling effective correction of facial asymmetry and reduction of involuntary movements. • Emphasize the psycho-emotional benefits of aesthetic interventions in functional rehabilitation. Introduction: Facial nerve palsy is one of the most prevalent cranial nerve disorders. Its irreversible consequences, including flaccid paralysis (weakness of mimic muscles, ectropion, lagophthalmos, difficulties with chewing and articulation) and spastic paralysis (synkinesis, involuntary spasms, hyperkinesis, myokymia, and "crocodile tears" syndrome), can lead to significant physical and psychological distress. This presentation explores the relevance of botulinum therapy in the treatment of the irreversible consequences of facial paralysis. Materials / method: In this presentation, an analysis was conducted of four clinical cases of patients with long-term consequences of facial nerve palsy, including cases with synkinesis, hyperkinesias, and platysma hypertonicity. Botulinum toxin was used to target key mimetic muscles with individualized dosages and injection sites. Treatment outcomes were assessed through visual evaluations, patient-reported satisfaction, and objective improvements in facial symmetry, muscle relaxation, and reduction of involuntary movements. Ethical approval and informed consent were obtained. Results: Botulinum toxin treatment led to significant improvements in patients with long-term consequences of facial nerve palsy. Enhanced facial symmetry, reduced platysma hypertonicity, and relaxation of mimetic muscles were observed in all cases. Synkinesis and hyperkinesias were minimized, resulting in better control of involuntary movements. Patients reported high satisfaction due to aesthetic and functional improvements, alongside positive psycho-emotional changes. Follow-up evaluations confirmed consistent results, with no adverse effects recorded during the treatment period. Conclusion: Botulinum toxin treatment is an effective approach for managing long-term consequences of facial nerve palsy. It improves facial symmetry, reduces hypertonicity, and minimizes involuntary movements, such as synkinesis and hyperkinesias. These outcomes not only enhance facial aesthetics but also significantly improve patients' psycho-emotional well-being and quality of life. The treatment is safe, with no adverse effects observed during follow-up, making it a valuable option in aesthetic and functional rehabilitation.