The Facial Nerve is the seventh cranial nerve (or VII cranial nerve). It is a mixed nerve, therefore, it has both motor nerve fibers and sensory nerve fibers. The Paralysis of the VII cranial nerve or facial nerve is a condition that can occur without any apparent cause, commonly known as “Bell’s palsy“, or following Cranial Base Oncological Surgery on the course of the facial nerve (acoustic neuroma). It manifests with the inability to close the eyelids, due to retraction of the upper eyelid and paralysis of the lower eyelid, exposing the eyeball and risking perforation. The paralysis of the VII cranial nerve manifests as a deficit of the orbicularis muscle, the frontal muscle, and the facial mimic muscles, resulting in the inability to close the eyelids.
This condition is called lagoftalmo and is associated with frontal region paralysis and paralysis of the middle third of the face (i.e., the area between the lower eyelids and the mouth) and the lower third (mouth).
The impairment of vision depends on the severity of the lagoftalmo and the time elapsed before corrective intervention. The diagnosis is essentially clinical and is based on a multidisciplinary consultation that includes:

• medical examination with assessment of the degree of paralysis;
• orthoptic examination;
• radiological imaging;
• multidisciplinary consultation.

No special preparation rules are required for the patient, but the doctor may advise bringing all documentation regarding other in-depth examinations to be performed (magnetic resonance imaging, computed tomography – CT, etc.).

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