Article: PDF OnlyDellon A. LeeNeurosurgery Quarterly: September 1992 - p 199-222 Buy Abstract Summary The doctor may now approach the patient with facial paralysis with the confidence that surgical treatment is possible to restore animation of the face. Strategies for facial restoration are based on the period of denervation of the facial muscles. If the period of denervation is one year or less, then cross-facial nerve grafting is used; if the period of denervation is more than one year, then the procedure involves cross-facial nerve grafting followed by a free microneurovascular muscle transfer after one year. A hemihypoglossal neurotization of the facial nerve is now included in the procedure, to maintain neurotrophic influences and to tone the facial musculature while minimizing the lingual atrophy that accompanied traditional XII-VII transfers. Eyelid function can be restored immediately with gold weight placement into the upper lid; this procedure eliminates the need for tarsorraphy. This article provides examples of each approach. © Williams & Wilkins 1992. All Rights Reserved.