Clinical anatomy of face 

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Bell’s palsy

It is lower motor neuron type paralysis of facial muscles which occurs because of compression of facial nerve in the facial canal near stylomastoid foramen. It results in ipsilateral paralysis of facial muscles. The symptoms of Bell’s palsy include:

Facial asymmetry because of unopposed muscular contraction of normal side.Loss of horizontal wrinkles on forehead because of paralysis of frontalis muscle.  Inability to close the eyes and widening of palpebral fissure because of paralysis of orbicularis oculi. Loss of corneal reflex (efferent limb of the reflex is formed by facial nerve). Drooling of saliva from corner of mouth because of paralysis of orbicularis oris, muscles of facial expression . Absence of nasolabial fold because of paralysis of levator labii superioris alaeque nasi, muscles of facial expression.

Epiphora (tears flow down from the eye) because of paralysis of the lower part of the orbicularis oculi.

When the person tries to smile the angle of mouth of the normal side moves upwards and laterally. Accumulation of food into the vestibule of mouth because of paralysis of buccinator muscle.

• Why Facial plastic surgery is mostly successful
• As skin of the face has very rich blood supply, it is uncommon in plastic surgery for skin flaps to necrose.
• Why does edema on the face spread quickly owing to water retention in the body caused by heart and kidney failure?
• The laxity of skin over most of the parts of face allows fast spread of edema in the region of the face.
• Why face is common site for acne?
• It is due to the presence of large number of sebaceous glands in this region.
•  What is Ectropion and Epiphora?
• Paralysis of orbicularis oculi leads to drooping of the lower eyelid called ectropion, which causes spilling of tear on the cheek (Epiphora).
•  What happens in case of paralysis of buccinator muscle?
• Paralysis of buccinator muscle (in facial palsy – injury to facial nerve, lower motor type of paralysis), food tends to accumulate in the vestibule of mouth and the person is unable to blow and whistle.