The facial nerve exits the base of the skull and then has a long tortuous course through the bone around the ear (temporal bone) and then fans out in five branches in the middle of the parotid gland just in front of the ear before going in to the facial muscles.
The facial nerve can therefore be vulnerable (to different kinds of lumps or diseases) along its path. This will include skull base tumours, parotid gland tumours, ear disease, a stroke, trauma and viral herpes infections. Many times the cause for a facial weakness is never found and is then called Bell’s palsy. These patients usually get seen by an ENT surgeon. Fortunately, a lot of the time, the nerve function recovers on its own although this could take up to twelve months. Various treatments may be proposed to potentially help with the recovery of a facial nerve weakness.