Facial Nerve Center

The OHSU Facial Nerve Center offers treatment for children and adults with facial nerve disorders. Our doctors and therapists understand the challenges for people who are unable to move muscles in their face due to trauma or other conditions such as Bell's Palsey. With our expertise, we create an individualized plan for each person to improve your ability to blink, smile, speak look better and help overall well-being. People with sudden new facial weakness or long-standing facial paralysis are treated at the clinic. We offer many different types of therapies, including rehabilitation, retraining and surgical treatments.

Make an appointment

Call 503-494-8879

Smiling again

Following a stroke in 2015, Jarmila "Jarm" Hawes was left with one side of her face severely paralyzed. Dr. Loyo Li at OHSU was able to transfer nerves from one side of Hawes' face and tongue to the other, which eventually allowed her to regain the ability to smile. Read the article: Grinning big: Facial reanimation returns the gift of a smile.

Our providers

    • Appointments and titles

      • Social Worker, Casey Eye Institute, School of Medicine
    • Carrie Crino, M.S., CCC-SLP
    • Speech Language Pathologist
    • Otolaryngology (ENT), Facial Paralysis and Head and Neck Cancer Portland
    • Accepting new patients
    • Appointments and titles

      • Instructor of Otolaryngology - Head and Neck Surgery, Laryngology, School of Medicine
    • Expertise

      • Otolaryngology (ENT)
      • Facial Paralysis
      • Head and Neck Cancer
      • Parkinson's and Movement Disorders
      • Speech Language Pathology
      • Swallowing Disorders
      • Voice Disorders
    • Brooke M. Harkness
    • Optometry, Contact Lenses (Adult) - Optometry and Contact Lenses (Medical) Portland
    • Accepting new patients
    • Appointments and titles

      • Instructor of Ophthalmology, School of Medicine
    • Expertise

      • Optometry
      • Contact Lenses (Adult) - Optometry
      • Contact Lenses (Medical)
      • Optometry
    • Lori K. Howell, M.D., F.A.A.P.
    • Assistant Professor of Surgery
    • Pediatrics, Plastic and Reconstructive Surgery and Cleft Lip and Palate Portland
    • Accepting new patients
    • Appointments and titles

      • Assistant Professor of Surgery, Division of Plastic and Reconstructive Surgery, School of Medicine
    • Expertise

      • Pediatrics
      • Plastic and Reconstructive Surgery
      • Cleft Lip and Palate
      • Facial Paralysis
      • Microsurgery
    • Expertise

      • Rehabilitation
      • Concussion Management
      • Multiple Sclerosis
      • Neurological Conditions
      • Stroke Rehabilitation
      • Traumatic Brain Injury Rehabilitation
    • Appointments and titles

      • Associate Professor of Ophthalmology, School of Medicine
    • Expertise

      • Ophthalmology
      • Optometry
      • Contact Lenses (Adult) - Optometry
      • Contact Lenses (Medical)
      • Eye Exams (Adult) - Optometry
      • Optometry
    • Myriam Loyo Li, MD, MCR
    • Co-director of Facial Nerve Center, Facial Plastic & Reconstructive Surgeon, Otolaryngologist
    • Otolaryngology (ENT), Pediatrics and Surgery Portland
    • Accepting new patients
    • Appointments and titles

      • Assistant Professor of Otolaryngology - Head and Neck Surgery, School of Medicine
      • Assistant Professor of Otolaryngology - Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, School of Medicine
    • Expertise

      • Otolaryngology (ENT)
      • Pediatrics
      • Surgery
      • Facial Plastic and Reconstructive Surgery
      • Facial Plastic and Reconstructive Surgery/Trauma
    • John D. Ng, M.D., M.S., F.A.C.S.
    • Chief of the Division of Oculofacial Plastics, Orbital and Reconstructive Surgery
    • Ophthalmology, Melanoma and Oculofacial Plastic Surgery Portland
    • Accepting new patients
    • Appointments and titles

      • Professor of Ophthalmology, School of Medicine
    • Expertise

      • Ophthalmology
      • Melanoma
      • Oculofacial Plastic Surgery
      • Ophthalmology
    • Leo Urbinelli, M.D., M.A.
    • Pediatrics, Plastic and Reconstructive Surgery and Cleft and Craniofacial Surgery Portland
    • Accepting new patients
    • Appointments and titles

      • Assistant Professor of Surgery, Division of Plastic and Reconstructive Surgery, School of Medicine
    • Expertise

      • Pediatrics
      • Plastic and Reconstructive Surgery
      • Cleft and Craniofacial Surgery
      • Cleft Lip and Palate
      • Congenital Anomalies
      • Craniosynostosis
      • Microsurgery
    • Mark K. Wax, M.D., F.A.C.S., F.R.C.S.
    • Director of the Residency Program and Director of Microvascular Fellowship Program
    • Cancer, Otolaryngology (ENT) and Head and Neck Cancer Portland
    • Accepting new patients
    • Appointments and titles

      • Professor of Otolaryngology - Head and Neck Surgery, School of Medicine
      • Professor of Otolaryngology - Head and Neck Surgery, Division of Head and Neck Surgery, School of Medicine
    • Expertise

      • Cancer
      • Otolaryngology (ENT)
      • Head and Neck Cancer
      • Head and Neck Surgery
      • Melanoma
      • Microvascular Reconstructive Surgery
      • Sleep Apnea

John Ng, M.D., MS, FACS
Chief of the Division of Oculofacial Plastics, Orbital and Reconstructive Surgery
Professor of Ophthalmology, School of Medicine

Myriam Loyo Li, M.D.
Assistant Professor of Otolaryngology - Head and Neck Surgery 
Division of Facial Plastic and Reconstructive Surgery, School of Medicine

Common symptoms

Facial nerve disorders mean that people can not control muslces in their faces on one or both sides, and this can lead to the inability to move muscles, facial spasms, inability to smile and facial drooping. Combined, these symptoms can affect how we communicate, express emotions and how other perceive us. 

Facial paralysis affects different parts of the face, and common symptoms include: 

Eyelid and brow region

  • Droopy eyebrow and eyelid 
  • Inability to completely close the eye 
  • Dry eye and excessive tearing
  • Involuntary eye closure 
  • Corneal scarring 
  • Red eye 
  • Blurry vision
  • Pain or discomfort 

Mouth and smile

  • Inability to smile
  • Difficulty with speech and eating 
  • Frequent biting of the lips or inside cheek 
  • Drooling 
  • Inability to keep food in mouth 

Midface

  • Droopy cheek
  • Nasal obstruction 

Neck

  • Neck spasms 

Common conditions

The Facial Nerve Center at OHSU treats patients with different conditions that affect muscle movement in the face and the facial nerve. Here are the conditions we treat:

Conditions that affect the facial nerve and are treated at the center include: 

  • Bell's palsy (including incomplete recovery) 
  • Facial Synkinesis and Hemifacial spasms 
  • Blepharospasm - Facial nerve tumors 
  • Facial paralysis from vestibular schwannomas (also called acoustic neuroma tumors
  • Facial paralysis from head and neck cancers (including skin cancer and salivary gland cancer
  • Facial paralysis from trauma 
  • Facial paralysis from brain tumors and facial spasms from vascular tumors 
  • Congenital facial paralysis (such as Mobius syndrome or congenital unilateral lip palsy (CULP)) 
  • Facial paralysis after surgery 
  • Facial paralysis from ear disease or ear surgery 
  • Facial paralysis from viral infection (including Ramsay Hunt Syndrome) 
  • Facial paralysis from a stroke
Symptoms of facial nerve disorders can include loss of voluntary facial control.
People with facial nerve disorders may experience facial weakness or not be able to control their face muscles.
After treatment, people with facial nerve disorders can experience improvement in their facial movement.
Treatment may be an option to help make facial movement better.

Treatment

Treatment options we offer include: 

  • Rehabilitation services including mirror therapy and massage therapy, exercise, pain control and motor control therapy 
  • Surgery for brow and eyelid paralysis including brow lift surgery, eyelid weight placement, and ectropion correction  
  • Neuromodulation with botulinum toxin (also known as botox) 
  • Nerve transfers and selective surgical neurolysis - Gracilis free muscle transfer 
  • Regional muscle transfer and static suspension 
  • Meditation 
  • Mirror therapy 
  • Neuro glides 
  • Scleral contact lenses  

Pediatric facial paralysis

Although facial paralysis is rare in children, our group has dedicated doctors who specialize in treating children with facial paralysis. There are surgeries that can help make facial movement better and recreate a smile. 

Facial paralysis can be congenital (present at birth) or happen later – both of which can be treated. It is important to see a specialist right away as soon as paralysis happens for the best chance of success. Treatment for facial paralysis may include surgery where nerves or muscles are taken from other parts of the face, and it is even an option in cases of incomplete paralysis. 

Common causes of paralysis in children

  • Hemifacial/Craniofacial Microsomia
  • Moebius Syndrome and other congenital abnormalities
  • Intracranial Tumors
  • Craniofacial Trauma
  • Post-Surgical Injury
  • Bell’s Palsy

Research

Description: Patients with complete paralysis and over 60 years of age are eligible to participate in a study to test electrical stimulation to improve recovery. Patients are randomized to sensory and subsensory stimulation. 

Electric stimulation is done at home with the equipment we provide. Participants receive monetary compensation for their time. 

Source: Medical Research Foundation of Oregon 

Role: Myriam Loyo, M.D., Principal Investigator  

If you are interested in finding more about this study please email or call 503-494-5678.

Description: Patients with and without synkinesis after Bell's palsy are tested by evaluating their central nervous system with functional MRI during facial motor tasks. This study will allow us to evaluate the way the brain changes in response to injury of the facial nerve. 

Role: Natalie Krane, study coordinator 

If you are interested in finding more about this study, please email or call 503-494-5678.