Facial reanimation after skull base trauma.

Three basic types of procedures are used by the author to reanimate the face paralyzed by interruption of the facial nerve at the skull base. In order of choice they are direct nerve repair or grafting; hypoglossal-facial nerve anastomosis; and regional facial reanimation (brow lift, implantation of a gold weight or spring in the eyelid, tightening of the lower eyelid, and temporalis muscle transposition to reanimate the mouth). The indications for and expected results of each approach are presented with special emphasis on the usefulness of regional reanimation.