Unilateral transient forehead paralysis following injury to the temporal branch of the facial nerve.

BACKGROUND

Cutaneous surgery in the temporal region of the forehead can lead to injury to the superficial temporal branch of the facial nerve. A flattened forehead and with ipsilateral forehead paralysis can occur with damage to this nerve.

METHODS

A case is presented of transient forehead paralysis resulting from Mohs' micrographic surgery with reconstruction of the defect. The paralysis resolved over a period of fifteen months.

RESULTS

The anatomy of the nerve makes it susceptible to injury during cutaneous surgery. The area of danger is the area superior to the zygomatic arch and lateral to the lateral eyebrow where the nerve is closest to the skin.

CONCLUSIONS

Restoration of motor function usually occurs without intervention, but may take several months. Should motor function not recur, nerve grafting of a repair of the ptotic brow may be needed. The anatomy of the nerve is reviewed and brow lifting options are discussed.