Facial palsy after orthognathic surgery: A systematic review

Yoshitsugu Hattori, Lun Jou Lo*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations


It was the aim of the systematic review to evaluate the incidence of facial palsy following orthognathic surgery, and to assess the possible mechanisms of injury, subsequent management, and eventual outcomes. The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews. A thorough search of PubMed, Scopus, Cochrane Library, and CINAHL databases up to April 2022 was conducted. In total, 34 articles were selected for this review, including 54 facial palsies in 53 patients. The incidence of facial palsy was estimated to range from 0.04% to 0.77%. Most of the possible etiologies proposed involved intraoperative nerve compression or postoperative edema. Physical therapy and steroid administration were the most frequently employed management approaches. Surgical exploration for the facial nerve was executed in one patient. Forty-three facial palsies (79.6%) attained complete recovery with conservative management, whereas 11 facial palsies (20.4%) continued to show incomplete recovery during the follow-up period. Earlier facial palsy onset (timing after surgery) was related to a higher risk of continuing palsy (p = 0.018). Within the limitations of this review it seems that facial palsy following orthognathic surgery should be treated conservatively whenever appropriate.

Original languageEnglish
Pages (from-to)52-59
Number of pages8
JournalJournal of Cranio-Maxillofacial Surgery
Issue number1
StatePublished - 01 2023

Bibliographical note

Copyright © 2023 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.


  • Facial nerve injury
  • Facial palsy
  • Management
  • Mechanism
  • Orthognathic surgery
  • Outcome
  • Bell Palsy/complications
  • Facial Nerve Injuries/etiology
  • Humans
  • Facial Paralysis/etiology
  • Orthognathic Surgery
  • Facial Nerve


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