Duke recently opened a new facial nerve clinic in South Durham designed to offer one-stop, comprehensive care for patients with facial paralysis. The clinic is the first in the region to consolidate the services from a wide variety of specialists. 

Dane M. Barrett, MD, and Brett T. Phillips, MD, Duke facial plastic and reconstructive surgeons and co-founders of the clinic, recognized the need to better serve patients who otherwise may need to travel to many different providers to receive the complex care they can require. 

“There is a gap in medicine where patients with disorders of the facial nerves and muscles don’t receive the care they need,” Barrett says.

“Patients with facial paralysis need to be seen by many different providers, but they end up going to multiple places scattered all over. It gets very confusing,” adds Phillips, noting that Duke’s clinic provides the needed centralization of services for patients with the condition.

Facial paralysis—the loss of movement on one or both sides of the face because of a damaged facial nerve, muscle, or both—can be caused by a wide range of conditions that require different kinds of interventions. Patients who can benefit from the clinic’s expertise include those with:

• congenital facial paralysis
• Bell’s palsy
• synkinesis
• a traumatic injury such as a fracture or deep cut
• damage from a tumor, viral infection, or autoimmune disease

The clinic’s team of facial paralysis specialists can evaluate a patient’s symptoms to determine the type and severity of their condition and recommend a personalized treatment plan. Gathering the expertise in one place is important, Barrett says, because patients generally require interdisciplinary care that could include subspecialists in plastic surgery, otolaryngology, neuro-ophthalmology, skull-base surgery, oculofacial surgery, or maxillofacial surgery.

Treatment can be surgical and nonsurgical, with surgical techniques including nerve transfers, nerve grafts, and microsurgical muscle transfers. Nonsurgical interventions require special