Facial nerve injuries associated with orthognathic surgery: a review of incidence and management.

While facial nerve injuries associated with both extraoral and intraoral orthognathic surgery are rare, the results of such an injury can be devastating to the patient. A review of the literature shows that the majority of such injuries fall into the first-, second-, and third-degree injury categories. Prevention cannot be stressed enough; however, early recognition of an injury with prompt electrodiagnostic testing can assist with determining prognosis and treatment planning. When close observation is indicated, a variety of medical therapies have been suggested. For more severe injuries, nerve repair and facial reanimation have been reported.