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7 March 2019

Surgeon Kallirroi Tzafetta on pioneering work for patients with facial paralysis

Facial Palsy awareness week
Facial Palsy awareness week

This week is Facial Palsy Awareness Week. It’s a condition that affects two to three people in 10,000 annually and the St Andrew’s Centre at Broomfield Hospital is one of only five places in the country to offer specialist treatment.

The team is led by consultant plastic surgeon Kallirroi Tzafetta, a world authority on the subject.

Facial palsy is asymmetry caused by temporary or permanent damage to the facial nerve. If muscles in the face do not receive the signals to function, this results in paralysis in the damaged side of the face. It can affect the brow, eyelids, cheek and mouth.

Patients may be unable to close their eyes, smile or speak clearly. 

Facial paralysis can occur as a result of Bell’s palsy – which could be linked to a viral infection and can be brought on by stress or pregnancy – a tumour in the head or neck, trauma, or be a congenital condition from birth.

Ms Tzafetta, who is originally from Greece and trained in the UK and America, has developed two ground-breaking techniques which have led to patients travelling from all over the country to be treated at the St Andrew’s Centre. 

She explains: “We’re a specialist, world-class service and treat 60 patients a month. I have regulars who come from Manchester, Yorkshire, Brighton, Bristol, Worcester, from all over. 

“In America, I learned techniques which I modified. I can give movement back to a paralysed lower lip, and I can also give people their smiles back with a nerve transfer. These were techniques nobody else in the world was doing. Now others are following me.”

In June, Ms Tzafetta will present her work to the Congress of the World Society of Reconstructive Microsurgery in Bologna, the world’s foremost meeting of microsurgeons.

With 80% of the clinic’s patients being adults, the psychological effects of developing facial paralysis can be debilitating.

“Your face is how you face the world. I had a patient who developed facial palsy after head and neck surgery – he had a tumour on his jaw.  We did reconstructive surgery and he’s doing extremely well but still now he cannot say his Ps or Bs. People cannot understand him on the telephone so he refuses to pick up the phone. He says it’s so frustrating.

“People can suffer from drooling and be socially embarrassed so they don’t want to eat in public areas. Other patients don’t want to be photographed, even with their families.”

The greatest improvements can often be seen in children who are referred because of asymmetrical smiles. If surgery is required, they are operated on in stages between the ages of five and eight.

Ms Tzafetta’s multidisciplinary team includes dedicated facial therapist Marie Matanle - whose career was inspired by a family member’s battle with facial paralysis - specialist nurse Nadine Harris, Jackie Kelly from medical photography who charts patients’ journeys, and secretary Pauline Prance.  They are supported by consultant Mr Fateh Ahmad.

The team also run a twice-yearly support group where patients can meet and share their experiences.

“We have fantastic feedback from the facial palsy support group,” added Ms Tzafetta. “The patients are so grateful for what we do for them, even for the smallest things. 

“Compared to twenty years ago, the developments in treatment have been huge. There are a group of about ten of us specialists worldwide and we are always trying to think of ways to improve.”