1. Dynamic examination: During emotional exercise, bilateral facial expressions are asymmetrical, and the affected side is dull or stiff, and there is no expression.
Frontal area: the affected side can't or can't lift the forehead, which means that the forehead lines on the affected side are obviously lighter than those on the side or there are no forehead lines at all.
Periorbital area: the eyebrows of the affected side are weak or unable to lift; Cannot or cannot frown; Bilateral blink reflex is asymmetric, the affected side reaction is obviously slow, and the eyelids cannot be closed spontaneously or completely, which is called "closing eyes and exposing white".
Midface: the affected side is weak or unable to shrug the nose; The nose cannot contract; It is difficult or impossible to lift the upper lip.
Perioral area: the affected side leaks air or can't increase cheeks, and the corners of the mouth are skewed when pouting, smiling and opening the mouth. The maximum moving distance of facial muscles on both sides is obviously different, and the affected side can't move or the moving distance is obviously shorter than that on the healthy side.
Mandibular and neck: when opening the mouth, the mouth is skewed, and the affected lower lip has weak or no movement.
Second, the examination method of facial paralysis: static examination.
At rest, bilateral facial expressions are asymmetrical, and in severe cases, the whole face is skewed and stiff.
Frontal area: the frontal line of the affected side can be unchanged, especially for children and some young patients; According to the degree of facial paralysis, the number of frontal lines in elderly patients can be reduced, shallowed or completely disappeared.
Periorbital area: the affected eyebrows, upper eyelids and canthus often droop; At the initial stage of the disease, the palpebral fissure can remain unchanged or become larger with the aggravation of the disease. In severe cases, the lower eyelid may be everted, and the eyelid cannot be closed, thus causing tearing, congestion, inflammation and even ulcer of the eyelid and bulbar conjunctiva, and eventually leading to blindness. Therefore, eye protection during the onset of facial paralysis is very important and should be paid enough attention to.
Midface: the nasolabial groove of the affected side becomes shallow or disappears; Nose droops and nostrils become larger; Buccal swelling at the initial stage of onset, and atrophy in patients with advanced facial paralysis.
Perioral area: the upper lip and corners of the mouth of the affected side can droop, and the ridge line of the human body is biased towards the healthy side.
Mandibular and neck: There is no obvious asymmetry in this area in the early stage of facial paralysis. Some patients with late facial paralysis have inertial torticollis due to the discomfort of the affected side, and usually tilt to the healthy side to cover up their facial paralysis.