A large percentage of patients with facial palsy suffer from trauma or surgery. In the case of facial palsy caused by fractures of the head or removal of intracranial tumors (auditory neuroma, aural cholesteatoma, etc.) caused by car accidents, further repair is extremely difficult. This is because these injuries can cause damage to the intracranial portion of the facial nerve, making re-suture repair of the facial nerve difficult and nearly impossible. For this reason, many doctors advise patients to wait and see, hoping that the nerve will recover on its own. Unfortunately, the results of such a wait are often unsatisfactory and the best time for nerve repair (1 year) is missed. What should the patient do in such a situation? First of all, the nature of the injury should be clarified: is the nerve completely severed? This can be clarified by history and physical examination: whether complete facial paralysis occurs immediately after the injury; whether electrophysiological examinations can confirm this; and special examinations: CT and intracranial MRI of the temporal bone can help clarify this. If it is completely broken, then surgical treatment is the only way to go. If the quintuplegic surgeon is experienced enough, then nerve repair in the temporal bone may be of great help to the patient, and if not, then treatment by a plastic surgeon will help. If nerve continuity is suspected, the nerve needs to be closely monitored for recovery, along with neurotrophic treatment and electrophysiological examination. If there are signs of recovery after three months, further observation is possible, but if not, then aggressive surgical treatment should be considered. At this point, if the quintuple surgeon believes that direct intracranial facial nerve repair is not possible, then the patient should turn to revision therapy: a trans-facial nerve graft combined with partial occlusal nerve transposition can be used. This procedure actually uses the patient’s own nerve to bridge a portion of the branch of the facial nerve on the healthy side to the facial muscles on the paralyzed side, using the healthy facial nerve branch to innervate the facial muscles on the paralyzed side. However, since it takes a long time (about 10 months) for the nerve to grow from the healthy side to the paralyzed side of the facial muscles and thus affects the final outcome, we currently choose to use part of the nerve from the occlusal muscle on the same side to anastomose with the facial nerve, allowing the patient to close his eyes and smile in a shorter period of time (special training is required). The surgery is usually a 7-10 day hospital stay and is not very invasive. After about a month of careful protection, the training of the bite can begin. The fastest recovery is currently around 2 months after surgery, which usually takes 3 months, and gives a more significant improvement in facial muscle activity six months after surgery. This is a recently emerged and effective treatment that has the advantage of faster recovery and fewer side effects compared to the treatment of the hypoglossal nerve. Since the efficacy of nerve repair is closely linked to the duration of the paralytic injury, the optimal time frame is within one year, preferably less than two years. Therefore, it is extremely important for the patient to clarify whether the facial nerve is disconnected in a timely manner once the injury has occurred. Once it is clear, it should be treated as promptly as possible, even if it is not clear at that time, then it should be waited for in a limited period of close clinical observation. In addition to the pentaphysician, an experienced plastic surgeon can give you a more comprehensive treatment: from the repair of the nerve, to the later plastic treatment.