Unilateral transient forehead paralysis following injury to the temporal branch of the facial nerve

Background Cutaneous surgery in the temporal region of the forehead can lea d to injury to the superficial temporal branch of the facial nerve. A flatt ened forehead and with ipsilateral forehead paralysis can occur with damage to this nerve. Methods A case is presented of transient forehead paralysis resulting from Mohs' micrographic surgery with reconstruction of the defect. The paralysis resolved over a period of fifteen months. Results The anatomy of the nerve makes it susceptible to injury during cuta neous surgery. The area of danger is the area superior to the zygomatic arc h and lateral to the lateral eyebrow where the nerve is closest to the skin . Conclusions Restoration of motor function usually occurs without interventi on, but may take several months. Should motor function not recur, nerve gra fting of a repair of the ptotic brow may be needed. The anatomy of the nerv e is reviewed and brow lifting options are discussed.