Temporomandibular joint surgeons must have astute surgical principles to avoid facial nerve injury in approaching the joint. Injury to any of the terminal branches can leave the patient with cosmetic, functional, and psychosocial deficiencies. Facial nerve rehabilitation after injury is a challenge. In the majority of situations, full recovery of spontaneous nerve function is unattainable and realistic goals must be set. The timing and etiology of the injury determines the available treatment options. Primary nerve repair, when indicated, is possibly the best option. Multiple reconstructive techniques may be needed to achieve best results. Therefore, understanding the facial nerve anatomy, the prevention of surgical injuries, and quickly recognizing any injury are important for a TMJ surgeon.
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