Facial nerve paralysis is one of the diseases that commonly lead to the loss of facial expression. We treat more than 70 patients with facial nerve paralysis, including 80% with Bell’s palsy and 20% with Ramsay-Hunt syndrome each year. Patients with severe facial nerve paralysis are hospitalized and treated with intravenous prednisolone tapering from 120mg, low-molecular dextran, vitamin B12, ATP and glycerin. Speech-language-hearing therapists (ST) perform rehabilitation of facial muscles in these patients. We assess the possibility of the mitigation of facial nerve paralysis by electroneurography (ENoG). Patients with severe facial nerve paralysis who do not improve with steroidal therapy and ENoG < 10% are considered for facial nerve decompression. We inject botulinum toxin (Botox®) to the ocular and zygomatic muscle to improve pathologically associated movement.