Aims: Paragangliomas (PGLs) of the facial nerve canal (FNC) are rare tumours that often present with progressive facial nerve dysfunction due to tumour infiltration. While disease control is typically achievable, facial nerve morbidity remains a major contributor to long-term functional impairment. This study presents a reconstructive-first approach, emphasising facial nerve rehabilitation alongside tumour management. Methodology: Three patients with FNC PGLs underwent detailed preoperative imaging, biochemical testing, and succinate dehydrogenase gene (SDHx) mutation screening. Surgical planning involved multidisciplinary input, with timing of tumour resection determined alongside with the facial nerve reconstruction strategy. Patients received combinations of dynamic and static procedures with their facial reconstruction. Functional outcomes were assessed pre- and postoperatively using the House-Brackmann (HB) scale, Oral Competence Questionnaire (OCQ), Speech Handicap Index (SHI), intelligibility ratings, and speech error analysis. Results: All patients achieved improvement in facial nerve function from HBIV, IV and VI to HB grade III, with a mean time to movement of 7 months (SD = 4 months). Speech and oral competence also improved, with reduced SHI scores and improved intelligibility ratings from a preoperative mean of 78.3 to a post operative mean of 86.7. Static procedures addressed eye closure, brow position, and midface tone, while dynamic procedures were facilitated by immediate reinnervation and salvage of the facial nerve motor end plates. No major treatment-related complications occurred, and tumour control was maintained in all cases (at 66, 68, 60 months respectively). Conclusion: Early, multidisciplinary integration of facial nerve reconstruction into the management of FNC PGLs can achieve near-normal function with minimal morbidity, supporting a paradigm shift toward function-centred treatment planning.