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Paralysie facial nerve

Andrew William Joseph, Jennifer C Kim
Flaccid facial paralysis results in disfiguring facial changes. The treatment of flaccid facial paralysis is complex and treatment approaches should be determined based on duration and the causes of paralysis, status and accessibility of the affected facial nerve, medical comorbidities, and patient-specific goals. Although primary nerve repair is the preferred treatment strategy when possible, nerve substitution procedures are the mainstay of treatment for patients with flaccid facial paralysis of less than 2 years duration...
October 5, 2018: Otolaryngologic Clinics of North America
Teresa M O
Acute facial paralysis (FP) describes acute onset of partial or complete weakness of the facial muscles innervated by the facial nerve. Acute FP occurs within a few hours to days. The differential diagnosis is broad; however, the most common cause is viral-associated Bell Palsy. A comprehensive history and physical examination are essential in arriving at a diagnosis. Medical treatment for acute FP depends on the specific diagnosis; however, corticosteroids and antiviral medications are the cornerstone of therapy...
October 5, 2018: Otolaryngologic Clinics of North America
Hongmei Song, Chengyuan Ma, Dahai Xu, Mingxin Yu, Jiachun Feng, Lichao Sun
Facial nerve paralysis is a common complication following cerebellopontine angle (CPA) surgery. This study investigated the prognostic value of facial nerve motor-evoked potentials (FNMEPs) elicited by transcranial electrical stimulation for facial nerve outcome after CPA tumorectomy.A total of 95 patients were enrolled in this study between January 2014 and January 2016. All these patients underwent CPA tumorectomy (unilateral, n = 95; bilateral, n = 1). Intraoperative FNMEP elicited by transcranial electrical stimulation was recorded...
October 2018: Medicine (Baltimore)
Xiaoxue Han, Xifeng Zhang, Yuqin Gao, Pai Pang, Fayu Liu, Changfu Sun
Objective This study was performed to analyze the clinical management of accessory parotid gland (APG) cancer and possible risk factors for disease-related death. Methods Patients diagnosed with primary APG cancers in the largest medical center in Northeast China were enrolled from January 1990 to December 2016. Results All 43 patients underwent resection of the tumors and superficial parotid gland by a standard Blair incision. Seven (16.3%) patients also required selective neck dissection. The most common lesion was mucoepidermoid carcinoma...
October 5, 2018: Journal of International Medical Research
Dirsko J F von Pfeil, Eric Zellner, Michele C Fritz, Ingeborg Langohr, Caroline Griffitts, Bryden J Stanley
OBJECTIVE To characterize congenital laryngeal paralysis (CLP) in Alaskan Huskies. DESIGN Prospective case series. ANIMALS 25 Alaskan Huskies with CLP. PROCEDURES Data were collected for each dog regarding signalment; history; results of physical, orthopedic, neurologic, and laryngeal examinations; esophagraphic findings; treatments; histologic findings; and outcomes. RESULTS Severely affected dogs were profoundly dyspneic at birth or collapsed after brief exercise; less affected dogs reportedly tired easily or overheated with minimal exercise...
October 15, 2018: Journal of the American Veterinary Medical Association
Orlando Guntinas-Lichius, Carl E Silver, Jovanna Thielker, Manuel Bernal-Sprekelsen, Carol R Bradford, Remco De Bree, Luis P Kowalski, Kerry D Olsen, Miquel Quer, Alessandra Rinaldo, Juan R Rodrigo, Alvaro Sanabria, Ashok R Shaha, Robert P Takes, Vincent Vander Poorten, Peter Zbären, Alfio Ferlito
PURPOSE: Management of the facial nerve is instrumental in the surgical treatment of parotid cancer. METHODS: A literature search was conducted using PubMed and ScienceDirect database. A total of 195 articles were finally included into the analysis, based on relevance, scientific evidence and actuality. RESULTS: In the majority of cases the facial nerve is not involved by tumor. In these cases, identification and preservation of the nerve, in addition to complete tumor removal, are essential for successful surgery...
September 28, 2018: European Archives of Oto-rhino-laryngology
Samer Bassilios Habre, Benjamin J Googe, James B Depew, Robert D Wallace, Petros Konofaos
Facial expressions play a fundamental role in interpersonal communication and interaction; consequently, facial palsy has profound effects on the quality of life of patients. Reanimation of lower lip depressors is rarely addressed during facial reanimation but is as important as treating the eye sphincter and the lip levators. Depressors of lower lip are vital for full denture smile and the expression of facial emotions. Static and dynamic techniques are used to reanimate the lower lip depressors. Static techniques provide stationary results either by weakening the contralateral normal side to achieve symmetry using botulinum toxin injection, depressor labi inferioris myectomy and marginal mandibular nerve neurectomy, or by creating static slings and tightening procedures on the affected side...
September 26, 2018: Annals of Plastic Surgery
Ahmet Erim Pamuk, Gözde Pamuk, Münir Demir Bajin, F Gokcem Yildiz, Levent Sennaroğlu
We present a rare case of traumatic facial and vestibulocochlear nerve injury in the internal acoustic canal in the absence of a temporal bone fracture. A 2.5-year-old female presented with sudden-onset left-sided facial paralysis and ipsilateral total hearing loss after being hit by a falling television. High-resolution computed tomography revealed an occipital fracture line that spared the temporal bone and otic capsule. Diagnostic auditory brainstem response testing showed that wave V at 90-db normal hearing level was absent in the left ear...
August 2018: Journal of International Advanced Otology
Sanjeev Yadav, Naresh Kumar Panda, Roshan Verma, Jaimanti Bakshi, Manish Modi
PURPOSE: Early facial nerve decompression is recommended for cases of post-traumatic facial palsy on the basis of ENoG with degeneration > 95%. There is still a dispute in the literature concerning the role and timing of surgery versus conservative treatment in such cases. This study has been planned to evaluate the outcome of conservative management in traumatic facial paralysis with regard to type of trauma, onset, and electrodiagnostic tests. METHODS: A prospective cohort study included 39 patients with post-traumatic facial palsy...
September 25, 2018: European Archives of Oto-rhino-laryngology
Geoffrey C Casazza, Seth R Schwartz, Richard K Gurgel
OBJECTIVES: The surgical timing and approach for patients with Bell's palsy and complete facial paralysis is controversial. A previous meta-analysis demonstrated no benefit from surgical decompression, however, only transmastoid decompression (TMD) was investigated. No study has evaluated both the outcomes of TMD and middle fossa decompression (MFD). STUDY DESIGN: Systematic review with meta-analysis. METHODS: A systematic literature search identifying all studies meeting inclusion criteria and published between 1985 and 2015 was performed...
September 19, 2018: Otology & Neurotology
Jae Ho Jung, Eun Hye Oh, Jin-Hong Shin, Dae-Seong Kim, Seo-Young Choi, Kwang-Dong Choi, Jae-Hwan Choi
Miller Fisher syndrome (MFS) is characterized by a clinical triad of ophthalmoplegia, ataxia, and areflexia, and is closely associated with serum anti-GQ1b antibody. Although the clinical triad is the cardinal diagnostic clue, a variety of other symptoms and signs beyond the triad have been reported. To elucidate the frequency and characteristics of atypical clinical manifestations of MFS, we recruited 38 patients with MFS and evaluated the symptoms or signs beyond the classic triad. Eleven (29%) of 38 patients had atypical clinical manifestations of MFS such as headache (n = 6), delayed facial palsy (n = 3), divergence insufficiency (n = 2), and taste impairment (n = 2)...
September 19, 2018: Neurological Sciences
Marina Miranda Poloni, Nelson Pereira Marques, Noé Vital Ribeiro Junior, Felipe Fornias Sperandio, João Adolfo Costa Hanemann, Marina Lara de Carli
BACKGROUND: Bell's palsy represents a peripheral unilateral facial nerve paralysis, being an acute, idiopathic disorder, which can affect children and adolescents. Some therapeutic approaches have been proposed including facial exercises, biofeedback, photobiomodulation, electrotherapy, massage, and thermotherapy. The present report documents a rare case of Bell's palsy in an adolescent successfully treated with a new protocol of photobiomodulation, consisting of a short-term treatment...
September 14, 2018: International Journal of Paediatric Dentistry
D S Grewal
The facial nerve is unique among the motor nerves. It has long and tortuous course through the temporal bone and within the Fallopian canal. Because of this it is more prone to paralysis than any other nerve in the body. The most frequent type of facial palsy is Bell's palsy. This is an acute idiopathic lower motor neuron palsy of the facial nerve which does not normally progress and which is most usually unilateral and self limiting,: the majority of cases remit within 4-6 months and nearly always remission is complete by 1 year...
September 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
M C Fischer, A M Adrian, J Demetriou, P Nelissen, C Busse
OBJECTIVE: To describe concurrent ophthalmic diseases in dogs with retrobulbar cellulitis and abscessation. MATERIALS AND METHODS: Retrospective analysis of clinical records of dogs with retrobulbar inflammation. RESULTS: Forty-one dogs were diagnosed with retrobulbar inflammation; of these, 23 presented with abscessation and two with zygomatic sialoadenitis. Diagnosis was based on orbital ultrasound, MRI, CT and cytological and microbiological examination of fluid or tissue samples...
September 12, 2018: Journal of Small Animal Practice
Jonathan H Sin, Hira Shafeeq, Zachary D Levy
PURPOSE: The uses of nimodipine for otolaryngic indications are reviewed, and recommendations for its use in clinical practice are provided. SUMMARY: Nimodipine is currently indicated for the improvement of neurologic outcomes in adult patients with aneurysmal subarachnoid hemorrhage (aSAH). However, other oral and i.v. calcium channel blockers have not exhibited the same beneficial effects in patients with aSAH, leading clinicians to believe that nimodipine possesses unique neuroprotective effects in addition to its calcium channel-blocking and vasodilatory properties...
September 15, 2018: American Journal of Health-system Pharmacy: AJHP
Washington Lima, Alessandra Grassi Salles, Jose Carlos Marques de Faria, André C Nepomuceno, Raquel Salomone, Patricia Krunn, Rolf Gemperli
BACKGROUND: There is clinical and experimental evidence that botulinum toxin applied to the healthy side of patients with facial paralysis positively affects functional recovery of the paralyzed side. We created an experimental model to study the effects of botulinum toxin injection in the gastrocnemius muscle contralateral to the side of tibial nerve lesion/repair in rats. METHODS: Fifty rats were allocated into five groups: I: control; II: tibial nerve section; III: tibial nerve section, immediate neurorrhaphy; IV: tibial nerve section, immediate neurorrhaphy and botulinum toxin injected into the contralateral gastrocnemius muscle; V: botulinum toxin injected into the gastrocnemius muscle, no surgery...
September 1, 2018: Plastic and Reconstructive Surgery
Roberto C Portela, Andrew C Miller
Idiopathic facial paralysis (aka Bell's Palsy) is the most common cause of unilateral facial paralysis.1 Maximal disability occurs within 48-72 hours, with symptoms involving both the upper and lower face.1 Patients may exhibit flattening of the forehead and nasolabial fold on the affected side, with the forehead remaining flat on the affected side when the patient raises his/her eyebrows. Additional symptoms may include poor eyelid closure, eye pain, blurred vision, posterior auricular pain, otalgia, hyperacusis, and taste disturbances...
September 4, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Callum Faris, Oren Tessler, Alyssa Heiser, Tessa Hadlock, Nate Jowett
Importance: The severity of a health state may be quantified using health utility measures. The utility of flaccid unilateral facial paralysis and unilateral moderate to severe postparalytic facial nerve syndrome with synkinesis may be challenging to discern from photographs alone. Objective: To determine the societal health utility of flaccid unilateral facial paralysis, unilateral moderate to severe postparalytic facial nerve syndrome, and post-facial reanimation using standard video...
August 30, 2018: JAMA Facial Plastic Surgery
Daniel Q Sun, Nicholas S Andresen, Bruce J Gantz
Bell palsy and traumatic facial nerve injury are two common causes of acute facial palsy. Most patients with Bell palsy recover favorably with medical therapy alone. However, those with complete paralysis (House-Brackmann 6/6), greater than 90% degeneration on electroneurography, and absent electromyography activity may benefit from surgical decompression via a middle cranial fossa (MCF) approach. Patients with acute facial palsy from traumatic temporal bone fracture who meet these same criteria may be candidates for decompression via an MCF or translabyrinthine approach based on hearing status...
August 28, 2018: Otolaryngologic Clinics of North America
Babak Azizzadeh, Julia L Frisenda
Modified selective neurectomy of the distal branches of the buccal, zygomatic, and cervical branches of the facial nerve in addition to platysmal myotomy is an effective surgical procedure for the treatment of postfacial paralysis synkinesis. Success of this procedure depends on identification of the peripheral facial nerve branches, preservation of zygomatic and marginal mandibular branches that innervate key smile muscles, and ablation of buccal and cervical branches that cause lateral and/or inferior excursion of the oral commissure...
August 28, 2018: Otolaryngologic Clinics of North America
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