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facial nerve grading system

Alok Thakar, Madan P Gupta, Achal Srivastava, Deepak Agrawal, Atin Kumar
Importance: Current recommendations envisage early surgical exploration for complete facial nerve paralysis associated with temporal bone fracture and unfavorable electrophysiologic features (response to electroneuronography, <5%). However, the evidence base for such a practice is weak, with the potential for spontaneous improvement being unknown, and the expected results from alternative nonsurgical treatment also undefined. Objective: To document the results of nonsurgical treatment for posttraumatic complete facial paralysis with undisplaced temporal bone fracture and unfavorable electrophysiologic features...
February 22, 2018: JAMA Otolaryngology—Head & Neck Surgery
Hiroshi Doi, Kenji Uemoto, Norihisa Masai, Daisaku Tatsumi, Hiroya Shiomi, Ryoong-Jin Oh
PURPOSE: To analyze the outcomes following re-irradiation for local recurrence of rare head and neck tumors. MATERIAL AND METHODS: We retrospectively analyzed 11 patients who had received intensity-modulated radiation therapy (IMRT) for recurrent tumors in the head and neck except for laryngopharynx. RESULTS: Primary tumor sites included the maxillary sinus, nasal cavity, and external ear canal in six, three, and two patients, respectively...
February 22, 2018: Acta Oto-laryngologica
Ahmed H Qavi, Tasnim F Imran, Zachariah Hasan, Fariha Ilyas
Tuberculous meningitis (TBM) is an infection of the central nervous system (CNS) meninges that carries high morbidity and mortality. It is important to recognize, as patients may present with atypical symptoms. We describe the case of a 31-year-old man with a history of diabetes who presented with a sub-acute onset of right-sided facial weakness and right gaze difficulty with diplopia. History revealed low-grade fever, right-sided headache, fatigue and moderate weight loss for the past several weeks. The patient did not report neck stiffness, rigidity, fever, chills or cough...
December 7, 2017: Curēus
Rebecca MacKenzie, Peter Sporns, Tarek Zoubi, Mario Koopmann, Christian Ewelt, Walter Stummer, Benjamin Brokinkel, Eric Suero Molina
INTRODUCTION: Intended subtotal resection of large vestibular schwannomas (T4a and b according to the Hannover classification system) has been shown to be safe and, in combination with stereotactic radiosurgery, might enable sufficient tumor control. However, risk factors for postoperative neurological deterioration in these surgically challenging lesions are largely unknown. METHODS: Pre- and postoperative symptoms, clinical and radiological data of patients who underwent intended subtotal resection for vestibular schwannoma in our department between 2010 and 2014 were reviewed...
February 8, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Hiroshi Moriyama, Nobuyuki Mitsukawa, Masahiro Itoh, Naruhito Otsuka
OBJECTIVE: Details regarding the molecular biological features of Bell's palsy have not been widely reported in textbooks. We genetically analyzed facial muscles and clarified these points. MATERIALS AND METHODS: We performed genetic analysis of facial muscle specimens from Japanese patients with severe (House-Brackmann facial nerve grading system V) and moderate (House-Brackmann facial nerve grading system III) dysfunction due to Bell's palsy. Microarray analysis of gene expression was performed using specimens from the healthy and affected sides, and gene expression was compared...
December 14, 2017: Journal of International Advanced Otology
Miao Ling, Xiaorong Tao, Siyuan Ma, Xiaocui Yang, Li Liu, Xing Fan, Guijun Jia, Hui Qiao
OBJECTIVE: We sought to validate the feasibility of facial motor evoked potential (FMEP) in facial nerve (FN) monitoring during vestibular schwannoma (VS) surgery under 2 anesthesia protocols and to examine its value for postoperative prognosis. METHODS: This prospective study included 106 patients with VS who underwent microsurgical excision between May 2014 and November 2016 at the Beijing Tiantan Hospital, Capital Medical University, China. All patients were investigated for FMEP elicited by transcranial electrical stimulation in the contralateral facial motor cortex...
December 16, 2017: World Neurosurgery
Daniele Marchioni, Davide Soloperto, Barbara Masotto, Cristoforo Fabbris, Stefano De Rossi, Domenico Villari, Livio Presutti
BACKGROUND: Recently, the transcanal approach for the removal of acoustic neuromas has been introduced. Facial nerve (FN) preservation is one of the main challenges of this kind of surgery. OBJECTIVE: To describe our experience in the surgical treatment of acoustic neuromas, focusing on the functional results of FN preservation after a transcanal approach. METHODS: A retrospective chart review was carried out on clinical data and videos from operations on 49 patients who underwent surgery with a totally transcanal exclusive endoscopic approach for Koos stage I-II lesions, or an enlarged transcanal transpromontorial approach for Koos stage II-III tumors, between March 2012 and February 2017...
February 2018: Otology & Neurotology
Gabriel Torrealba-Acosta, Rajan Gadhia, Thabele Leslie-Mazwi
Bilateral and simultaneous facial nerve palsy (FNP) is a rare clinical condition occurring in 0.3-2.0% of facial palsy cases and is typically a manifestation of an underlying systemic disease. We here describe a case of a 67-year-old Hispanic man with a known history of Waldenstrom's Macroglobulinemia (WM) who presented to the clinic with a sub-acute onset of bilateral facial weakness. No alternate etiology for the facial weakness was identified after a thorough diagnostic approach. WM is a rare hematological condition due to low-grade B cell lymphoma, where lymphoplasmacytoid cells infiltrate different tissues and secrete monoclonal IgM...
November 4, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Keishi Fujiwara, Yasushi Furuta, Naoko Yamamoto, Kanako Katoh, Satoshi Fukuda
OBJECTIVE: To investigate factors affecting the effect of physical rehabilitation therapy for synkinesis as a sequela to facial nerve palsy. METHODS: A total of 37 patients with peripheral facial nerve palsy in Teine-Keijinkai Hospital were enrolled in this study. All patients showed synkinesis at 6 months after the onset of facial nerve palsy and were instructed in physical rehabilitation by expert staff from their first visit. The degree of synkinesis was evaluated at 6, 9 and 12 months after the onset of facial nerve palsy based on Sunnybrook facial grading system score and asymmetry in eye opening width...
October 31, 2017: Auris, Nasus, Larynx
Song Anping, Xu Guoliang, Ding Xuehai, Song Jiaxin, Xu Gang, Zhang Wu
Facial nerve paralysis (FNP) is a loss of facial movement due to facial nerve damage, which will lead to significant physical pain and abnormal function in patients. Traditional FNP grading methods are solely based on clinician's judgment and are time-consuming and subjective. Hence, an accurate, quantitative and objective method of evaluating FNP is proposed for constructing a standard system, which will be an invaluable tool for clinicians who treat the patient with FNP. In this paper, we introduce a novel method for quantitative assessment of FNP which combines an effective facial landmark estimation (FLE) algorithm and facial asymmetrical feature (FAF) by processing facial movement image...
October 31, 2017: Australasian Physical & Engineering Sciences in Medicine
Cheng-Siu Chang, Cheng-Wei Huang, His-Hsien Chou, Long-Yau Lin, Chuan-Fu Huang
We reviewed 130 patients from 1999 to 2012 to evaluate whether neurovascular compression (NVC) has prognostic value for pain relief in idiopathic trigeminal neuralgia (TN) treated by Gamma Knife radiosurgery (GKRS). Patients were assigned to one of the following groups based on NVC identified by MRI: no NVC, small vessel NVC, and large vessel (defined as part of the vertebrobasilar arterial system) NVC. Follow-up ranged from 4 to 14years. Primary outcome was pain graded by the Barrow Neurological Institute (BNI) pain scale...
October 23, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Verena Meier-Gallati, Henning Scriba
The objective of this paper is to assess synkinesis associated with post paretic voluntary facial movements using the objective OSCAR method and to investigate the correlation between synkinesis and paresis to compare the objective results with the subjective scaling systems of Fisch and House-Brackmann. The development of an objective assessment of synkinesis with the OSCAR method is focused on the clinically most relevant eye-mouth and forehead-mouth synkinetic movements. Thirteen patients with unilateral facial paralysis and synkinesis of the University Hospital Zurich were examined...
December 2017: European Archives of Oto-rhino-laryngology
Mihail A Akulov, Ol'ga R Orlova, Aleksandra S Orlova, Dmitrij J Usachev, Vadim N Shimansky, Sergey V Tanjashin, Svetlana E Khatkova, Anna V Yunosha-Shanyavskaya
BACKGROUND: This study evaluates the effect of incobotulinumtoxinA in the acute and chronic phases of facial nerve palsy after neurosurgical interventions. METHODS: Patients received incobotulinumtoxinA injections (active treatment group) or standard rehabilitation treatment (control group). Functional efficacy was assessed using House-Brackmann, Yanagihara System and Sunnybrook Facial Grading scales, and Facial Disability Index self-assessment. RESULTS: Significant improvements on all scales were seen after 1month of incobotulinumtoxinA treatment (active treatment group, р<0...
October 15, 2017: Journal of the Neurological Sciences
Jin Hoon Lee, Kyung Ah Lee
A 25-years-old woman with mandibular prognathism underwent a mandibular setback by way of mandibular sagittal split ramus osteotomy (MSSRO). After 2 days of operation, she developed difficulty of closing her right eye. The blink reflex test and motor nerve conduction study of the right orbicularis oris muscle were revealed right facial neuropathy of unknown origin and House-Brackmann facial nerve grading system (HBFNGS) grade V. For treatment, we initially prescribed oral prednisolone and nimodipine including physical therapy...
March 2017: Archives of Craniofacial Surgery
Takashi Kasahara, Saori Ikeda, Ayaka Sugimoto, Shinji Sugawara, Yuji Koyama, Minoru Toyokura, Yoshihisa Masakado
BACKGROUND: Mirror feedback rehabilitation is effective in preventing the development of oro-ocular synkinesis following severe facial palsy. However, we do not have effective maneuvers to prevent the deterioration of oculo-oral synkinesis. We developed a new method of biofeedback rehabilitation using tape for the prevention of oculo-oral synkinesis. OBJECTIVE: The aim of the present study was to investigate the efficacy of taping feedback rehabilitation. METHODS: Twelve consecutive patients with peripheral facial nerve palsy who developed synkinesis were divided into 2 groups...
September 20, 2017: Tokai Journal of Experimental and Clinical Medicine
X Y Wang, X R Yuan, Y W Liao, D Y Liu, Y Y Xie, J Yuan, J Su, Z J Zhao, Q Liu
Objective: To explore the effects of paracondylar-lateral cervical approach for resection of the jugular foramen schwannoma(JFS). Methods: A total of 15 patients with JFS operated via the paracondylar-lateral cervical approach between December 2011 and March 2016 at Department of Neurosurgery in Xiangya Hospital of Central South University were retrospectively analyzed. There were 7 males and 8 females, aging from 22 to 77 years with a mean age of (41.9±15.8) years.There were 12 patients who accepted primary surgery, 3 patients who accepted secondary surgery...
September 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Huan Li, Liang Wang, Shuyu Hao, Da Li, Zhen Wu, Liwei Zhang, Junting Zhang
BACKGROUND: Preoperative visualization of the facial nerve could help neurosurgeons to prevent facial nerve injury during vestibular schwannoma surgery. Some studies have addressed diffusion tensor tractography (DTT) for preoperative identification of the facial nerve. However, few studies have focused on tractography-integrated neuronavigation for DTT verification. This study aimed to explore the appropriate DTT tracing parameters and evaluate the effect of intraoperative facial nerve tractography-integrated neuronavigation for verifying the DTT accuracy...
November 2017: World Neurosurgery
Simonetta Monini, Franco Marinozzi, Francesca Atturo, Fabiano Bini, Silvia Marchelletta, Maurizio Barbara
HYPOTHESIS: To propose a new objective video-recording procedure to assess and monitor over time the severity of facial nerve palsy. BACKGROUND: No objective methods for facial palsy (FP) assessment are universally accepted. METHODS: The face of subjects presenting with different degrees of facial nerve deficit, as measured by the House-Brackmann (HB) grading system, was videotaped after positioning, at specific points, 10 gray circular markers made of a retroreflective material...
September 2017: Otology & Neurotology
Sung Mo Ryu, Jung-Il Lee, Kwan Park, Jung Won Choi, Doo-Sik Kong, Do-Hyun Nam, Han-Shin Jeong, Yang-Sun Cho, Ho Jun Seol
BACKGROUND: The goal of treatment for jugular foramen schwannomas (JFSs) is to achieve complete tumor removal with cranial nerve preservation. However, achieving this goal remains a challenge despite the advances in microsurgical techniques. The aim of this study was to determine optimal treatment strategies for JFSs based on a review of a series of 29 surgical cases in our institute. MATERIALS AND METHODS: Between 1997 and 2013, 29 patients with JFSs underwent surgical treatment by multidisciplinary otoneurosurgical approaches...
June 6, 2017: Acta Neurochirurgica
Eduardo Martin-Sanz, Almudena Rueda, Jonathan Esteban-Sanchez, Joaquin Yanes, Jorge Rey-Martinez, Ricardo Sanz-Fernandez
OBJECTIVE: To evaluate vestibular restoration and the evolution of the compensatory saccades in acute severe inflammatory vestibular nerve paralysis, including vestibular neuritis and Ramsay Hunt syndrome with vertigo. STUDY DESIGN: Prospective. SETTING: Tertiary referral center. PATIENTS: Vestibular neuritis (n = 18) and Ramsay Hunt syndrome patients with vertigo (n = 13) were enrolled. INTERVENTION: After treatment with oral corticosteroids, patients were followed up for 6 months...
August 2017: Otology & Neurotology
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