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facial nerve grading system

Eman Mohamed Khedr, Reda Badry, Anwer Mohamed Ali, Noha Abo El-Fetoh, Dina Hatem El-Hammady, Abeer Mohamed Ghandour, Ahmed Abdel-Haleem
BACKGROUND: A large number of patients with Bell's palsy fail to recover facial function completely after steroid therapy. Only a few small trials have been conducted to test whether outcomes can be improved by the addition of antiviral therapy. OBJECTIVE: To evaluate the efficacy of treatment with steroid alone versus steroid + antiviral in a group of patients with moderately severe to severe acute Bell's palsy. METHODS: Fifty eligible patients out of a total of 65 with acute onset Bell's palsy were randomized to receive the two treatments...
September 29, 2016: Restorative Neurology and Neuroscience
Brian S Tanaka, Peng Zhao, Fadia B Dib-Hajj, Valerie Morisset, Simon Tate, Stephen G Waxman, Sulayman D Dib-Hajj
Idiopathic trigeminal neuralgia (TN) is a debilitating pain disorder characterized by episodic unilateral facial pain along the territory of branches of the trigeminal nerve. Human painful disorders, but not TN, have been linked to gain-of-function mutations in peripheral voltage-gated sodium channels (NaV1.7, NaV1.8 and NaV1.9). Gain-of-function mutations in NaV1.6, which is expressed in myelinated and unmyelinated CNS and peripheral nervous system neurons and supports neuronal high-frequency firing, have been linked to epilepsy but not to pain...
August 3, 2016: Molecular Medicine
Margarida Ferreira, João Firmino-Machado, Elisa A Marques, Paula C Santos, Ana Daniela Simões, José A Duarte
OBJECTIVE: The main aim of this study was to identify the prognostic factors that contribute to complete recovery at 6 weeks and 6 months in patients with Bell's palsy. MATERIAL AND METHODS: This is a prospective, longitudinal, and descriptive study that included 123 patients diagnosed with facial nerve palsy (FNP) at a hospital in Guimarães, Portugal. However, only 73 patients with Bell's palsy (BP) were included in the assessment of recovery at 6 weeks and 6 months...
October 2016: Neurological Research
Robert J Yawn, Harry V Wright, David O Francis, Scott Stephan, Marc L Bennett
PURPOSE: Reanimation of facial paralysis is a complex problem with multiple treatment options. One option is hypoglossal-facial nerve grafting, which can be performed in the immediate postoperative period after nerve transection, or in a delayed setting after skull base surgery when the nerve is anatomically intact but function is poor. The purpose of this study is to investigate the effect of timing of hypoglossal-facial grafting on functional outcome. MATERIALS AND METHODS: A retrospective case series from a single tertiary otologic referral center was performed identifying 60 patients with facial nerve injury following cerebellopontine angle tumor extirpation...
May 17, 2016: American Journal of Otolaryngology
Jiantao Liang, Mingchu Li, Ge Chen, Hongchuan Guo, Qiuhang Zhang, Yuhai Bao
OBJECTIVE: To evaluate the efficiency of the descending hypoglossal branch-facial nerve anastomosis for the severe facial palsy after acoustic neuroma resection. METHODS: The clinical data of 14 patients (6 males, 8 females, average age 45. 6 years old) underwent descending hypoglossal branch-facial nerve anastomosis for treatment of unilateral facial palsy was analyzed retrospectively. All patients previously had undergone resection of a large acoustic neuroma...
December 15, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Giorgio Cruccu, Nanna B Finnerup, Troels S Jensen, Joachim Scholz, Marc Sindou, Peter Svensson, Rolf-Detlef Treede, Joanna M Zakrzewska, Turo Nurmikko
Trigeminal neuralgia (TN) is an exemplary condition of neuropathic facial pain. However, formally classifying TN as neuropathic pain based on the grading system of the International Association for the Study of Pain is complicated by the requirement of objective signs confirming an underlying lesion or disease of the somatosensory system. The latest version of the International Classification of Headache Disorders created similar difficulties by abandoning the term symptomatic TN for manifestations caused by major neurologic disease, such as tumors or multiple sclerosis...
July 12, 2016: Neurology
Onur Celik, Gorkem Eskiizmir, Yuksel Pabuscu, Burak Ulkumen, Gokce Tanyeri Toker
INTRODUCTION: The exact etiology of Bell's palsy still remains obscure. The only authenticated finding is inflammation and edema of the facial nerve leading to entrapment inside the facial canal. OBJECTIVE: To identify if there is any relationship between the grade of Bell's palsy and diameter of the facial canal, and also to study any possible anatomic predisposition of facial canal for Bell's palsy including parts which have not been studied before. METHODS: Medical records and temporal computed tomography scans of 34 patients with Bell's palsy were utilized in this retrospective clinical study...
April 29, 2016: Brazilian Journal of Otorhinolaryngology
Koichiro Wasano, Taiji Kawasaki, Sayuri Yamamoto, Shuta Tomisato, Seiichi Shinden, Toru Ishikawa, Shujiro Minami, Takeshi Wakabayashi, Kaoru Ogawa
OBJECTIVE: To examine the relationship between prognosis of 2 different facial palsies and pretreatment hematologic laboratory values. STUDY DESIGN: Multicenter case series with chart review. SETTING: Three tertiary care hospitals. SUBJECTS AND METHODS: We examined the clinical records of 468 facial palsy patients who were treated with an antiviral drug in combination with either oral or intravenous corticosteroids in participating hospitals between 2010 and 2014...
October 2016: Otolaryngology—Head and Neck Surgery
Robert A Gaudin, Mara Robinson, Caroline A Banks, Jennifer Baiungo, Nate Jowett, Tessa A Hadlock
IMPORTANCE: Most rehabilitation specialists and many facial reanimation surgeons use the Sunnybrook Facial Grading System (FGS) to measure and detect changes in facial function. The eFACE, an electronic and digitally graded facial measurement scale, was recently created to provide similar information to the Sunnybrook FGS, but with scaling uniformity across all categories of facial function, graphical outputs, and easy-to-use visual analog scales. OBJECTIVES: To establish the correlation between the scores on the eFACE and the Sunnybrook FGS among patients with facial paralysis and to compare the reliability of the 2 scales...
July 1, 2016: JAMA Facial Plastic Surgery
Kenichi Takano, Nozomi Takahashi, Noriko Ogasawara, Tetsuo Himi
OBJECTIVE: To investigate the relationship between the severity of ear anomaly and mandibular dysplasia in congenital microtia. STUDY DESIGN: Retrospective case review. SETTING: Sapporo Medical University Hospital. PATIENTS: Congenital microtia: 44 patients over a period of 4 years. INTERVENTIONS: The height of the condylar process of the mandible was assessed by three-dimensional computed tomography (CT), and the patients were divided into three groups based on the ratio of the condylar process height on the affected side to that on the unaffected side: Group A, ≥1...
August 2016: Otology & Neurotology
Daniele Marchioni, Matteo Alicandri-Ciufelli, Alessia Rubini, Babara Masotto, Giacomo Pavesi, Livio Presutti
OBJECTIVE The aim of this study was to describe the first case series in which an exclusive endoscopic transcanal transpromontorial approach (EETTA) was used to treat small vestibular schwannomas (VSs) and meningiomas of the internal auditory canal (IAC). METHODS The authors performed a retrospective review of patients who had undergone surgery using an EETTA to the IAC at 2 university tertiary care referral centers during the period from November 2011 to January 2015. RESULTS Ten patients underwent surgery via an EETTA for the treatment of VS in the IAC at the University Hospital of Modena or the University Hospital of Verona...
March 11, 2016: Journal of Neurosurgery
Mario A Aycart, Bridget Perry, Muayyad Alhefzi, Ericka M Bueno, Maximilian Kueckelhaus, Sebastian Fischer, Bohdan Pomahac
BACKGROUND: Face transplantation (FT) has emerged as a viable option for treating devastating facial injuries. Most reported outcomes have demonstrated satisfactory motor and sensory restoration despite differences in technique. The authors have developed an algorithm of facial nerve management in these challenging patients. Our principles of management are illustrated by 2 specific patients. METHODS: A retrospective analysis of prospectively collected data on 2 full face transplants was performed...
March 2016: Journal of Craniofacial Surgery
Min Ding, Hua Feng, Changxu Jin, Lei Xu, Tianyun Lin
OBJECTIVE: To compare the clinical therapeutic effects on intractable facial paralysis among acupuncture, acupoint catgut embedding and PDS embedding. METHODS: Two hundred and seventy-nine patients of intractable facial paralysis were randomized into an acupuncture group, a catgut embedding group and a PDS embedding group, 93 cases in each one. Cuanzhu (BL 2), Yuyao (EX-HN 4), Taiyang (EX-HN 5), Xuanlu (GB 5), Dicang (ST 4), Jiache (ST 6), Quanliao (SI 18), Qianzheng (Extra), Xiaguan (ST 7) and Fengchi (GB 20) on the affected side and bilateral Hegu (LI 4) and Zusanli (ST 36) were selected in the three groups...
October 2015: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
Abbas Ali Pourmomeny, Sahar Asadi, Ahmad Cheatsaz
INTRODUCTION: Synkinesis and facial asymmetry due to facial nerve palsy are distressing conditions that affect quality of life. Unfortunately, these sequelae of facial nerve palsy are unresolved. The aim of this study was to investigate the efficacy of a combination of biofeedback therapy and botulinum toxin A (BTX-A) injection for the management of synkinesis and asymmetry of facial muscles. MATERIALS AND METHODS: Among referrals from three university hospitals, 34 patients with facial synkinesis were divided randomly into two groups...
November 2015: Iranian Journal of Otorhinolaryngology
Mikhail Galkin, Andrey V Golanov, Natalia Antipina, Gennady Gorlachev
Meningiomas are common benign tumors with accepted treatment approaches and usually don't challenge healthcare specialists. We present a case of a huge unresectable hemicranial meningioma, which was successfully treated with hypofractionated irradiation. A male patient, sixty-two years of age, suffered for over 12 years from headaches, facial deformity, right eye displacement, right eye movement restriction, right-sided ptosis, and facial hypoesthesia. MRI and CT studies revealed an extended hemicranial meningioma...
2015: Curēus
Shai M Rozen, Bridget L Harrison, Brandon Isaacson, J Walter Kutz, Peter S Roland, Patricia A Blau, Samuel L Barnett, Bruce E Mickey
BACKGROUND: Reconstructive surgeons may encounter patients presenting after intracranial facial nerve resection and grafting in the setting of skull base tumors, who inquire regarding progression, final facial function, and need for future operations. Study goals were to analyze global and regional facial function using established grading systems and videography, while examine variables possibly affecting outcomes. METHODS: Between 1997 and 2012, 28 patients underwent intracranial nerve grafting...
January 2016: Plastic and Reconstructive Surgery
Yunhua Zhu, Yuxin Yang, Daowen Wang, Mingmin Dong
OBJECTIVE: To introduce our experience of preventing further episodes of idiopathic recurrent facial palsy by facial nerve decompression via middle cranial fossa approach. METHODS: Twelve cases (surgery group) who had idiopathic recurrent facial palsy underwent facial nerve decompression via middle cranial fossa approach, and 6 cases (control group) who declined surgery accepted conservative treatment. Further episodes of facial palsy and final outcomes of facial nerve were recorded...
January 2016: American Journal of Otolaryngology
John P Leonetti, Sam J Marzo, Douglas A Anderson, Joshua M Sappington
Objective To present a grading scale to assess the functional recovery of the facial nerve in patients who have undergone mimetic and static surgical techniques for facial reanimation. Study design This is a proposed new facial nerve grading system that will be demonstrated with specific case presentations. All patients underwent a variety of neural grafting, microvascular free-flap reconstruction, or surgical static procedures. Results The proposed facial nerve grading scale is one that has not been described previously in the literature and is applicable to a unique patient population...
December 2015: Journal of Neurological Surgery. Part B, Skull Base
Pedro Infante-Cossio, Victoria-Eugenia Prats-Golczer, Ricardo Lopez-Martos, Enrique Montes-Latorre, Jose Antonio Exposito-Tirado, Eduardo Gonzalez-Cardero
OBJECTIVES: To compare the effectiveness of a daily home-based facial exercise therapy with a supervised rehabilitation technique for the treatment of postoperative facial dysfunction in patients undergoing conventional superficial parotidectomy. DESIGN: Prospective, randomized trial, controlled. SETTING: Surgery and Rehabilitation Units, university hospital. SUBJECTS: Consecutive patients (n=79, mean age 48 years) who underwent superficial parotidectomy with facial nerve dissection were randomly divided into two groups...
November 20, 2015: Clinical Rehabilitation
Monirah Albathi, Sam Oyer, Lisa E Ishii, Patrick Byrne, Masaru Ishii, Kofi O Boahene
IMPORTANCE: Preserving facial nerve function is a primary goal and a key decision factor in the comprehensive management of vestibular schwannoma and other cerebellopontine angle (CPA) tumors. OBJECTIVE: To evaluate the use of the pattern of facial paralysis recovery in the early postoperative months as a sole predictor in selecting patients for facial nerve grafting after CPA tumor resection when cranial nerve VII is uninterrupted. DESIGN, SETTING, AND PARTICIPANTS: Sixty-two patients with facial paralysis and uninterrupted cranial nerve VII who developed facial paralysis after CPA tumor resection at The Johns Hopkins Hospital were followed up prospectively to assess for spontaneous recovery and to determine candidacy for facial reanimation surgery...
January 2016: JAMA Facial Plastic Surgery
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