Dataset Information

Complete and Fast Recovery from Idiopathic Facial Paralysis Using Laser-Photobiomodulation.

ABSTRACT: Idiopathic facial paralysis, also known as Bell's palsy, exerts a negative effect on the quality of life. Although the prognosis is good in the majority of cases, a significant percentage of affected individuals may have sequelae that can negatively affect their lives. The use of therapeutic measures as early as possible can improve the prognosis. This article describes the successful use of laser-photobiomodulation as a single therapy in a patient with Bell's palsy and confirms the possibility of using this therapeutic modality as a good choice, since it is a therapy that is painless, comfortable, and without systemic side effects. The findings demonstrate that the adequate use of laser-photobiomodulation can be an effective therapeutic option for patients with Bell's palsy, regardless of the age, shortening the recovery time obtained with conventional therapies and avoiding sequelae. Further studies are needed for the establishment of adequate protocols.

SUBMITTER: Tanganeli JPC

PROVIDER: S-EPMC7091526 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Complete and Fast Recovery from Idiopathic Facial Paralysis Using Laser-Photobiomodulation.

Tanganeli João Paulo Colesanti JPC de Oliveira Simone Saldanha Ignácio SSI da Silva Tamiris T Fernandes Kristianne Porta Santos KPS Motta Lara Jansiski LJ Bussadori Sandra Kalil SK

Case reports in dentistry 20200311

Idiopathic facial paralysis, also known as Bell's palsy, exerts a negative effect on the quality of life. Although the prognosis is good in the majority of cases, a significant percentage of affected individuals may have sequelae that can negatively affect their lives. The use of therapeutic measures as early as possible can improve the prognosis. This article describes the successful use of laser-photobiomodulation as a single therapy in a patient with Bell's palsy and confirms the possibility ...[more]

PMID: 32231809

Similar Datasets

Project description:ObjectiveFunctional deficits induced by nerve injuries can be restored by achieving effective reinnervation of the denervated targets and functional reorganization of the central nervous system after nerve reconstruction. In this study, we investigated the effect and extent of cortical functional reorganization related to the ability of transferred hypoglossal neurons to restore facial function in facial paralysis patients after a surgical bridge of neurorrhaphy ectopically between the ipsilateral hypoglossal nerve and injured facial nerve.MethodsWe treated 23 patients (35.4 ± 10.3 years, 10 males) and followed them up for 2.9 ± 0.61 years. We used motor-task-related functional magnetic resonance imaging to map activation change at multiple time points before and after neurorrhaphy; 20 normal subjects were included as control.ResultsAll patients regained facial function to some extent after neurorrhaphy. Enhanced activation in motor-related cortices gradually returned to normal levels and was positively correlated with regained facial function. The related cortical functional areas included the left middle temporal gyrus, left inferior frontal gyrus, insula, bilateral motor cortex and the supplementary motor area extending to the paracingulate involved in intensive eye closing, as well as the left superior temporal gyrus, right putamen and the bilateral motor cortex involved in lip pursing. Intriguingly, significant correlations were found between the pre-surgery activation while intensive eye closing in bilateral motor cortex and recovery of facial nerve function induced by the neurorrhaphy treatment.ConclusionThis is the first study mapping activation change in motor cortices at multiple time points before and after repair of the facial nerve. The cortex functional reorganization found may suggest potential treatment targets in the central nervous system for adjuvant therapies such as repetitive transcranial magnetic stimulation to further improve functional recovery.

Project description: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.To document the results of nonsurgical treatment for posttraumatic complete facial paralysis with undisplaced temporal bone fracture and unfavorable electrophysiologic features.Prospective cohort study recruiting from April 2010 to April 2013 at a tertiary care university hospital. Follow-up continued until 9 months or until complete recovery if earlier. Study group included 28 patients with head injury-associated complete unilateral facial nerve paralysis with unfavorable results of electroneuronography (<5% response) with or without undisplaced temporal bone fracture. Undisplaced temporal bone fractures were documented in 26 patients (24 longitudinal fractures and 2 transverse fractures).Patients received prednisolone, 1 mg/kg, for 3 weeks combined with clinical monitoring every 2 weeks and electromyography monitoring every 4 weeks. As per study protocol, surgical exploration was limited to patients demonstrating motor end plate degeneration on results of electromyography, or having no improvement until 18 weeks.Facial nerve function was evaluated by the House-Brackmann grading system; Forehead, Eye, Mouth, and Associated defect grading system; and the modified Adour system. Observations were completed at 40 weeks.Among the 28 patients in the study (3 women and 25 men; mean [SD] age, 32.2 [8.7] years), facial nerve recovery with conservative treatment alone was noted in all patients. No recovery was seen in any patient at the initial 4-week review. The first signs of clinical recovery were noted in 4 patients by 8 weeks, in 27 patients by 12 weeks, and in all patients by 20 weeks. No patient required surgical exploration. At 40 weeks, 27 patients recovered to House-Brackmann grade I/II and 1 patient to grade III. All 24 patients with longitudinal fractures had grade I/II recovery.For undisplaced temporal bone fractures, nonsurgical treatment leads to near-universal recovery to House-Brackmann grade I/II and is superior to reported surgical results. Recovery is delayed and usually first manifests at 8 to 12 weeks after the fracture. In the current era of high-resolution computed tomography, surgical exploration should not be first-line treatment for undisplaced longitudingal temporal bone fractures associated with complete facial nerve paralysis and unfavorable electrophysiologic features.

Project description:Importance:In the setting of facial paralysis, inadequate eyelid closure and lower eyelid ectropion can lead to corneal exposure and impaired quality of life. Repair of paralytic ectropion is challenging, and an ideal surgical approach for all cases has not been identified. Objective:To assess the patient-reported outcomes and eyelid position improvement in patients with flaccid facial paralysis undergoing lateral eyelid coupling with a tarsal strip canthoplasty and modified tarsoconjunctival flap to correct eyelid malposition. Design, Setting, and Participants:Review of medical records of adults with flaccid facial paralysis who underwent a single-stage tarsal strip canthoplasty and modified tarsoconjunctival flap at a tertiary academic center. Inclusion criteria included a minimum of 3 months of follow-up. Intervention:The lateral upper and lower eyelid are coupled with the hybrid tarsoconjunctival flap. Main Outcomes and Measures:Patient-reported outcome measures and objective photograph analysis. Preoperative and postoperative Facial Clinimetric Evaluation (FaCE) scores and Moe Ectropion Grading Scale scores were compared. The relationship between radiation therapy (RT) and outcomes was analyzed. Results:Sixteen patients (8 [50%] female; mean [SD] age at surgery, 71.5 [9.6] years) were identified between January 2014 and August 2017. Twelve (75%) had paralysis from facial nerve sacrifice during cancer ablation. The mean time between paralysis and referral for surgical repair of ectropion was 23 months (range, 0-151 months) and mean follow-up after surgery was 9.8 months (range, 3-39 months). The most common symptom was epiphora, which was significantly reduced after surgery (75% vs 25%; P?=?.01). Median Moe Ectropion Grading Scale score improved from 3 (interquartile range, 2-3) to 0 (interquartile range, 0-1; P?<?.001). Quality of life measured using the FaCE scale demonstrated a significant improvement in mean eye comfort (from 18.8 [95% CI, 2.3-35.2] to 47.9 [95% CI, 31.9-63.9]; P?=?.01) and lacrimal control scores (from 12.5 [95% CI, 0-29.2] to 45.8 [95% CI, 29.3-62.3]; P?=?.03) in the 6 patients in the RT group, but no difference in the 4 patients in the non-RT group. Conclusions and Relevance:Ocular symptoms, eyelid appearance, and quality of life were improved after lateral eyelid coupling among patients with flaccid facial paralysis and paralytic ectropion. The tarsoconjunctival flap does limit peripheral vision, but is reversible if dynamic eyelid closure is returned with nerve grafting. Level of Evidence:4.

Dataset Information

Complete and Fast Recovery from Idiopathic Facial Paralysis Using Laser-Photobiomodulation.

Publications

Complete and Fast Recovery from Idiopathic Facial Paralysis Using Laser-Photobiomodulation.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets