Dataset Information

Using High-Resolution Ultrasound to Assess Post-Facial Paralysis Synkinesis-Machine Settings and Technical Aspects for Facial Surgeons.

ABSTRACT:

Background

Synkinesis of the facial musculature is a detrimental sequalae in post-paralytic facial palsy (PPFP) patients. Detailed knowledge on the technical requirements and device properties in a high-resolution ultrasound (HRUS) examination is mandatory for a reliable facial muscle assessment in PPFP patients. We therefore aimed to outline the key steps in a HRUS examination and extract an optimized workflow schema.

Methods

From December 2020 to April 2021, 20 patients with unilateral synkinesis underwent HRUS. All HRUS examinations were performed by the first author using US devices with linear multifrequency transducers of 4-18 MHz, including a LOGIQ E9 and a LOGIQ S7 XDclear (GE Healthcare; Milwaukee, WI, USA), as well as Philips Affinity 50G (Philips Health Systems; Eindhoven, the Netherlands).

Results

Higher-frequency and multifrequency linear probes ≥15 MHz provided superior imaging qualities. The selection of the preset program Small Parts, Breast or Thyroid was linked with a more detailed contrast of the imaging morphology of facial tissue layers. Frequency (Frq) = 15 MHz, Gain (Gn) = 25-35 db, Depth (D) = 1-1.5 cm, and Focus (F) = 0.5 cm enhanced the image quality and assessability.

Conclusions

An optimized HRUS examination protocol for quantitative and qualitative facial muscle assessments was proposed.

SUBMITTER: Kehrer A

PROVIDER: S-EPMC9322000 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

Using High-Resolution Ultrasound to Assess Post-Facial Paralysis Synkinesis-Machine Settings and Technical Aspects for Facial Surgeons.

Kehrer Andreas A Ruewe Marc M Platz Batista da Silva Natascha N Lonic Daniel D Heidekrueger Paul Immanuel PI Knoedler Samuel S Jung Ernst Michael EM Prantl Lukas L Knoedler Leonard L

Diagnostics (Basel, Switzerland) 20220707 7

<h4>Background</h4>Synkinesis of the facial musculature is a detrimental sequalae in post-paralytic facial palsy (PPFP) patients. Detailed knowledge on the technical requirements and device properties in a high-resolution ultrasound (HRUS) examination is mandatory for a reliable facial muscle assessment in PPFP patients. We therefore aimed to outline the key steps in a HRUS examination and extract an optimized workflow schema.<h4>Methods</h4>From December 2020 to April 2021, 20 patients with uni ...[more]

PMID: 35885554

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Project description:Background and objectiveAfter vestibular schwannoma (VS) surgery, some patients exhibit different degrees of peripheral facial paralysis, which can seriously affect their quality of life. The recovery of facial nerve function after surgery typically takes a considerable amount of time; therefore, the recovery of facial nerve function depends mainly on the rehabilitation treatment and nursing after discharge. In the past, we implemented conventional paralysis rehabilitation nursing program for patients with facial paralysis due to VS surgery. However, several patients with facial paralysis have bad compliance and do not achieve ideal facial nerve function recovery. Therefore, this study aimed to investigate whether modified facial paralysis rehabilitation nursing improves the effectiveness of rehabilitation of facial paralysis after VS surgery by analysing the clinical data of patients.MethodsWe screened the patients with facial paralysis after VS surgery from December 2019 to May 2023. The patients were divided into the conventional and modified groups based on the different nursing programs (conventional vs. modified facial paralysis rehabilitation nursing program) to compare the differences in facial nerve function, quality of life of patients, and compliance of rehabilitation between the two groups.ResultsWe analysed 128 patients with facial paralysis after VS surgery who met the inclusion and exclusion criteria; 65 and 63 patients in the conventional and modified group, respectively. The number of patients in the modified group with House-Brackmann grade changes >0 in facial nerve function was significantly higher than that in the conventional group 3 months after surgery (82.5 % vs 63.1 %, p = 0.01). Except for the lacrimal control score, the mean scores of the Chinese version of the FaCE scale were significantly higher in the modified group than those in the conventional group at 1 and 3 months postoperatively.ConclusionsThe modified facial paralysis rehabilitation nursing, i.e., integrated use of facial expressive muscle exercises and facial massage with video-assisted education, substantially improved the facial nerve function, quality of life, and compliance of rehabilitation nursing of patients with facial paralysis after VS surgery.

Project description:ImportanceIn the last decade, there has been a significant increase in the number of practitioners administering botulinum toxin for facial synkinesis. However, there are few resources available to guide treatment patterns, and little is known about how these patterns are associated with functional outcomes and quality of life.ObjectiveTo evaluate botulinum treatment patterns, including the dosing and frequency of muscle targeting, for treatment of facial synkinesis and to quantify patient outcomes.Design, setting, and participantsThis prospective cohort study of 99 patients treated for facial synkinesis was conducted from January 2016 through December 2018 at the Vanderbilt Bill Wilkerson Center in Nashville, Tennessee, a tertiary referral center.InterventionOnabotulinum toxin A treatment of facial synkinesis.Main outcomes and measuresPatient-reported outcomes on the Synkinesis Assessment Questionnaire and botulinum treatment patterns, including the dosages and frequency of injection for each facial muscle, were compared at the initiation of treatment and at the end of recorded treatment.ResultsIn total, 99 patients (80 female patients [81%]) underwent botulinum injections for treatment of facial synkinesis. The median (interquartile range) age was 54.0 (43.5-61.5) years, and the median (interquartile range) follow-up was 27.1 (8.9-59.7) months. Most patients underwent injections after receiving a diagnosis of Bell palsy (41 patients, 41%) or after resection of vestibular schwannoma (36 patients [36%]). The patients received a total of 441 treatment injections, and 369 pretreatment and posttreatment Synkinesis Assessment Questionnaire scores were analyzed. The mean botulinum dose was 2 to 3 U for each facial muscle and 9 to 10 U for the platysma muscle. The dose increased over time for the majority of all muscles, with steady state achieved after a median of 3 treatments (interquartile range, 2-3). Linear regression analysis for cluster data of the mean total questionnaire score difference was -14.2 (95% CI, -17.0 to -11.5; P < .001). There was a significant association of postinjection questionnaire score with younger patients, female sex, total dose, and synkinesis severity. Oculo-oral synkinesis may respond more to treatment compared with oro-ocular synkinesis.Conclusion and relevancePatients with facial synkinesis responded significantly to botulinum treatment. Treatment began with 6 core facial muscles that were injected during most treatment sessions, and dosages increased after the first injection until steady state was achieved. Those with a greater degree of morbidity, younger patients, and females showed significant improvement, and the larger the dose administered, the greater the response. Oculo-oral synkinesis may be more responsive than oro-ocular synkinesis.Level of evidence3.

Dataset Information

Using High-Resolution Ultrasound to Assess Post-Facial Paralysis Synkinesis-Machine Settings and Technical Aspects for Facial Surgeons.

Background

Methods

Results

Conclusions

Publications

Using High-Resolution Ultrasound to Assess Post-Facial Paralysis Synkinesis-Machine Settings and Technical Aspects for Facial Surgeons.

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