Management of peripheral facial nerve palsy.
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ABSTRACT:
SUBMITTER: Finsterer J
PROVIDER: S-EPMC2440925 | biostudies-other | 2008 Jul
REPOSITORIES: biostudies-other
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Project description:A few approaches can be used to decompress traumatic facial nerve paralysis including the middle cranial fossa approach or transmastoid approach depending on the site of injury. In some specific situation of treating traumatic facial nerve palsy whose injured site was confined from the geniculate ganglion to the second genu, transcanal endoscopic approach for facial nerve decompression can be used. We performed two cases of total endoscopic transcanal facial nerve decompression in patients with traumatic facial nerve palsy. After a six month follow-up, both patients showed improvement in facial function by 2 grades according to House-Brackmann grade system. In terms of treatment outcomes, total transcanal endoscopic facial nerve decompression for traumatic facial nerve palsy is an alternative for lesions limited to the tympanic segment I, and has an advantages of being minimally invasive and is cosmetically acceptable without an external scar or bony depression due to drilling.
| S-EPMC5890000 | biostudies-literature
Project description:PurposeTo report a rather rare entity of facial palsy due to chondromyxoid fibroma. The authors present a case along with clinico-pathological features, management, treatment options and follow-up.MethodsThe authors present a case of a 29-year-old male who suffered from right facial weakness and numbness for a period of 6-months. imaging studies demonstrated a soft, locally invasive tumor, located mainly in the right temporal bone and extended extracranially.ResultsA surgical procedure of local excision followed by cross-facial nerve grafting was performed.ConclusionsDiagnosis should be based on combination of histo-pathologic and radiographic findings, because of its histological similarities to chondrosarcoma.
| S-EPMC8918436 | biostudies-literature
Project description:Objectives:Long-term facial paralysis results in degeneration of the distal nerve segment and atrophy of the supplied muscles. Options for these patients include free muscle transfer, temporalis myoplasty, and botulinum toxin injections for smile reanimation. In this study we aimed to evaluate the subjective and objective outcomes of these procedures. Materials and Methods:In our study, we retrospectively analyzed smile symmetry in patients with facial palsy (n=8) who underwent facial reanimation procedures. Results:Subjective analysis showed high satisfaction in seven out of eight patients. Objective analysis showed statistically significant improvement postoperatively in both vertical and horizontal smile symmetry at rest and during maximum smile (P<0.001). Conclusion:Choosing the ideal procedure for the patients is the most critical aspect for facial reanimation. Though free muscle transfer is considered gold standard procedure, temporalis myoplasty also gives satisfactory results. Residual synkinesis which can lead to disturbing aesthetic deformity can be effectively treated with botulinum toxin.
| S-EPMC7222615 | biostudies-literature
Project description:Background There has been lot of speculation around the possible side effects associated with COVID vaccination and incidence of facial palsy is one of them. Bilateral facial palsy is less likely to be idiopathic as compared to unilateral facial nerve palsy and warrants further investigations to find any secondary cause. COVID 19 infection and the vaccinations for the same are also included in the unique list of differentials. Case report We report an interesting case of bilateral rapidly sequential facial nerve palsy following the administration of COVID vaccination that showed subsequent improvement. We provide literature review to report the current incidence of same, secondary to the vaccination as well the infection itself Case presentation Following the introduction of COVID 19 vaccine, there have been reports of various cranial nerve involvement including lower motor neuron type facial paresis. Bilateral facial palsy is less likely to be idiopathic as compared to unilateral palsy(23% vs 70%) and requires further work up to determine the etiology before determining to be idiopathic. Unilateral facial palsy(FP) has been reported in the Phase I and II trials for Pfizer and Moderna vaccine, with a total of 7 cases reported in these initial trials. To date, there is no direct evidence that these vaccines have increased the incidence of facial palsy as compared to adverse events reported with other vaccines or compared to COVID 19 infection itself. We report a unique case of bilateral lower motor neuron type facial palsy noted in a young male within hours of receiving the vaccine that later improved with treatment. Reports of simultaneous bilateral facial palsy after vaccine are rare with only few cases reported to date in literature. Conclusion In conclusion from current available literature, we would like to postulate that though there is a risk of facial nerve palsy following the vaccination, it is comparable to the risks associated with any other vaccinations and not been higher than the non-vaccinated population. The overall risk is higher with the actual COVID 19 infection itself as compared to the vaccine.
| S-EPMC9556870 | biostudies-literature
Project description:Facial palsy (FP) is a functional disorder of the facial nerve involving paralysis of the mimic muscles. According to the principle "time is muscle," early surgical treatment is tremendously important for preserving the mimic musculature if there are no signs of nerve function recovery. In a 49-year-old female patient, even 19 months after onset of FP, successful neurotization was still possible by a V-to-VII nerve transfer and cross-face nerve grafting. Our patient suffered from complete FP after vestibular schwannoma surgery. With continuous application of electrostimulation (ES) therapy, the patient was able to bridge the period between the first onset of FP and neurotization surgery. The significance of ES for mimic musculature preservation in FP patients has not yet been fully clarified. More attention should be paid to this form of therapy in order to preserve the facial musculature, and its benefits should be evaluated in further prospective clinical studies.
| S-EPMC8143947 | biostudies-literature
Project description:PurposeFacial nerve electrodiagnostics is a well-established and important tool for decision making in patients with facial nerve diseases. Nevertheless, many otorhinolaryngologist-head and neck surgeons do not routinely use facial nerve electrodiagnostics. This may be due to a current lack of agreement on methodology, interpretation, validity, and clinical application. Electrophysiological analyses of the facial nerve and the mimic muscles can assist in diagnosis, assess the lesion severity, and aid in decision making. With acute facial palsy, it is a valuable tool for predicting recovery.MethodsThis paper presents a guideline prepared by members of the International Head and Neck Scientific Group and of the Multidisciplinary Salivary Gland Society for use in cases of peripheral facial nerve disorders based on a systematic literature search.ResultsRequired equipment, practical implementation, and interpretation of the results of facial nerve electrodiagnostics are presented.ConclusionThe aim of this guideline is to inform all involved parties (i.e. otorhinolaryngologist-head and neck surgeons and other medical specialists, therapeutic professionals and the affected persons) and to provide practical recommendations for the diagnostic use of facial nerve electrodiagnostics.
| S-EPMC7286870 | biostudies-literature
Project description:INTRODUCTION: In long-standing facial palsy, muscles on the normal side overcontract causing difficulty in articulation, eating, drinking, cosmetic embarrassment, and psychological effects as patients lack confidence in public. METHODS: We injected botulinum toxin A (BTXA) into the normal contralateral smile muscles to weaken them and restore symmetry to both active and passive movements by neutralising these overacting muscles. RESULTS: A total of 14 patients received BTXA (79% women, median age 47 years, average length of palsy 8 years). They were all difficult cases graded between 2 and 6 (average grade 3 House-Brackmann). All 14 patients reported improved facial symmetry with BTXA (dose altered in some to achieve maximum benefit). Average dose was 30 units, but varied from 10 to 80 units. Average time to peak effect was 6 days; average duration of effect was 11 weeks. Three patients had increased drooling (resolved within a few days). CONCLUSION: The improvement in symmetry was observed by both patient and examining doctor. Patients commented on increased confidence, being more likely to allow photographs taken of themselves, and families reported improved legibility of speech. Younger patients have more muscle tone than older patients; the effect is more noticeable and the benefit greater for them. BTXA improves symmetry in patients with facial palsy, is simple and acceptable, and provides approximately 4 months of benefit. The site of injection depends on the dynamics of the muscles in each individual patient.
| S-EPMC3496102 | biostudies-other
Project description:ObjectivesThere is a lack of data on patients' and diagnostic factors for prognostication of complete recovery in patients with non-idiopathic peripheral facial palsy (FP).MethodsCohort register-based study of 264 patients with non-idiopathic peripheral FP and uniform diagnostics and standardized treatment in a university hospital from 2007 to 2017 (47% female, median age: 57 years). Clinical data, facial grading, electrodiagnostics, motor function tests, non-motor function tests, and onset of prednisolone therapy were assessed for their impact on the probability of complete recovery using univariable and multivariable statistics.ResultsThe most frequent reason for a non-idiopathic peripheral FP was a reactivation of Varicella Zoster Virus (VZV; 36.4%). Traumatic origin had a higher proportion of complete FP (52.9%). Furthermore, in traumatic FP, the mean interval between onset and start of prednisolone therapy was longer than in other cases (5.6 ± 6.2 days). Patients with reactivation of VZV, Lyme disease or otogenic FP had a significant higher recovery rate (p = 0.002, p < 0.0001, p = 0.018, respectively), whereas patients with post-surgery FP and other reasons had a significant lower recovery rate (p < 0.0001). After multivariate analyses voluntary activity in first EMG, Lyme disease and post-surgery cause were identified as independent diagnostic and prognostic factors on the probability of complete recovery (all p < 0.05).ConclusionInfectious causes for non-idiopathic FP like VZV reactivation and Lyme disease had best probability for complete recovery. Post-surgery FP had a worse prognosis.Level of evidence2.
| S-EPMC8328849 | biostudies-literature
Project description:Background: The aim of this study is to report outcomes of eyelid full-thickness skin grafting augmentation in facial nerve palsy (FNP) patients younger than 50 years of age. Methods: In a retrospective, consecutive case series, nine eyelid skin grafts performed on eight FNP patients with skin contraction (five females; median age 42 years [range, 17-47]) are presented. In most cases, upper eyelid skin grafting was combined with levator recession and anterior lamellar repositioning. Lower eyelid skin grafting was combined with lower retractors recession in all cases. Functional and cosmetic outcomes were measured preoperatively and at early (1-3 months), intermediate (3-6 months), and late (≥12 months) follow-up. Results: The corneal score improved at early follow-up (p = 0.03) and remained improved at late follow-up (p = 0.042). The gentle closure lagophthalmos was improved at late follow-up (p = 0.042). (p = 0.048). The grades of graft color, edge/skin interface, and size improved at 3-6 months post-grafting and remained improved at late follow-up (p < 0.05). Over the follow-up, four patients (50%) were recommended to have further surgical procedures. Conclusions: The preliminary results from this small cohort suggest that eyelid skin grafting is a viable option for young patients prioritizing cosmesis. This technique warrants consideration for its functional benefits.
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Project description:Pathogenic heterozygous variants in SGMS2 cause a rare monogenic form of osteoporosis known as calvarial doughnut lesions with bone fragility (CDL). The clinical presentations of SGMS2-related bone pathology range from childhood-onset osteoporosis with low bone mineral density and sclerotic doughnut-shaped lesions in the skull to a severe spondylometaphyseal dysplasia with neonatal fractures, long-bone deformities, and short stature. In addition, neurological manifestations occur in some patients. SGMS2 encodes sphingomyelin synthase 2 (SMS2), an enzyme involved in the production of sphingomyelin (SM). This review describes the biochemical structure of SM, SM metabolism, and their molecular actions in skeletal and neural tissue. We postulate how disrupted SM gradient can influence bone formation and how animal models may facilitate a better understanding of SGMS2-related osteoporosis.
| S-EPMC10598846 | biostudies-literature