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Sample records for facial nerve branch

  1. Mandibular branch of the facial nerve in wistar rats: new experimental model to assess facial nerve regeneration.

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    Bento, Ricardo Ferreira; Salomone, Raquel; Nascimento, Silvia Bona do; Ferreira, Ricardo Jose Rodriguez; Silva, Ciro Ferreira da; Costa, Heloisa Juliana Zabeu Rossi

    2014-07-01

    Introduction The ideal animal model for nerve regeneration studies is the object of controversy, because all models described by the literature have advantages and disadvantages. Objective To describe the histologic and functional patterns of the mandibular branch of the facial nerve of Wistar rats to create a new experimental model of facial nerve regeneration. Methods Forty-two male rats were submitted to a nerve conduction test of the mandibular branch to obtain the compound muscle action potential. Twelve of these rats had the mandibular branch surgically removed and submitted to histologic analysis (number, partial density, and axonal diameter) of the proximal and distal segments. Results There was no statistically significant difference in the functional and histologic variables studied. Conclusion These new histologic and functional standards of the mandibular branch of the facial nerve of rats establish an objective, easy, and greatly reproducible model for future facial nerve regeneration studies.

  2. Branch facial nerve trauma after superficial temporal artery biopsy: a case report

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    Rison Richard A

    2011-01-01

    Full Text Available Abstract Introduction Giant cell arteritis is an emergency requiring prompt diagnosis and treatment. Superficial temporal artery biopsy is the gold diagnostic standard. Complications are few and infrequent; however, facial nerve injury has been reported, leaving an untoward cosmetic outcome. This case report is to the best of our knowledge only the fourth one presented in the available literature so far regarding facial nerve injury from superficial temporal artery biopsy. Case presentation A 73-year-old Caucasian woman presented for neurological evaluation regarding eyebrow and facial asymmetry after a superficial temporal artery biopsy for presumptive giant cell arteritis-induced cephalalgia. Conclusion Damage to branches of the facial nerve may occur after superficial temporal artery biopsy, resulting in eyebrow droop. Although an uncommon and sparsely reported complication, all clinicians of various specialties involved in the care of these patients should be aware of this given the gravity of giant cell arteritis and the widespread use of temporal artery biopsy.

  3. Constriction of the buccal branch of the facial nerve produces unilateral craniofacial allodynia.

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    Lewis, Susannah S; Grace, Peter M; Hutchinson, Mark R; Maier, Steven F; Watkins, Linda R

    2016-12-18

    Despite pain being a sensory experience, studies of spinal cord ventral root damage have demonstrated that motor neuron injury can induce neuropathic pain. Whether injury of cranial motor nerves can also produce nociceptive hypersensitivity has not been addressed. Herein, we demonstrate that chronic constriction injury (CCI) of the buccal branch of the facial nerve results in long-lasting, unilateral allodynia in the rat. An anterograde and retrograde tracer (3000MW tetramethylrhodamine-conjugated dextran) was not transported to the trigeminal ganglion when applied to the injury site, but was transported to the facial nucleus, indicating that this nerve branch is not composed of trigeminal sensory neurons. Finally, intracisterna magna injection of interleukin-1 (IL-1) receptor antagonist reversed allodynia, implicating the pro-inflammatory cytokine IL-1 in the maintenance of neuropathic pain induced by facial nerve CCI. These data extend the prior evidence that selective injury to motor axons can enhance pain to supraspinal circuits by demonstrating that injury of a facial nerve with predominantly motor axons is sufficient for neuropathic pain, and that the resultant pain has a neuroimmune component.

  4. Location of the mandibular branch of the facial nerve according to the neck position.

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    Hwang, Kun; Huan, Fan; Ki, Sae Hwi; Nam, Yong Seok; Han, Seung Ho

    2012-09-01

    The aim of this study was to elucidate the exact location of the mandibular branch of the facial nerve according to different neck positions. Twenty-two hemifaces of 11 fresh human cadavers were used (age range, 53-89 y; mean age, 72.3 ± 10.5 y; 8 men and 3 women). Working through skin windows, the distance from the mandibular border to the mandibular branch of the facial nerve (border-nerve distance or BND) was measured at 3 points: (1) the mandible angle (gonion or Go point), (2) the point where the mandibular branch of the facial nerve crosses the facial artery (FA point), and (3) the one-fourth point from the gonion to the menton (1/4 point). Threads were hung on the skin windows along the mandibular border. With the neck in the neutral position and then full flexion (15 degrees), extension (15 degrees), and left and right rotations (30 degrees), the distance of the mandibular branch from the thread of the mandibular border was measured using calipers. In the neutral position, the mandibular branch was 3.50 ± 2.82 mm above the mandibular border at the Go point, 5.34 ± 2.98 mm above the mandibular border at the FA point, and 5.28 ± 1.86 mm above the mandibular border at the 1/4 point. At all 3 points, flexion or extension of the neck did not significantly move the mandibular branch. At the Go point and FA point, there was no significant difference between the ipsilateral rotation position and the contralateral rotation. Yet at the 1/4 point, the BND decreased (4.32 ± 2.60 mm) with the neck in ipsilateral rotation and the BND increased (5.97 ± 2.62 mm) with the neck in contralateral rotation. There was a significant difference between the ipsilateral rotation position and the contralateral rotation position (P = 0.020, t-test). Surgeons should keep in mind that at the 1/4 point, the mandibular branch of the facial nerve moves downward 1.10 ± 1.42 mm with the neck in ipsilateral rotation and moves upward 0.49 ± 1.84 mm with the neck in contralateral

  5. Study on distribution of terminal branches of the facial nerve in mimetic muscles (orbicularis oculi muscle and orbicularis oris muscle).

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    Mitsukawa, Nobuyuki; Moriyama, Hiroshi; Shiozawa, Kei; Satoh, Kaneshige

    2014-01-01

    There have been many anatomical reports to date regarding the course of the facial nerve to the mimetic muscles. However, reports are relatively scarce on the detailed distribution of the terminal branches of the facial nerve to the mimetic muscles. In this study, we performed detailed examination of the terminal facial nerve branches to the mimetic muscles, particularly the branches terminating in the orbicularis oculi muscle and orbicularis oris muscle. Examination was performed on 25 Japanese adult autopsy cases, involving 25 hemifaces. The mean age was 87.4 years (range, 60-102 years). There were 12 men and 13 women (12 left hemifaces and 13 right hemifaces). In each case, the facial nerve was exposed through a preauricular skin incision. The main trunk of the facial nerve was dissected from the stylomastoid foramen. A microscope was used to dissect the terminal branches to the periphery and observe them. The course and distribution were examined for all terminal branches of the facial nerve. However, focus was placed on the course and distribution of the zygomatic branch, buccal branch, and mandibular branch to the orbicularis oculi muscle and orbicularis oris muscle. The temporal branch was distributed to the orbicularis oculi muscle in all cases and the marginal mandibular branch was distributed to the orbicularis oris muscle in all cases. The zygomatic branch was distributed to the orbicularis oculi muscle in all cases, but it was also distributed to the orbicularis oris muscle in 10 of 25 cases. The buccal branch was not distributed to the orbicularis oris muscle in 3 of 25 cases, and it was distributed to the orbicularis oculi muscle in 8 cases. There was no significant difference in the variations. The orbicularis oculi muscle and orbicularis oris muscle perform particularly important movements among the facial mimetic muscles. According to textbooks, the temporal branch and zygomatic branch innervate the orbicularis oculi muscle, and the buccal branch

  6. Variant Anterior Digastric Muscle Transfer for Marginal Mandibular Branch of Facial Nerve Palsy

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    Matthew J. Zdilla, DC

    2014-02-01

    Full Text Available Summary: Marginal mandibular branch of facial nerve (MMBFN palsy is a common consequence of head and neck surgeries. MMBFN palsy results in paralysis of muscles which depress the inferior lip. Current management of MMBFN palsy involves ruination of normal neuromuscular anatomy and physiology to restore symmetry to the mouth. The article outlines the possibility to transfer variant anterior digastric musculature to accomplish reanimation of the mouth without adversely affecting normal nonvariant anatomy. The procedure may have the additional cosmetic benefit of correcting asymmetrical muscular bulk in the submental region.

  7. Reconstruction of Multiple Facial Nerve Branches Using Skeletal Muscle-Derived Multipotent Stem Cell Sheet-Pellet Transplantation.

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    Kosuke Saito

    Full Text Available Head and neck cancer is often diagnosed at advanced stages, and surgical resection with wide margins is generally indicated, despite this treatment being associated with poor postoperative quality of life (QOL. We have previously reported on the therapeutic effects of skeletal muscle-derived multipotent stem cells (Sk-MSCs, which exert reconstitution capacity for muscle-nerve-blood vessel units. Recently, we further developed a 3D patch-transplantation system using Sk-MSC sheet-pellets. The aim of this study is the application of the 3D Sk-MSC transplantation system to the reconstitution of facial complex nerve-vascular networks after severe damage. Mouse experiments were performed for histological analysis and rats were used for functional examinations. The Sk-MSC sheet-pellets were prepared from GFP-Tg mice and SD rats, and were transplanted into the facial resection model (ST. Culture medium was transplanted as a control (NT. In the mouse experiment, facial-nerve-palsy (FNP scoring was performed weekly during the recovery period, and immunohistochemistry was used for the evaluation of histological recovery after 8 weeks. In rats, contractility of facial muscles was measured via electrical stimulation of facial nerves root, as the marker of total functional recovery at 8 weeks after transplantation. The ST-group showed significantly higher FNP (about three fold scores when compared to the NT-group after 2-8 weeks. Similarly, significant functional recovery of whisker movement muscles was confirmed in the ST-group at 8 weeks after transplantation. In addition, engrafted GFP+ cells formed complex branches of nerve-vascular networks, with differentiation into Schwann cells and perineurial/endoneurial cells, as well as vascular endothelial and smooth muscle cells. Thus, Sk-MSC sheet-pellet transplantation is potentially useful for functional reconstitution therapy of large defects in facial nerve-vascular networks.

  8. Sound-induced facial synkinesis following facial nerve paralysis

    NARCIS (Netherlands)

    Ma, Ming-San; van der Hoeven, Johannes H.; Nicolai, Jean-Philippe A.; Meek, Marcel F.

    2009-01-01

    Facial synkinesis (or synkinesia) (FS) occurs frequently after paresis or paralysis of the facial nerve and is in most cases due to aberrant regeneration of (branches of) the facial nerve. Patients suffer from inappropriate and involuntary synchronous facial muscle contractions. Here we describe two

  9. Fluorescently labeled peptide increases identification of degenerated facial nerve branches during surgery and improves functional outcome.

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    Timon Hussain

    Full Text Available Nerve degeneration after transection injury decreases intraoperative visibility under white light (WL, complicating surgical repair. We show here that the use of fluorescently labeled nerve binding probe (F-NP41 can improve intraoperative visualization of chronically (up to 9 months denervated nerves. In a mouse model for the repair of chronically denervated facial nerves, the intraoperative use of fluorescent labeling decreased time to nerve identification by 40% compared to surgeries performed under WL alone. Cumulative functional post-operative recovery was also significantly improved in the fluorescence guided group as determined by quantitatively tracking of the recovery of whisker movement at time intervals for 6 weeks post-repair. To our knowledge, this is the first description of an injectable probe that increases visibility of chronically denervated nerves during surgical repair in live animals. Future translation of this probe may improve functional outcome for patients with chronic denervation undergoing surgical repair.

  10. Temporal branch of facial nerve: a normative study of nerve conduction Ramo temporal do nervo facial: um estudo normativo da condução nervosa

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    Paula Fabiana Sobral da Silva

    2010-08-01

    Full Text Available The temporal branch of the facial nerve is particularly vulnerable to traumatic injuries during surgical procedures. It may also be affected in clinical conditions. Electrodiagnostic studies may add additional information about the type and severity of injuries, thus allowing prognostic inferences. The objective of the present study was to develop and standardize an electrophysiological technique to specifically evaluate the temporal branch of the facial nerve. METHOD: Healthy volunteers (n=115 underwent stimulation of two points along the nerve trajectory, on both sides of the face. The stimulated points were distal (on the temple, over the temporal branch and proximal (in retro-auricular region. Activities were recorded on the ipsilateral frontalis muscle. The following variables were studied: amplitude (A, distal motor latency (DML and conduction velocity (NCV. RESULTS: Differences between the sides were not significant. The proposed reference values were: A >0.4 mV, DML 40 m/s. Variation between hemifaces should account for less than 60% for amplitudes and latency, and should be inferior to 20% for conduction velocity. CONCLUSION: These measurements are an adequate way for proposing normative values for the electrophysiological evaluation of the temporal branch.O ramo temporal do nervo facial é particularmente vulnerável a lesões traumáticas nos procedimentos cirúrgicos. Também pode ser acometido em várias condições clínicas. Estudos eletrodiagnósticos podem acrescentar informações quanto ao tipo e severidade das lesões. A pesquisa visa aperfeiçoar técnica eletrofisiológica para avaliação específica daquele ramo. MÉTODO: Voluntários (n=115 foram submetidos a estimulação eletroneurográfica em dois pontos, nas duas hemifaces. Estímulo distal na têmpora, estímulo proximal na região retroauricular. Foram registradas distâncias dos pontos de estímulo até pontos anatômicos da face; assim como vari

  11. Evidence Suggesting that the Buccal and Zygomatic Branches of the Facial Nerve May Contain Parasympathetic Secretomotor Fibers to the Parotid Gland by Means of Communications from the Auriculotemporal Nerve.

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    Tansatit, Tanvaa; Apinuntrum, Prawit; Phetudom, Thavorn

    2015-12-01

    The auriculotemporal nerve is one of the peripheral nerves that communicates with the facial nerve. However, the function of these communications is poorly understood. Details of how these communications form and connect with each other are still unclear. In addition, a reliable anatomical landmark for locating these communications during surgery has not been sufficiently described. Microdissection was performed on 20 lateral hemifaces of 10 soft-embalmed cadavers to investigate facial-auriculotemporal nerve communications with emphasis on determining their function. The auriculotemporal nerve was identified in the retromandibular space and traced towards its terminations. The communicating branches were followed and the anatomical relationships to surrounding structures observed. The auriculotemporal nerve is suspended above the maxillary artery in the dense retromandibular fascia behind the mandibular ramus. It forms a knot and fans out, providing multiple branches in all directions in the sagittal plane. Inferiorly, it connects the maxillary periarterial plexus, while minute branches supply the temporomandibular joint anteriorly. The larger branches mainly communicate with the branches of the temporofacial division of the facial nerve, and the auricular branches enter the fascia of the auricular cartilage posteriorly. The temporal branches and occasionally the zygomatic branches arise superiorly to distribute within the temporoparietal fascia. The auriculotemporal nerve forms the parotid retromandibular plexus through two types of communication. It sends one to three branches to join the zygomatic and buccal branches of the facial nerve at the branching area of the temporofacial division. It also communicates with the periarterial plexus of the superficial temporal and maxillary arteries. This plexus continues anteriorly along the branches of the facial nerve and the periarterial plexus of the transverse facial artery as the parotid periductal autonomic plexus

  12. Techniques for Preservation of the Frontotemporal Branch of Facial Nerve during Orbitozygomatic Approaches

    DEFF Research Database (Denmark)

    Spiriev, Toma; Poulsgaard, Lars; Fugleholm, Kaare

    2015-01-01

    arch directly, whereas the subfascial dissection requires an additional cut on the DTF to expose the zygomatic arch. Proper subperiosteal dissection on the zygomatic arch is another important step in FTB preservation. Conclusion Detailed understanding of the complex relationship of the tissue planes...... of the facial nerve was dissected and followed in its tissue planes on fresh-frozen cadaver heads. The interfascial and subfascial dissections were performed, and every step was photographed and examined. Results The interfascial dissection is safe to be started from the most anterior part of the superior...

  13. [Peripheral facial nerve palsy].

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    Pons, Y; Ukkola-Pons, E; Ballivet de Régloix, S; Champagne, C; Raynal, M; Lepage, P; Kossowski, M

    2013-06-01

    Facial palsy can be defined as a decrease in function of the facial nerve, the primary motor nerve of the facial muscles. When the facial palsy is peripheral, it affects both the superior and inferior areas of the face as opposed to central palsies, which affect only the inferior portion. The main cause of peripheral facial palsies is Bell's palsy, which remains a diagnosis of exclusion. The prognosis is good in most cases. In cases with significant cosmetic sequelae, a variety of surgical procedures are available (such as hypoglossal-facial anastomosis, temporalis myoplasty and Tenzel external canthopexy) to rehabilitate facial aesthetics and function.

  14. A Review of Facial Nerve Anatomy

    OpenAIRE

    2004-01-01

    An intimate knowledge of facial nerve anatomy is critical to avoid its inadvertent injury during rhytidectomy, parotidectomy, maxillofacial fracture reduction, and almost any surgery of the head and neck. Injury to the frontal and marginal mandibular branches of the facial nerve in particular can lead to obvious clinical deficits, and areas where these nerves are particularly susceptible to injury have been designated danger zones by previous authors. Assessment of facial nerve function is no...

  15. Anatomical considerations to prevent facial nerve injury.

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    Roostaeian, Jason; Rohrich, Rod J; Stuzin, James M

    2015-05-01

    Injury to the facial nerve during a face lift is a relatively rare but serious complication. A large body of literature has been dedicated toward bettering the understanding of the anatomical course of the facial nerve and the relative danger zones. Most of these prior reports, however, have focused on identifying the location of facial nerve branches based on their trajectory mostly in two dimensions and rarely in three dimensions. Unfortunately, the exact location of the facial nerve relative to palpable or visible facial landmarks is quite variable. Although the precise location of facial nerve branches is variable, its relationship to soft-tissue planes is relatively constant. The focus of this report is to improve understanding of facial soft-tissue anatomy so that safe planes of dissection during surgical undermining may be identified for each branch of the facial nerve. Certain anatomical locations more prone to injury and high-risk patient parameters are further emphasized to help minimize the risk of facial nerve injury during rhytidectomy.

  16. A review of facial nerve anatomy.

    Science.gov (United States)

    Myckatyn, Terence M; Mackinnon, Susan E

    2004-02-01

    An intimate knowledge of facial nerve anatomy is critical to avoid its inadvertent injury during rhytidectomy, parotidectomy, maxillofacial fracture reduction, and almost any surgery of the head and neck. Injury to the frontal and marginal mandibular branches of the facial nerve in particular can lead to obvious clinical deficits, and areas where these nerves are particularly susceptible to injury have been designated danger zones by previous authors. Assessment of facial nerve function is not limited to its extratemporal anatomy, however, as many clinical deficits originate within its intratemporal and intracranial components. Similarly, the facial nerve cannot be considered an exclusively motor nerve given its contributions to taste, auricular sensation, sympathetic input to the middle meningeal artery, and parasympathetic innervation to the lacrimal, submandibular, and sublingual glands. The constellation of deficits resulting from facial nerve injury is correlated with its complex anatomy to help establish the level of injury, predict recovery, and guide surgical management.

  17. Connections between the facial and trigeminal nerves: Anatomical basis for facial muscle proprioception

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    J.L. Cobo

    2017-06-01

    Full Text Available Proprioception is a quality of sensibility that originates in specialized sensory organs (proprioceptors that inform the central nervous system about static and dynamic conditions of muscles and joints. The facial muscles are innervated by efferent motor nerve fibers and typically lack proprioceptors. However, facial proprioception plays a key role in the regulation and coordination of the facial musculature and diverse reflexes. Thus, facial muscles must be necessarily supplied also for afferent sensory nerve fibers provided by other cranial nerves, especially the trigeminal nerve. Importantly, neuroanatomical studies have demonstrated that facial proprioceptive impulses are conveyed through branches of the trigeminal nerve to the central nervous system. The multiple communications between the facial and the trigeminal nerves are at the basis of these functional characteristics. Here we review the literature regarding the facial (superficial communications between the facial and the trigeminal nerves, update the current knowledge about proprioception in the facial muscles, and hypothesize future research in facial proprioception.

  18. Trigeminal neuralgia and facial nerve paralysis

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    Borges, Alexandra [IPOFG, Department of Radiology, Lisbon (Portugal)

    2005-03-01

    The trigeminal nerve is the largest of the cranial nerves. It provides sensory input from the face and motor innervation to the muscles of mastication. The facial nerve is the cranial nerve with the longest extracranial course, and its main functions include motor innervation to the muscles of facial expression, sensory control of lacrimation and salivation, control of the stapedial reflex and to carry taste sensation from the anterior two-thirds of the tongue. In order to be able adequately to image and follow the course of these cranial nerves and their main branches, a detailed knowledge of neuroanatomy is required. As we are dealing with very small anatomic structures, high resolution dedicated imaging studies are required to pick up normal and pathologic nerves. Whereas CT is best suited to demonstrate bony neurovascular foramina and canals, MRI is preferred to directly visualize the nerve. It is also the single technique able to detect pathologic processes afflicting the nerve without causing considerable expansion such as is usually the case in certain inflammatory/infectious conditions, perineural spread of malignancies and in very small intrinsic tumours. Because a long course from the brainstem nuclei to the peripheral branches is seen, it is useful to subdivide the nerve in several segments and then tailor the imaging modality and the imaging study to that specific segment. This is particularly true in cases where topographic diagnosis can be used to locate a lesion in the course of these nerves. (orig.)

  19. Pediatric facial nerve rehabilitation.

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    Banks, Caroline A; Hadlock, Tessa A

    2014-11-01

    Facial paralysis is a rare but severe condition in the pediatric population. Impaired facial movement has multiple causes and varied presentations, therefore individualized treatment plans are essential for optimal results. Advances in facial reanimation over the past 4 decades have given rise to new treatments designed to restore balance and function in pediatric patients with facial paralysis. This article provides a comprehensive review of pediatric facial rehabilitation and describes a zone-based approach to assessment and treatment of impaired facial movement.

  20. Imaging of the facial nerve

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    Veillon, F. [Service de Radiologie I, Hopital de Hautepierre, 67098 Strasbourg Cedex (France)], E-mail: Francis.Veillon@chru-strasbourg.fr; Ramos-Taboada, L.; Abu-Eid, M. [Service de Radiologie I, Hopital de Hautepierre, 67098 Strasbourg Cedex (France); Charpiot, A. [Service d' ORL, Hopital de Hautepierre, 67098 Strasbourg Cedex (France); Riehm, S. [Service de Radiologie I, Hopital de Hautepierre, 67098 Strasbourg Cedex (France)

    2010-05-15

    The facial nerve is responsible for the motor innervation of the face. It has a visceral motor function (lacrimal, submandibular, sublingual glands and secretion of the nose); it conveys a great part of the taste fibers, participates to the general sensory of the auricle (skin of the concha) and the wall of the external auditory meatus. The facial mimic, production of tears, nasal flow and salivation all depend on the facial nerve. In order to image the facial nerve it is mandatory to be knowledgeable about its normal anatomy including the course of its efferent and afferent fibers and about relevant technical considerations regarding CT and MR to be able to achieve high-resolution images of the nerve.

  1. Microsurgical anatomy and clinical significance of temporal branches of facial nerve%面神经颞支的显微解剖及其临床意义

    Institute of Scientific and Technical Information of China (English)

    孙永强; 杨雯雯; 梁宪斌

    2011-01-01

    目的 为防止涉及颞区的颅底手术损伤面神经颞支提供显微解剖学依据.方法 选用福尔马林固定的成人头颅标本20侧,应用颞下-耳前-颞下窝入路,在手术显微镜下模拟手术人路,解剖观察面神经颞支的分支数目、走行层次,测量颞支与所选标志点的关系.结果 ①面神经颞支越过颧弓时分为2~4支,其中85%为3支.②颞支距耳屏尖距离:最后支16.32±2.43mm,最前支31.30±2.64mm.③在颧弓上面神经颞支走行于颞浅筋膜深面.结论 面神经颞支在耳屏尖前颧弓表面16.32~31.30mm范围内较集中,相关手术应避免损伤.在颞深筋膜深层与颞肌之间分离颞肌可保护面神经颞支免受损伤.%Objective To provide anatomical basis for the preservation of the temporal branches of the facial nerve under operation on temporal region. Methods Ten adult cadaveric heads (20 sides) fixed in 10% formalin were examined using microsurgical techniques and instruments, including the operating microscope. Subtemporal - preauricular infratemporal fossa was selected to study. The number of the temporal branches of the facial nerve and its distribution were observed. The distances between the temporal branches and marking point selected were measured. Results ①The number of the temporal branches was 2 ~4 acrossing the zygomatic arch, and about 85% was 3.②The distances from the apex of tragus to the most posterior temporal branch, most anterior temporal branch were (16. 32 ±2. 43) mm, (31. 30 ±2. 64) mm, respectively. ③They ran between the superficial temporal fascia and the superficial layer of the deep temporal fascia after acrossing the zygomatic arch. Conclusions The temporal branches of the facial nerve cross zygomatic arch at the distance of 16. 32 ~ 31. 30mm before the tragus. It is safe to dissect in the plane between the deep layer of the deep temporal fascia and the temporal muscle.

  2. Facial nerve paralysis in children.

    Science.gov (United States)

    Ciorba, Andrea; Corazzi, Virginia; Conz, Veronica; Bianchini, Chiara; Aimoni, Claudia

    2015-12-16

    Facial nerve palsy is a condition with several implications, particularly when occurring in childhood. It represents a serious clinical problem as it causes significant concerns in doctors because of its etiology, its treatment options and its outcome, as well as in little patients and their parents, because of functional and aesthetic outcomes. There are several described causes of facial nerve paralysis in children, as it can be congenital (due to delivery traumas and genetic or malformative diseases) or acquired (due to infective, inflammatory, neoplastic, traumatic or iatrogenic causes). Nonetheless, in approximately 40%-75% of the cases, the cause of unilateral facial paralysis still remains idiopathic. A careful diagnostic workout and differential diagnosis are particularly recommended in case of pediatric facial nerve palsy, in order to establish the most appropriate treatment, as the therapeutic approach differs in relation to the etiology.

  3. Facial Nerve in Foetal Cadavers: An Anatomical Study with Clinical Relevance

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    Kotian SR

    2016-01-01

    Full Text Available Introduction: Facial nerve paralysis is a major complication of parotid surgery and is widely reported. Little attention is paid to the facial nerve trunk in children. The facial nerve trunk in children and infants can be easily injured since they lie close to the surface. The present study therefore intends to describe the variability in the facial nerve trunk and its branching pattern in foetuses. Methods: The study was done bilaterally in 30 formalin-fixed foetuses (15 females, 15 males, age ranging from 21.0 to 35.5 weeks of gestation. The length of the facial nerve trunk was measured and bifurcation and trifurcation of the trunk was examined. Variability in the branching pattern was also noted. Results: The most common facial nerve trunk branching type was bifurcation (53.33%, followed by trifurcation (33.33%. Multiple branching of the facial nerve was also observed in 13.34% of the cases. Other variations related to the facial nerve were also noted. The mean length of the facial nerve trunk was 7.15 ± 2.12 mm. There was no significant difference between the right and left sides and in case of males and female foetuses. Conclusion: Facial nerve injury during parotid surgery is a main cause of paediatric facial paralysis. The length of the facial nerve trunk therefore must be accurately known in any surgical procedure planned in the area. The main furcation of the facial nerve should also receive special attention.

  4. The Dehiscent Facial Nerve Canal

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    Sertac Yetiser

    2012-01-01

    Full Text Available Accidental injury to the facial nerve where the bony canal defects are present may result with facial nerve dysfunction during otological surgery. Therefore, it is critical to know the incidence and the type of facial nerve dehiscences in the presence of normal development of the facial canal. The aim of this study is to review the site and the type of such bony defects in 144 patients operated for facial paralysis, myringoplasty, stapedotomy, middle ear exploration for sudden hearing loss, and so forth, other than chronic suppurative otitis media with or without cholesteatoma, middle ear tumors, and anomaly. Correlation of intraoperative findings with preoperative computerized tomography was also analyzed in 35 patients. Conclusively, one out of every 10 surgical cases may have dehiscence of the facial canal which has to be always borne in mind during surgical manipulation of the middle ear. Computerized tomography has some limitations to evaluate the dehiscent facial canal due to high false negative and positive rates.

  5. Altered prosaposin expression in the rat facial nerve nucleus following facial nerve transection and repair

    Institute of Scientific and Technical Information of China (English)

    Dong Wang; Wenlong Luo; Cuiying Zhou; Jingjing Li

    2009-01-01

    BACKGROUND: Studies have demonstrated that damaged facial nerves synthesize prosaposin to promote repair of facial neurons.OBJECTIVE: To observe time-course changes of prosaposin expression in the facial nerve nucleus of Sprague Dawley rats following facial nerve transection and repair.DESIGN, TIME AND SETTING: A randomized control neuropathological animal experiment was performed in Chongqing Medical University between March 2007 and September 2008.MATERIALS: A total of 48 adult, male, Sprague Dawley rats were selected and randomly divided into transection and transection + end-to-end anastomosis groups (n =24). Rabbit anti-rat prosaposin antibody, instant SABC immunohistochemical kit, and antibody dilution solution were purchased from Wuhan Uscn Science Co., Ltd., China.METHODS: In the transection group, the nerve trunk of the distal retroauricular branch of the left facial nerves was ligated in Sprague Dawley rats, and a 5-mm nerve trunk at the distal end of the ligation site was removed. In the transection + end-to-end anastomosis group, epineurial anastomosis was performed immediately following transection of the left facial nerves. The right facial nerves in the two groups sewed as the normal control group.MAIN OUTCOME MEASURES: The number of prosaposin-positive neurons, as well as intensity of immunostaining in facial nerve nucleus, following transection and end-to-end anastomosis were determined by immunohistochemistry at 1,3, 7, 14, 21, and 35 days after injury.RESULTS: Transection group: transection of facial nerves resulted in increased number of prosaposin-positive neurons and immunoreactivity intensity in the facial nucleus on day 1. These values significantly increased by day 3. Expression was greater than in the control side. The peak of the reduction was reached at 7 days post-surgery. Transection + end-to-end anastomosis group: the number of prosaposin-positive neurons and immunoreactivity intensity was reduced in the facial nerve nucleus following

  6. 3D-FIESTA MRI at 3 T demonstrating branches of the intraparotid facial nerve, parotid ducts and relation with benign parotid tumours.

    Science.gov (United States)

    Li, Chuanting; Li, Yan; Zhang, Dongsheng; Yang, Zhenzhen; Wu, Lebin

    2012-11-01

    To investigate the usefulness of three-dimensional (3D) fast imaging employing steady state precession (FIESTA) magnetic resonance imaging (MRI) at 3 T in evaluating the intraparotid components of the facial nerve and parotid ducts, and to compare the MRI images with surgical findings. Thirty-one cases of benign parotid tumours were studied with conventional and 3D FIESTA MRI sequences at 3T using a head coil. The most clinically useful 3D FIESTA images were acquired at parameters of 4.9 ms repetition time (TR); 1.5 effective echo time (TEeff); a flip of 55°, a field of view of 18 to 20 cm, a matrix of 512 × 320, an axial plane, no gaps, and a section thickness of 1 mm. Post-processed multiplanar images were obtained with an Advantage Windows (AW sdc 4.3) workstation. Parotid ducts, facial nerves, and tumours were identified on these images. The relationship of the tumours to the facial nerves and parotid ducts was confirmed at surgery. The facial nerves appeared as linear structures of low intensity. The main trunk of the facial nerve was identified bilaterally in 93.5% of the 3D-FIESTA sequence images. Parotid ducts appeared as structures of high intensity on multiplanar 3D-FIESTA images (100%). The relationships of the tumours with the cervicofacial and temporofacial divisions of the facial nerve were correctly diagnosed in 26 of 31 cases (83.9%) using 3D-FIESTA sequence images. 3D-FIESTA MRI at 3 T depicted the main trunk, cervicofacial and temporofacial divisions of the facial nerve, and the main parotid duct. It is useful for preoperative evaluation of parotid gland tumours. Copyright © 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  7. Facial nerve palsy due to birth trauma

    Science.gov (United States)

    Seventh cranial nerve palsy due to birth trauma; Facial palsy - birth trauma; Facial palsy - neonate; Facial palsy - infant ... this condition. Some factors that can cause birth trauma (injury) include: Large baby size (may be seen ...

  8. Facial Nerve Palsy In Secondary Syphilis

    Directory of Open Access Journals (Sweden)

    Masuria B.L

    1999-01-01

    Full Text Available A case of secondary syphilis with right facial nerve palsy is reported. A 28 year old unmarried male presented with diffuse maculopapular rash and facial nerve palsy. He had elevated while cells and protein in cerebrospinal fluid. Serum and cerebrospinal fluid were positive for VDRL and TPHA tests. Facial nerve palsy and maculopapular rash improved with penicillin therapy.

  9. Parotid lymphangioma associated with facial nerve paralysis.

    Science.gov (United States)

    Imaizumi, Mitsuyoshi; Tani, Akiko; Ogawa, Hiroshi; Omori, Koichi

    2014-10-01

    Parotid lymphangioma is a relatively rare disease that is usually detected in infancy or early childhood, and which has typical features. Clinical reports of facial nerve paralysis caused by lymphangioma, however, are very rare. Usually, facial nerve paralysis in a child suggests malignancy. Here we report a very rare case of parotid lymphangioma associated with facial nerve paralysis. A 7-year-old boy was admitted to hospital with a rapidly enlarging mass in the left parotid region. Left peripheral-type facial nerve paralysis was also noted. Computed tomography and magnetic resonance imaging also revealed multiple cystic lesions. Open biopsy was undertaken in order to investigate the cause of the facial nerve paralysis. The histopathological findings of the excised tumor were consistent with lymphangioma. Prednisone (40 mg/day) was given in a tapering dose schedule. Facial nerve paralysis was completely cured 1 month after treatment. There has been no recurrent facial nerve paralysis for eight years.

  10. [Dynamics of lagophthalmos depending on facial nerve repair and its intraoperative monitoring in neurosurgical patients].

    Science.gov (United States)

    Tabachnikova, T V; Serova, N K; Shimansky, V N

    2014-01-01

    Over 200 patients with acoustic neuromas and over 100 patients with posterior cranial fossa meningiomas are annually operated on at the N.N. Burdenko Neurosurgical Institute. Intraoperative monitoring of the facial nerve function is used in most patients with tumors of the posterior cranial fossa to identify the facial nerve in the surgical wound. If the anatomical integrity of the facial nerve in the cranial cavity cannot be retained, facial nerve repair is performed to restore the facial muscle function. Intraoperative electrical stimulation of the facial nerve has a great prognostic significance to evaluate the dynamics of lagophthalmos in the late postoperative period and to select the proper method for lagophthalmos correction. When the facial nerve was reinnervated by the descending branch or trunk of the hypoglossal nerve, sufficient eyelid closure was observed only in 3 patients out of 17.

  11. Chitosan conduits combined with nerve growth factor microspheres repair facial nerve defects

    Institute of Scientific and Technical Information of China (English)

    Huawei Liu; Weisheng Wen; Min Hu; Wenting Bi; Lijie Chen; Sanxia Liu; Peng Chen; Xinying Tan

    2013-01-01

    Microspheres containing nerve growth factor for sustained release were prepared by a compound method, and implanted into chitosan conduits to repair 10-mm defects on the right buccal branches of the facial nerve in rabbits. In addition, chitosan conduits combined with nerve growth factor or normal saline, as wel as autologous nerve, were used as controls. At 90 days post-surgery, the muscular atrophy on the right upper lip was more evident in the nerve growth factor and normal sa-line groups than in the nerve growth factor-microspheres and autologous nerve groups. Electro-physiological analysis revealed that the nerve conduction velocity and amplitude were significantly higher in the nerve growth factor-microspheres and autologous nerve groups than in the nerve growth factor and normal saline groups. Moreover, histological observation il ustrated that the di-ameter, number, alignment and myelin sheath thickness of myelinated nerves derived from rabbits were higher in the nerve growth factor-microspheres and autologous nerve groups than in the nerve growth factor and normal saline groups. These findings indicate that chitosan nerve conduits com-bined with microspheres for sustained release of nerve growth factor can significantly improve facial nerve defect repair in rabbits.

  12. Anatomical study of the variations in innervation of the orbicularis oculi by the facial nerve.

    Science.gov (United States)

    Ouattara, D; Vacher, C; de Vasconcellos, J-J Accioli; Kassanyou, S; Gnanazan, G; N'Guessan, B

    2004-02-01

    While the divisions of the facial nerve in the face are well known, the innervation of the orbicularis oculi by the different distal branches of the facial nerve is poorly described. To determine which branches of the facial nerve play a role in this innervation, the facial nerve was dissected in 30 fresh cadavers. The innervation of this muscle was in the form of two plexuses, a superior one, most often (93%) formed by the union of the temporal and superior zygomatic branches, and an inferior one, usually formed (63%) by the union of the inferior zygomatic and superior buccal branches. This new mode of innervation explains how, without damage to both plexuses, innervation of orbicularis oculi by the facial nerve remains functional. It also explains the often unsatisfactory results of treatment of primary blepharospasm, and the unusual character of palsies of this muscle in cervicofacial lifts.

  13. Immunobiology of Facial Nerve Repair and Regeneration

    Institute of Scientific and Technical Information of China (English)

    QUAN Shi-ming; GAO Zhi-qiang

    2006-01-01

    Immunobiological study is a key to revealing the important basis of facial nerve repair and regeneration for both research and development of clinic treatments. The microenvironmental changes around an injuried facial motoneuron, i.e., the aggregation and expression of various types of immune cells and molecules in a dynamic equilibrium, impenetrate from the start to the end of the repair of an injured facial nerve. The concept of "immune microenvironment for facial nerve repair and regeneration", mainly concerns with the dynamic exchange between expression and regulation networks and a variaty of immune cells and immune molecules in the process of facial nerve repair and regeneration for the maintenance of a immune microenvironment favorable for nerve repair.Investigation on microglial activation and recruitment, T cell behavior, cytokine networks, and immunological cellular and molecular signaling pathways in facial nerve repair and regeneration are the current hot spots in the research on immunobiology of facial nerve injury. The current paper provides a comprehensive review of the above mentioned issues. Research of these issues will eventually make immunological interventions practicable treatments for facial nerve injury in the clinic.

  14. [Motor nerves of the face. Surgical and radiologic anatomy of facial paralysis and their surgical repair].

    Science.gov (United States)

    Vacher, C; Cyna-Gorse, F

    2015-10-01

    Motor innervation of the face depends on the facial nerve for the mobility of the face, on the mandibular nerve, third branch of the trigeminal nerve, which gives the motor innervation of the masticator muscles, and the hypoglossal nerve for the tongue. In case of facial paralysis, the most common palliative surgical techniques are the lengthening temporalis myoplasty (the temporal is innervated by the mandibular nerve) and the hypoglossal-facial anastomosis. The aim of this work is to describe the surgical anatomy of these three nerves and the radiologic anatomy of the facial nerve inside the temporal bone. Then the facial nerve penetrates inside the parotid gland giving a plexus. Four branches of the facial nerve leave the parotid gland: they are called temporal, zygomatic, buccal and marginal which give innervation to the cutaneous muscles of the face. Mandibular nerve gives three branches to the temporal muscles: the anterior, intermediate and posterior deep temporal nerves which penetrate inside the deep aspect of the temporal muscle in front of the infratemporal line. The hypoglossal nerve is only the motor nerve to the tongue. The ansa cervicalis, which is coming from the superficial cervical plexus and joins the hypoglossal nerve in the submandibular area is giving the motor innervation to subhyoid muscles and to the geniohyoid muscle.

  15. MRI of the facial nerve in idiopathic facial palsy

    Energy Technology Data Exchange (ETDEWEB)

    Saatci, I. [Dept. of Radiology, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey); Sahintuerk, F. [Dept. of Radiology, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey); Sennaroglu, L. [Dept. of Otolaryngology, Head and Neck Surgery, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey); Boyvat, F. [Dept. of Radiology, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey); Guersel, B. [Dept. of Otolaryngology, Head and Neck Surgery, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey); Besim, A. [Dept. of Radiology, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey)

    1996-10-01

    The purpose of this prospective study was to define the enhancement pattern of the facial nerve in idiopathic facial paralysis (Bell`s palsy) on magnetic resonance (MR) imaging with routine doses of gadolinium-DTPA (0.1 mmol/kg). Using 0.5 T imager, 24 patients were examined with a mean interval time of 13.7 days between the onset of symptoms and the MR examination. Contralateral asymptomatic facial nerves constituted the control group and five of the normal facial nerves (20.8%) showed enhancement confined to the geniculate ganglion. Hence, contrast enhancement limited to the geniculate ganglion in the abnormal facial nerve (3 of 24) was referred to a equivocal. Not encountered in any of the normal facial nerves, enhancement of other segments alone or associated with geniculate ganglion enhancement was considered to be abnormal and noted in 70.8% of the symptomatic facial nerves. The most frequently enhancing segments were the geniculate ganglion and the distal intracanalicular segment. (orig.)

  16. Promising Technique for Facial Nerve Reconstruction in Extended Parotidectomy

    Directory of Open Access Journals (Sweden)

    Ithzel Maria Villarreal

    2015-11-01

    Full Text Available Introduction: Malignant tumors of the parotid gland account scarcely for 5% of all head and neck tumors. Most of these neoplasms have a high tendency for recurrence, local infiltration, perineural extension, and metastasis. Although uncommon, these malignant tumors require complex surgical treatment sometimes involving a total parotidectomy including a complete facial nerve resection. Severe functional and aesthetic facial defects are the result of a complete sacrifice or injury to isolated branches becoming an uncomfortable distress for patients and a major challenge for reconstructive surgeons.   Case Report: A case of a 54-year-old, systemically healthy male patient with a 4 month complaint of pain and swelling on the right side of the face is presented. The patient reported a rapid increase in the size of the lesion over the past 2 months. Imaging tests and histopathological analysis reported an adenoid cystic carcinoma. A complete parotidectomy was carried out with an intraoperative notice of facial nerve infiltration requiring a second intervention for nerve and defect reconstruction. A free ALT flap with vascularized nerve grafts was the surgical choice. A 6 month follow-up showed partial facial movement recovery and the facial defect mended.   Conclusion:  It is of critical importance to restore function to patients with facial nerve injury.  Vascularized nerve grafts, in many clinical and experimental studies, have shown to result in better nerve regeneration than conventional non-vascularized nerve grafts. Nevertheless, there are factors that may affect the degree, speed and regeneration rate regarding the free fasciocutaneous flap. In complex head and neck defects following a total parotidectomy, the extended free fasciocutaneous ALT (anterior-lateral thigh flap with a vascularized nerve graft is ideally suited for the reconstruction of the injured site.  Donor–site morbidity is low and additional surgical time is minimal

  17. Promising Technique for Facial Nerve Reconstruction in Extended Parotidectomy

    Science.gov (United States)

    Villarreal, Ithzel Maria; Rodríguez-Valiente, Antonio; Castelló, Jose Ramon; Górriz, Carmen; Montero, Oscar Alvarez; García-Berrocal, Jose Ramon

    2015-01-01

    Introduction: Malignant tumors of the parotid gland account scarcely for 5% of all head and neck tumors. Most of these neoplasms have a high tendency for recurrence, local infiltration, perineural extension, and metastasis. Although uncommon, these malignant tumors require complex surgical treatment sometimes involving a total parotidectomy including a complete facial nerve resection. Severe functional and aesthetic facial defects are the result of a complete sacrifice or injury to isolated branches becoming an uncomfortable distress for patients and a major challenge for reconstructive surgeons. Case Report: A case of a 54-year-old, systemically healthy male patient with a 4 month complaint of pain and swelling on the right side of the face is presented. The patient reported a rapid increase in the size of the lesion over the past 2 months. Imaging tests and histopathological analysis reported an adenoid cystic carcinoma. A complete parotidectomy was carried out with an intraoperative notice of facial nerve infiltration requiring a second intervention for nerve and defect reconstruction. A free ALT flap with vascularized nerve grafts was the surgical choice. A 6 month follow-up showed partial facial movement recovery and the facial defect mended. Conclusion: It is of critical importance to restore function to patients with facial nerve injury. Vascularized nerve grafts, in many clinical and experimental studies, have shown to result in better nerve regeneration than conventional non-vascularized nerve grafts. Nevertheless, there are factors that may affect the degree, speed and regeneration rate regarding the free fasciocutaneous flap. In complex head and neck defects following a total parotidectomy, the extended free fasciocutaneous ALT (anterior-lateral thigh) flap with a vascularized nerve graft is ideally suited for the reconstruction of the injured site. Donor–site morbidity is low and additional surgical time is minimal compared with the time of a single

  18. Adenoid cystic carcinoma of the parotid gland: Anastamosis of the facial nerve with the great auricular nerve after radical parotidectomy

    Directory of Open Access Journals (Sweden)

    Bahadir Osman

    2008-01-01

    Full Text Available Adenoid cystic carcinoma of the parotid gland is a rare and slowly growing, but highly malignant tumor. Surgical resection of a malignant parotid tumor should include resection of the facial nerve when the nerve is involved in the tumor. Facial nerve reconstruction is required after nerve resection. A 14 year-old female presented with complaints of painless enlargement of the right parotid gland and facial asymmetry. Physical examination revealed a firm mass in the region of the parotid gland as well as right facial paralysis. Biopsy obtained from the mass showed an adenoid cystic carcinoma of the parotid gland. A radical parotidectomy with a modified radical neck dissection was carried out. Grafting material for the facial reconstruction was harvested from the great auricular nerve. The proximal main trunk and each distal branch of the facial nerve were coapted with the greater auricular nerve. The patient received radiotherapy after surgery and was seen to achieve grade IV facial function one year after surgery. Thus, the great auricular nerve is appropriate grafting material for coaptation of each distal branch of the facial nerve.

  19. Facial nerve paralysis after cervical traction.

    Science.gov (United States)

    So, Edmund Cheung

    2010-10-01

    Cervical traction is a frequently used treatment in rehabilitation clinics for cervical spine problems. This modality works, in principle, by decompressing the spinal cord or its nerve roots by applying traction on the cervical spine through a harness placed over the mandible (Olivero et al., Neurosurg Focus 2002;12:ECP1). Previous reports on treatment complications include lumbar radicular discomfort, muscle injury, neck soreness, and posttraction pain (LaBan et al., Arch Phys Med Rehabil 1992;73:295-6; Lee et al., J Biomech Eng 1996;118:597-600). Here, we report the first case of unilateral facial nerve paralysis developed after 4 wks of intermittent cervical traction therapy. Nerve conduction velocity examination revealed a peripheral-type facial nerve paralysis. Symptoms of facial nerve paralysis subsided after prednisolone treatment and suspension of traction therapy. It is suspected that a misplaced or an overstrained harness may have been the cause of facial nerve paralysis in this patient. Possible causes were (1) direct compression by the harness on the right facial nerve near its exit through the stylomastoid foramen; (2) compression of the right external carotid artery by the harness, causing transient ischemic injury at the geniculate ganglion; or (3) coincidental herpes zoster virus infection or idiopathic Bell's palsy involving the facial nerve.

  20. Degeneration and regeneration of motor and sensory nerves: a stereological study of crush lesions in rat facial and mental nerves

    DEFF Research Database (Denmark)

    Barghash, Ziad; Larsen, Jytte Overgaard; Al-Bishri, Awad

    2013-01-01

    The aim of this study was to evaluate the degeneration and regeneration of a sensory nerve and a motor nerve at the histological level after a crush injury. Twenty-five female Wistar rats had their mental nerve and the buccal branch of their facial nerve compressed unilaterally against a glass rod...... in the degenerative pattern; however, at day 19 the buccal branch had regenerated to the normal number of axons, whereas the mental nerve had only regained 50% of the normal number of axons. We conclude that the regenerative process is faster and/or more complete in the facial nerve (motor function) than...... for 30 s. Specimens of the compressed nerves and the corresponding control nerves were dissected at 3, 7, and 19 days after surgery. Nerve cross-sections were stained with osmium tetroxide and toluidine blue and analysed using two-dimensional stereology. We found differences between the two nerves both...

  1. Intratemporal Hemangiomas Involving the Facial Nerve

    Science.gov (United States)

    Bhatia, Sanjaya; Karmarkar, Sandeep; Calabrese, V.; Landolfi, Mauro; Taibah, Abdelkader; Russo, Alessandra; Mazzoni, Antonio; Sanna, Mario

    1995-01-01

    Intratemporal vascular tumors involving the facial nerve are rare benign lesions. Because of their variable clinical features, they are often misdiagnosed preoperatively. This study presents a series of 21 patients with such lesions managed from 1977 to 1994. Facial nerve dysfunction was the most common complaint, present in 60% of the cases, followed by hearing loss, present in 40% of cases. High-resolution computed tomography, magnetic resonance imaging with gadolinium, and a high index of clinical suspicion is required for preoperative diagnosis of these lesions. Early surgical resection of these tumors permits acceptable return of facial nerve function in many patients. ImagesFigure 1Figure 2Figure 3 PMID:17170963

  2. Significance of the Analysis of Early Motor Conduction of Facial Nerve Branches in Patients with Bell's Paralysis%贝尔麻痹患者早期面神经运动传导检测的临床意义

    Institute of Scientific and Technical Information of China (English)

    周敏杰; 卢娜; 周玲; 沈瑛

    2011-01-01

    目的 分析贝尔麻痹(Bell's麻痹)患者早期面神经运动传导检测指标,探讨其在贝尔麻痹早期诊断中的作用.方法 对22例贝尔麻痹患者在起病1周内进行双侧面神经运动传导对比检测,比较患、健侧面神经运动传导动作电位潜伏期、波幅,分析其与早期诊断的关系.结果 22例患者双侧面神经各支均引出运动传导动作电位,患侧面神经各支动作电位波幅较健侧明显下降,差异有统计学意义(P<0.05);患侧面神经各支动作电位潜伏期与健侧相比,差异无统计学意义(P>0.05).结论 面神经颞支和颊支的运动传导波幅检测可作为面神经损伤的早期诊断指标之一.颧支受累较颞支和颊支相对少,它是否能作为损伤程度及预后判定的指标尚需进一步观察.%Objective To analyze the indicators of motor conduction of facial nerve branches in patients with Bell's paralysis , and discuss the function of motor conduction in the early diagnosis. Methods The motor conduction of healthy and affected sides in 22 patients with Bell's paralysis were detected and compared one week within onset. Compare the latent period and wave amplitude of the two sides as well as its relation with early diagnosis in both sides. Results The wave amplitude was detected in all patients, and the amplitude of facial nerve in affected side declined. There was a significant difference in wave amplitude between the affected side and unaffected side ( P <0. 05 ). The latency of facial nerve in both sides showed no statistical difference ( P >0. 05 ). Conclusion The wave amplitude in action potentials of temporal and buccal branches of facial nerve is one of the objective indexes for the early diagnosis of Bell's paralysis. Further observation is needed to determine whether it can be an index for injury level and prognosis.

  3. Reanimation of reversible facial paralysis by the double innervation technique using an intraneural-dissected sural nerve graft.

    Science.gov (United States)

    Tomita, Koichi; Hosokawa, Ko; Yano, Kenji

    2010-06-01

    In treating reversible facial paralysis, cross-facial nerve grafting offers voluntary and emotional reanimation. In contrast, rapid re-innervation and strong neural stimulation can be obtained with hypoglossal-facial nerve crossover. In this article, we describe the method of a combination of these techniques as a one-stage procedure. A 39-year-old man presented with facial paralysis due to nerve avulsion within the stylomastoid foramen. The sural nerve was harvested and two branches were created at its distal end by intraneural dissection. One branch was anastomosed to the contralateral facial nerve, and the other branch was used for hypoglossal-facial nerve crossover, followed by connecting the proximal stump of the graft to the trunk of the paralysed facial nerve in an end-to-end fashion. At 9 months postoperatively, almost complete facial symmetry and co-ordinated movements of the mimetic muscles were obtained with no obvious tongue atrophy. Since our method can efficiently gather neural inputs from the contralateral facial nerve and the ipsilateral hypoglossal nerve, it may become a good alternative for reanimation of reversible facial paralysis when the ipsilateral facial nerve is not available.

  4. 3 dimensional volume MR imaging of intratemporal facial nerve

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jeong Jin; Kang, Heoung Keun; Kim, Hyun Ju; Kim, Jae Kyu; Jung, Hyun Ung; Moon, Woong Jae [Chonnam University Medical School, Kwangju (Korea, Republic of)

    1994-10-15

    To evaluate the usefulness of 3 dimensional volume MR imaging technique for demonstrating the facial nerves and to describe MR findings in facial palsy patients and evaluate the significance of facial nerve enhancement. We reviewed the MR images of facial nerves obtained with 3 dimensional volume imaging technique before and after intravenous administration of Gadopentetate dimeglumine in 13 cases who had facial paralysis and 33 cases who had no facial palsy. And we analyzed the detectability of ananatomical segments of intratemporal facial nerves and facial nerve enhancement. When the 3 dimensional volume MR images of 46 nerves were analyzed subjectively, the nerve courses of 43(93%) of 46 nerves were effectively demonstrated on 3 dimensional volume MR images. Internal acoustic canal portions and geniculate ganglion of facial nerve were well visualized on axial images and tympanic and mastoid segments were well depicted on oblique sagittal images. 10 of 13 patients(77%) were visibly enhanced along at least one segment of the facial nerve with swelling or thickening, and nerves of 8 of normal 33 cases(24%) were enhanced without thickening or swelling. MR findings of facial nerve parelysis is asymmetrical thickening of facial nerve with contrast enhancement. The 3 dimensional volume MR imaging technique should be a useful study for the evaluation of intratemporal facial nerve disease.

  5. Anatomic relationship between first interlobar duct of superficial parotid and zygomatic branch of facial nerve%腮腺浅部第1叶间导管与面神经颧支的解剖学关系

    Institute of Scientific and Technical Information of China (English)

    罗特坚; 曹妍群; 刘冬强; 易德保

    2013-01-01

    目的探讨腮腺叶间导管转移治疗干眼病的解剖学基础。方法对5具(10侧)成人尸体标本头面部腮腺区进行局部解剖,观察腮腺第1叶间导管与面神经颧支的关系,测量两者的相关数据。结果腮腺浅部第1叶间导管长度为(37.51±1.23) mm,注入腮腺导管处的外径为(0.53±0.15) mm。面神经颧支与腮腺第1叶间导管逆向而行,两者解剖关系密切。结论腮腺叶间导管转位治疗干眼病手术方式可供临床参考。%Objective To provide the anatomic basis of transferring the lobe of parotid gland duct for the treatment of dry eye disease. Methods The first interlobar parotid gland duct and zygomatic branch of facial nerve were dissected and observed on parotid gland region of head and face of 5 (10 sides) of adult head specimens. the measurement data was recorded. Results The length of first interlobar duct of superficial parotid was (37. 51±1. 23) mm, the outside diameter of injected parotid duct was (0. 53±0. 15) mm. There was a close ana-tomical relationship between zygomatic branch of facial nerve and first interlobar duct of parotid gland. Conclusion the parotid interlobar duct transposition operation has the reference value in treatment of dry eye desease.

  6. Facial nerve palsy and hemifacial spasm.

    Science.gov (United States)

    Valls-Solé, Josep

    2013-01-01

    Facial nerve lesions are usually benign conditions even though patients may present with emotional distress. Facial palsy usually resolves in 3-6 weeks, but if axonal degeneration takes place, it is likely that the patient will end up with a postparalytic facial syndrome featuring synkinesis, myokymic discharges, and hemifacial mass contractions after abnormal reinnervation. Essential hemifacial spasm is one form of facial hyperactivity that must be distinguished from synkinesis after facial palsy and also from other forms of facial dyskinesias. In this condition, there can be ectopic discharges, ephaptic transmission, and lateral spread of excitation among nerve fibers, giving rise to involuntary muscle twitching and spasms. Electrodiagnostic assessment is of relevance for the diagnosis and prognosis of peripheral facial palsy and hemifacial spasm. In this chapter the most relevant clinical and electrodiagnostic aspects of the two disorders are reviewed, with emphasis on the various stages of facial palsy after axonal degeneration, the pathophysiological mechanisms underlying the various features of hemifacial spasm, and the cues for differential diagnosis between the two entities.

  7. Repair of ocular-oral synkinesis of postfacial paralysis using cross-facial nerve grafting.

    Science.gov (United States)

    Zhang, Bo; Yang, Chuan; Wang, Wei; Li, Wei

    2010-08-01

    We present the surgical techniques and results of cross-facial nerve grafting that have been developed in the repair of ocular-oral synkinesis after facial paralysis. Eleven patients with ocular-oral synkinesis after facial paralysis underwent the cross-facial nerve grafting with facial nerve transposition at a tertiary academic hospital between 2003 and 2009. The patient selection for the study was based on the degree of disfigurement and facial function parameter rating using the Toronto Facial Grading System. The procedures used were surgeries done in two stages. All cases were followed up for 2 months to 6 years after the second surgery. The degree of improvement was evaluated at 6 to 7 months after the procedures. Six of the patients were followed up for more than 2 years after the stage-two surgery and demonstrated significant reduction in the ocular-oral synkinetic movements. The Toronto Facial Grading System scores from the postoperative follow-ups increased an average of 16 points (28%), and the patients had achieved symmetrical facial movement. We concluded that cross-facial nerve grafting with facial nerve branch transposition is effective and can be considered as an option for the repair of ocular-oral synkinesis after facial paralysis in select patients.

  8. Terminal Branch of Recurrent Human Laryngeal Nerve

    Directory of Open Access Journals (Sweden)

    Andréa Aparecida Ferreira Pascoal

    2014-01-01

    Full Text Available The importance of the recurrent laryngeal nerve in surgery on the anterior region of the neck has motivated many published papers on critical points of its pathway, relationship with the inferior thyroid artery, penetration in the larynx, division outside the larynx, and branches communicating with the internal branch of the superior laryngeal nerve. We analyze the terminal branches of the recurrent laryngeal nerve and their distribution through the laryngeal muscles. 44 laryngeal nerves had been dissected. Most frequently, the recurrent laryngeal nerve presents a division below or at the level of the lower margin of the cricoid cartilage (outside the larynx. One of these branches forms the communication with the internal branch of the superior laryngeal nerve, and the other penetrates the laryngeal space. Above the lower margin of the cricoid cartilage, the inferior laryngeal nerve issues a variable number of branches to muscles (3 to 7: to the posterior cricoarytenoid muscle; to the oblique and transversal arytenoid muscles; and to the lateral cricoarytenoid muscle and the thyroarytenoid muscle.

  9. Peripheral facial nerve palsy after therapeutic endoscopy.

    Science.gov (United States)

    Kim, Eun Jeong; Lee, Jun; Lee, Ji Woon; Lee, Jun Hyung; Park, Chol Jin; Kim, Young Dae; Lee, Hyun Jin

    2015-03-01

    Peripheral facial nerve palsy (FNP) is a mononeuropathy that affects the peripheral part of the facial nerve. Primary causes of peripheral FNP remain largely unknown, but detectable causes include systemic infections (viral and others), trauma, ischemia, tumor, and extrinsic compression. Peripheral FNP in relation to extrinsic compression has rarely been described in case reports. Here, we report a case of a 71-year-old man who was diagnosed with peripheral FNP following endoscopic submucosal dissection. This case is the first report of the development of peripheral FNP in a patient undergoing therapeutic endoscopy. We emphasize the fact that physicians should be attentive to the development of peripheral FNP following therapeutic endoscopy.

  10. Intraparotid facial nerve schwannoma: Report of two cases

    Directory of Open Access Journals (Sweden)

    Seyyed Basir Hashemi

    2008-07-01

    Full Text Available Introduction: Intra parotid facial nerve schowannoma is a rare tumor. Case report: In this article we presented two cases of intra parotid facial nerve schowannoma. In two cases tumor presented with asymptomatic parotid mass that mimic pleomorphic adenoma. No preoperative facial nerve dysfunction in cases is detected. Diagnostic result and surgical management are discussed in this paper.  

  11. Long-term subjective and objective outcome after primary repair of traumatic facial nerve injuries.

    Science.gov (United States)

    Frijters, Erik; Hofer, Stefan O P; Mureau, Marc A M

    2008-08-01

    Although traumatic facial nerve paralysis is a severe handicap, there are no follow-up studies evaluating outcome after primary repair of traumatic facial nerve injuries. From May 1988 to August 2005, 27 patients (mean age, 27 years) were operated for traumatic facial nerve lesions (mean number of affected branches, 2.2). End-to-end facial nerve repair was always performed. All patients were invited to our outpatient clinic for standardized questionnaires (Facial Disability Index, Short Form-36 Health Survey), physical examination (Sunnybrook Facial Grading System), and clinical photographs. Sixteen patients participated in the follow-up study (mean, 9.2 years). Mean Facial Disability Index Physical and Social scores were 86 and 81, respectively, indicating good subjective facial functioning. The mean Sunnybrook Facial Grading System score was 74 indicating adequate facial functioning. Mean physical and mental health scores (Short Form-36 Health Survey) were comparable with normative data. Primary end-to-end repair of traumatic facial nerve injuries results in good long-term objective and subjective functional and emotional outcome.

  12. The Angle at Which the Facial Nerve Leaves the Mastoid

    OpenAIRE

    Holt, James J.

    1991-01-01

    Some skull base procedures require extensive dissection of the facial nerve. This can be difficult at the mastoid tip, where the nerve is approximated to soft tissues. The nerve was dissected in this area in 15 cadaver specimens. The mean angle at which the facial nerve leaves the mastoid tip in 117°. This information should aid the skull base surgeon in the identification of the facial nerve at the mastoid tip.

  13. Facial Nerve Paralysis due to a Pleomorphic Adenoma with the Imaging Characteristics of a Facial Nerve Schwannoma.

    Science.gov (United States)

    Nader, Marc-Elie; Bell, Diana; Sturgis, Erich M; Ginsberg, Lawrence E; Gidley, Paul W

    2014-08-01

    Background Facial nerve paralysis in a patient with a salivary gland mass usually denotes malignancy. However, facial paralysis can also be caused by benign salivary gland tumors. Methods We present a case of facial nerve paralysis due to a benign salivary gland tumor that had the imaging characteristics of an intraparotid facial nerve schwannoma. Results The patient presented to our clinic 4 years after the onset of facial nerve paralysis initially diagnosed as Bell palsy. Computed tomography demonstrated filling and erosion of the stylomastoid foramen with a mass on the facial nerve. Postoperative histopathology showed the presence of a pleomorphic adenoma. Facial paralysis was thought to be caused by extrinsic nerve compression. Conclusions This case illustrates the difficulty of accurate preoperative diagnosis of a parotid gland mass and reinforces the concept that facial nerve paralysis in the context of salivary gland tumors may not always indicate malignancy.

  14. The surgical anatomy of the cervical distribution of the facial nerve.

    Science.gov (United States)

    Ziarah, H A; Atkinson, M E

    1981-09-01

    In an attempt to improve the safety of the submandibular approach to the mandible and submandibular anatomical dissections of 100 facial halves were undertaken. Observations were made on the course of the cervical branch of the facial nerve in relation to bony and soft tissue landmarks and fascial planes. The course of the nerve and its relation to the platysma muscle and investing fascia dictate the placement and depth of incision used for the submandibular approach.

  15. Nerve repair and cable grafting for facial paralysis.

    Science.gov (United States)

    Humphrey, Clinton D; Kriet, J David

    2008-05-01

    Facial nerve injury and facial paralysis are devastating for patients. Although imperfect, primary repair is currently the best option to restore facial nerve function. Cable, or interposition, nerve grafting is an acceptable alternative when primary repair is not possible. Several donor nerves are at the surgeon's disposal. Great auricular, sural, or medial and lateral antebrachial cutaneous nerves are all easily obtained. Both primary repair and interposition grafting typically result in better facial function than do other dynamic and static rehabilitation strategies. Proficient anastomotic technique and, when necessary, selection of an appropriate interposition graft will optimize patient outcomes. Promising research is under way that will enhance future nerve repair and grafting efforts.

  16. Degeneration and regeneration of motor and sensory nerves: a stereological study of crush lesions in rat facial and mental nerves.

    Science.gov (United States)

    Barghash, Z; Larsen, J O; Al-Bishri, A; Kahnberg, K-E

    2013-12-01

    The aim of this study was to evaluate the degeneration and regeneration of a sensory nerve and a motor nerve at the histological level after a crush injury. Twenty-five female Wistar rats had their mental nerve and the buccal branch of their facial nerve compressed unilaterally against a glass rod for 30s. Specimens of the compressed nerves and the corresponding control nerves were dissected at 3, 7, and 19 days after surgery. Nerve cross-sections were stained with osmium tetroxide and toluidine blue and analysed using two-dimensional stereology. We found differences between the two nerves both in the normal anatomy and in the regenerative pattern. The mental nerve had a larger cross-sectional area including all tissue components. The mental nerve had a larger volume fraction of myelinated axons and a correspondingly smaller volume fraction of endoneurium. No differences were observed in the degenerative pattern; however, at day 19 the buccal branch had regenerated to the normal number of axons, whereas the mental nerve had only regained 50% of the normal number of axons. We conclude that the regenerative process is faster and/or more complete in the facial nerve (motor function) than it is in the mental nerve (somatosensory function).

  17. Rat whisker movement after facial nerve lesion: evidence for autonomic contraction of skeletal muscle.

    Science.gov (United States)

    Heaton, James T; Sheu, Shu Hsien; Hohman, Marc H; Knox, Christopher J; Weinberg, Julie S; Kleiss, Ingrid J; Hadlock, Tessa A

    2014-04-18

    Vibrissal whisking is often employed to track facial nerve regeneration in rats; however, we have observed similar degrees of whisking recovery after facial nerve transection with or without repair. We hypothesized that the source of non-facial nerve-mediated whisker movement after chronic denervation was from autonomic, cholinergic axons traveling within the infraorbital branch of the trigeminal nerve (ION). Rats underwent unilateral facial nerve transection with repair (N=7) or resection without repair (N=11). Post-operative whisking amplitude was measured weekly across 10weeks, and during intraoperative stimulation of the ION and facial nerves at ⩾18weeks. Whisking was also measured after subsequent ION transection (N=6) or pharmacologic blocking of the autonomic ganglia using hexamethonium (N=3), and after snout cooling intended to elicit a vasodilation reflex (N=3). Whisking recovered more quickly and with greater amplitude in rats that underwent facial nerve repair compared to resection (Pwhisker movements decreased in all rats during the initial recovery period (indicative of reinnervation), but re-appeared in the resected rats after undergoing ION transection (indicative of motor denervation). Cholinergic, parasympathetic axons traveling within the ION innervate whisker pad vasculature, and immunohistochemistry for vasoactive intestinal peptide revealed these axons branching extensively over whisker pad muscles and contacting neuromuscular junctions after facial nerve resection. This study provides the first behavioral and anatomical evidence of spontaneous autonomic innervation of skeletal muscle after motor nerve lesion, which not only has implications for interpreting facial nerve reinnervation results, but also calls into question whether autonomic-mediated innervation of striated muscle occurs naturally in other forms of neuropathy. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

  18. Optical stimulation of the facial nerve: a surgical tool?

    Science.gov (United States)

    Richter, Claus-Peter; Teudt, Ingo Ulrik; Nevel, Adam E.; Izzo, Agnella D.; Walsh, Joseph T., Jr.

    2008-02-01

    One sequela of skull base surgery is the iatrogenic damage to cranial nerves. Devices that stimulate nerves with electric current can assist in the nerve identification. Contemporary devices have two main limitations: (1) the physical contact of the stimulating electrode and (2) the spread of the current through the tissue. In contrast to electrical stimulation, pulsed infrared optical radiation can be used to safely and selectively stimulate neural tissue. Stimulation and screening of the nerve is possible without making physical contact. The gerbil facial nerve was irradiated with 250-μs-long pulses of 2.12 μm radiation delivered via a 600-μm-diameter optical fiber at a repetition rate of 2 Hz. Muscle action potentials were recorded with intradermal electrodes. Nerve samples were examined for possible tissue damage. Eight facial nerves were stimulated with radiant exposures between 0.71-1.77 J/cm2, resulting in compound muscle action potentials (CmAPs) that were simultaneously measured at the m. orbicularis oculi, m. levator nasolabialis, and m. orbicularis oris. Resulting CmAP amplitudes were 0.3-0.4 mV, 0.15-1.4 mV and 0.3-2.3 mV, respectively, depending on the radial location of the optical fiber and the radiant exposure. Individual nerve branches were also stimulated, resulting in CmAP amplitudes between 0.2 and 1.6 mV. Histology revealed tissue damage at radiant exposures of 2.2 J/cm2, but no apparent damage at radiant exposures of 2.0 J/cm2.

  19. 面神经颞、颧、颊支与SMAS关系的解剖学研究%Anatomic study of the branche of the facial nerve and its relationship with superficial musculoaponeurotic system in rhytidectomy

    Institute of Scientific and Technical Information of China (English)

    刘志勇; 丁自海

    2011-01-01

    Objective To clear the movement of rami temporales, zygomatic branches, buccal branches and the relationship between facial superficial musculoaponeurotic system (SMAS) with them in order to provide important morphological data for mid facial thytidectomy. Methods 10 (20 sides) adult's pate samples were dissected observed and measured step by step. The results and data were drawn in the coordinate system with the X-aix which was in the plane the cut trace of paropia and tragus, and the origin was the cut point in tragus. Results ① Rami temporales were more 3 rami forma than other forms.Most of branches come from the front edge of parotid gland, the goacross the 1/3 border around zygomatic arch and move in the adipose tissue hyp-SMAS. ②There were more 2 rami forma than others in the zygomatic hranches. which come through the upper or front of edge of parotid gland and move in the masseteric fascia.The upper part was in the shallow position.It runs into the muscle from the outer edge of orbicularis oculi in the 1/3 surface of the zygomaticus major; The position of the lower part was more deaper,which can go deep into zygomaticus major. ③Zygomatic branches were mainly 3 rami forma. To fix their positions was difficult for they always move differently , form nerve plexus and walk at the surface of buccal fat pad or inside.Conclusion It's quite safe to doing the SMAS seperation in the parotid gland area with all branches moving in parotid glandular substance of prostate. Dull SMAS seperation should he used to avoid facial nerve injary at the surface of masseteric fascia and buccal fat pad. The seperation should be done under the surface of zygomaticus major and strittly limited below 0.5 cm of the surface (2/3 part of the surface ). Temporal region is safe when the seperation of fascia temporalis superficialis is done behide the hairline .but is should be tumed to the superficial seperation across the hairline. The surface and the upper part of zygomatic arch are

  20. Traumatic facial nerve palsy: CT patterns of facial nerve canal fracture and correlation with clinical severity

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jae Cheol; Kim, Sang Joon; Park, Hyun Min; Lee, Young Suk; Lee, Jee Young [College of Medicine, Dankook Univ., Chonan (Korea, Republic of)

    2002-07-01

    To analyse the patterns of facial nerve canal injury seen at temporal bone computed tomography (CT) in patients with traumatic facial nerve palsy and to correlate these with clinical manifestations and outcome. Thirty cases of temporal bone CT in 29 patients with traumatic facial nerve palsy were analyzed with regard to the patterns of facial nerve canal involvement. The patterns were correlated with clinical grade, the electroneurographic (ENoG) findings, and clinical outcome. For clinical grading, the House-Brackmann scale was used, as follows:grade I-IV, partial palsy group; grade V-VI, complete palsy group. The electroneuronographic findings were categorized as mild to moderate (below 90%) or severe (90% and over) degeneration. In 25 cases, the bony wall of the facial nerve canals was involved directly (direct finding): discontinuity of the bony wall was onted in 22 cases, bony spicules in ten, and bony wall displacement in five. Indirect findings were canal widening in nine cases and adjacent bone fracture in two. In one case, there were no direct or indirect findings. All cases in which there was complete palsy (n=8) showed one or more direct findings including spicules in six, while in the incomplete palsy group (n=22), 17 cases showed direct findings. In the severe degeneration group (n=13), on ENog, 12 cases demonstrated direct findings, including spicules in nine cases. In 24 patients, symptoms of facial palsy showed improvement at follow up evaluation. Four of the five patients in whom symptoms did not improve had spicules. Among ten patients with spicules, five underwent surgery and symptoms improved in four of these; among the five patients not operated on , symptoms did not improve in three. In most patients with facial palsy after temporal bone injury, temporal bone CT revealed direct or indirect facial nerve canal involvement, and in complete palsy or severe degeneration groups, there were direct findings in most cases. We believe that meticulous

  1. Facial nerve involvement in pseudotumor cerebri.

    Directory of Open Access Journals (Sweden)

    Bakshi S

    1992-07-01

    Full Text Available A woman with history of bifrontal headache, vomiting and loss of vision was diagnosed as a case of pseudotumor cerebri based on clinical and MRI findings. Bilateral abducens and facial nerve palsies were detected. Pseudotumor cerebri in this patient was not associated with any other illness or related to drug therapy. Treatment was given to lower the raised intracranial pressure to which the patient responded.

  2. Kawasaki disease with facial nerve paralysis.

    Science.gov (United States)

    Larralde, Margarita; Santos-Muñoz, Andrea; Rutiman, Ricardo

    2003-01-01

    Kawasaki disease (KD) is a multisystem disorder with varying clinical expression. We describe an instance of facial nerve paralysis in a patient with KD. A 5-month-old boy developed fever, irritability, and diarrhea, treated 8 days later with cefaclor and ibuprofen. Three days later a confluent, erythematous and papular rash appeared, his lips were reddened and swollen, and his white blood count and platelet count were 20,900/mm(3) and 558,000/mm(3), respectively. He was admitted to the hospital with a diagnosis of KD, and an echocardiogram showed a right coronary aneurysm. The patient then developed an acute, right-sided, facial nerve peripheral paralysis that resolved over the next 6 weeks. He was treated with intravenous immune globulin (IVIG) 2 g/kg and aspirin 100 mg/kg/day with improvement of signs and symptoms. This report documents facial nerve paralysis as an uncommon complication of KD and points out that it may be a marker of increased risk of cardiovascular disease in this disorder.

  3. Recovery of Facial Nerve Paralysis After Temporal Nerve Reconstruction: A Case Report

    Directory of Open Access Journals (Sweden)

    Emamhadi

    2015-11-01

    Full Text Available Introduction Facial paralysis is common following accidents, trauma, viral infection or tumors. Case Presentation A 24-year-old male patient was referred to us with a history of sharp penetrating trauma to the right temporal region causing unilateral paralysis of the muscles of the right forehead. He was unable to scowl or elevate his right eyebrow and there were no folds on his right forehead. Anastomosis of branches of the temporal nerve was done one month after trauma following regular physical therapy sessions, outcome was good and paralysis of the muscles of the right forehead improved after several months. Conclusions Immediate repair of the facial nerve injury will improve the process of recovery and rehabilitation of the face and forehead muscles and may play a very important role in the patient’s mental satisfaction and improve their quality of life.

  4. Transtympanic Facial Nerve Paralysis: A Review of the Literature.

    Science.gov (United States)

    Schaefer, Nathan; O'Donohue, Peter; French, Heath; Griffin, Aaron; Elliott, Devlin; Gochee, Peter

    2015-05-01

    Facial nerve paralysis because of penetrating trauma through the external auditory canal is extremely rare, with a paucity of published literature. The objective of this study is to review the literature on transtympanic facial nerve paralysis and increase physician awareness of this uncommon injury through discussion of its clinical presentation, management and prognosis. We also aim to improve patient outcomes in those that have sustained this type of injury by suggesting an optimal management plan. In this case report, we present the case of a 46-year-old white woman who sustained a unilateral facial nerve paresis because of a garfish penetrating her tympanic membrane and causing direct damage to the tympanic portion of her facial nerve. On follow-up after 12 months, her facial nerve function has largely returned to normal. Transtympanic facial nerve paralysis is a rare injury but can have a favorable prognosis if managed effectively.

  5. Facial nerve stimulation after cochlear implantation: our experience

    OpenAIRE

    BERRETTINI, S.; De Vito, A.; Bruschini, L.; PASSETTI, S.; Forli, F.

    2011-01-01

    SUMMARY Post-implantation facial nerve stimulation is one of the best known and most frequent complications of the cochlear implant procedure. Some conditions, such as otosclerosis and cochlear malformations, as well as high stimulation levels that may be necessary in patients with long auditory deprivation, expose patients to a higher risk of developing post-implant facial nerve stimulation. Facial nerve stimulation can frequently be resolved with minimal changes in speech processor fitting ...

  6. A hitherto unreported disruption of cervical branches of facial artery

    Directory of Open Access Journals (Sweden)

    Sharma P

    2011-03-01

    Full Text Available According to its course, the branches of the facial artery are arranged under two headings; cervical component (branches in the digastric triangle and facial component (branches on the face.Variations in the branches of the facial component of the facial artery have been frequently studied and reported. However, variations in the cervical component are rare. A hitherto unreported variant of the cervical component of the facial artery was observed in a 55-year-old male cadaver during routine undergraduate dissection. The facial artery was arising from the external carotid artery as a common trunk with the lingual artery in the right carotid triangle and its ascending palatine and tonsillar branches were arising from the external carotid artery. It is important for surgeons and radiologists to be aware of the normal anatomy of the facial artery and the external carotid artery. Herein, we describe the detailed anatomical features of the variant branching pattern of the right facial artery and its clinical implications.

  7. A polylactic acid non-woven nerve conduit for facial nerve regeneration in rats.

    Science.gov (United States)

    Matsumine, Hajime; Sasaki, Ryo; Yamato, Masayuki; Okano, Teruo; Sakurai, Hiroyuki

    2014-06-01

    This study developed a biodegradable nerve conduit with PLA non-woven fabric and evaluated its nerve regeneration-promoting effect. The buccal branch of the facial nerve of 8 week-old Lewis rats was exposed, and a 7 mm nerve defect was created. A nerve conduit made of either PLA non-woven fabric (mean fibre diameter 460 nm), or silicone tube filled with type I collagen gel, or an autologous nerve, was implanted into the nerve defect, and their nerve regenerative abilities were evaluated 13 weeks after the surgery. The number of myelinated neural fibres in the middle portion of the regenerated nerve was the highest for PLA tubes (mean ± SD, 5051 ± 2335), followed by autologous nerves (4233 ± 590) and silicone tubes (1604 ± 148). Axon diameter was significantly greater in the PLA tube group (5.17 ± 1.69 µm) than in the silicone tube group (4.25 ± 1.60 µm) and no significant difference was found between the PLA tube and autograft (5.53 ± 1.93 µm) groups. Myelin thickness was greatest for the autograft group (0.65 ± 0.24 µm), followed by the PLA tube (0.54 ± 0.18 µm) and silicone tube (0.38 ± 0.12 µm) groups, showing significant differences among the three groups. The PLA non-woven fabric tube, composed of randomly-connected PLA fibres, is porous and has a number of advantages, such as sufficient strength to maintain luminal structure. The tube has demonstrated a comparable ability to induce peripheral nerve regeneration following autologous nerve transplantation.

  8. Human vagus nerve branching in the cervical region.

    Directory of Open Access Journals (Sweden)

    Niels Hammer

    Full Text Available Vagus nerve stimulation is increasingly applied to treat epilepsy, psychiatric conditions and potentially chronic heart failure. After implanting vagus nerve electrodes to the cervical vagus nerve, side effects such as voice alterations and dyspnea or missing therapeutic effects are observed at different frequencies. Cervical vagus nerve branching might partly be responsible for these effects. However, vagus nerve branching has not yet been described in the context of vagus nerve stimulation.Branching of the cervical vagus nerve was investigated macroscopically in 35 body donors (66 cervical sides in the carotid sheath. After X-ray imaging for determining the vertebral levels of cervical vagus nerve branching, samples were removed to confirm histologically the nerve and to calculate cervical vagus nerve diameters and cross-sections.Cervical vagus nerve branching was observed in 29% of all cases (26% unilaterally, 3% bilaterally and proven histologically in all cases. Right-sided branching (22% was more common than left-sided branching (12% and occurred on the level of the fourth and fifth vertebra on the left and on the level of the second to fifth vertebra on the right side. Vagus nerves without branching were significantly larger than vagus nerves with branches, concerning their diameters (4.79 mm vs. 3.78 mm and cross-sections (7.24 mm2 vs. 5.28 mm2.Cervical vagus nerve branching is considerably more frequent than described previously. The side-dependent differences of vagus nerve branching may be linked to the asymmetric effects of the vagus nerve. Cervical vagus nerve branching should be taken into account when identifying main trunk of the vagus nerve for implanting electrodes to minimize potential side effects or lacking therapeutic benefits of vagus nerve stimulation.

  9. Relations of Facial Nerve With Retromandibular Vein in Human Fetuses.

    Science.gov (United States)

    Elvan, Özlem; Gilan, Yağmurhan; Beger, Orhan; Bobuş, Alev; Tezer, Mesut; Aktekin, Mustafa

    2017-06-01

    The relationship of facial nerve (FN) and its branches with the retromandibular vein (RMV) has been described in adults, whereas there is no data in the literature regarding this relationship in fetuses. The study was conducted to evaluate the anatomic relationships of these structures on 61 hemi-faces of fetuses with a mean age of 26.5 ± 4.9 weeks with no visible facial abnormalities. The FN trunk was identified at its emergence at the stylomastoid foramen. It was traced till its ramification within the parotid gland. In 46 sides, FN trunk ramified before crossing RMV and ran lateral to it, while in 8 sides FN trunk ramified on the lateral aspect of the RMV. In 3 sides, FN trunk ramified after crossing the RMV at its medial aspect. In only 1 side, FN trunk trifurcated as superior, middle, and inferior divisions and RMV lied anterior to FN trunk, lateral to superior division, medial to middle and inferior divisions. In 2 sides, FN trunk bifurcated as superior and inferior divisions. Retromandibular vein was located anterior to FN trunk, medial to superior division, lateral to inferior division in both of them. In 1 side, RMV ran medial to almost all branches, except the cervical branch of FN. Variability in the relationship of FN and RMV in fetuses as presented in this study is thought to be crucial in surgical procedures particularly in early childhood.

  10. Human Vagus Nerve Branching in the Cervical Region

    OpenAIRE

    Niels Hammer; Juliane Glätzner; Christine Feja; Christian Kühne; Jürgen Meixensberger; Uwe Planitzer; Stefan Schleifenbaum; Tillmann, Bernhard N.; Dirk Winkler

    2015-01-01

    Background: Vagus nerve stimulation is increasingly applied to treat epilepsy, psychiatric conditions and potentially chronic heart failure. After implanting vagus nerve electrodes to the cervical vagus nerve, side effects such as voice alterations and dyspnea or missing therapeutic effects are observed at different frequencies. Cervical vagus nerve branching might partly be responsible for these effects. However, vagus nerve branching has not yet been described in the context of vagus nerve...

  11. Whisking recovery after automated mechanical stimulation during facial nerve regeneration.

    NARCIS (Netherlands)

    Kleiss, I.J.; Knox, C.J.; Malo, J.S.; Marres, H.A.M.; Hadlock, T.A.; Heaton, J.T.

    2014-01-01

    IMPORTANCE Recovery from facial nerve transection is typically poor, but daily mechanical stimulation of the face in rats has been reported to remarkably enhance functional recovery after facial nerve transection and suture repair. This phenomenon needs additional investigation because of its import

  12. Facial nerve function in carcinoma of the parotid gland

    NARCIS (Netherlands)

    Terhaard, Chris; Lubsen, Herman; Tan, Bing; Merkx, Thijs; van der Laan, Bernard; Jong, Rob Baatenburg-de; Manni, Hans; Kneght, Paul

    2006-01-01

    Aim: To analyse, for patients with carcinoma of the parotid gland, the prognostic value for treatment outcome of the function of the facial nerve (NVII), and determining facial nerve dysfunction after treatment. Methods and materials: In a retrospective study of the Dutch head and Neck cooperative g

  13. Transient peripheral facial nerve paralysis after local anesthetic procedure

    OpenAIRE

    A. Rosmaninho; Lobo, I.; Caetano, M.; Taipa, R; Magalhães, M.; Costa, V; Selores, M.

    2012-01-01

    Complications may arise after laser therapy of the face. The most common ones are bleeding and infections; facial nerve paresis or paralysis is rarely reported. We describe a case of a transient peripheral facial nerve paralysis after laser therapy of an epidermal verrucous nevus localized at the left preauricular area.

  14. Modern concepts in facial nerve reconstruction

    Directory of Open Access Journals (Sweden)

    Pantel Mira

    2010-11-01

    Full Text Available Abstract Background Reconstructive surgery of the facial nerve is not daily routine for most head and neck surgeons. The published experience on strategies to ensure optimal functional results for the patients are based on small case series with a large variety of surgical techniques. On this background it is worthwhile to develop a standardized approach for diagnosis and treatment of patients asking for facial rehabilitation. Conclusion A standardized approach is feasible: Patients with chronic facial palsy first need an exact classification of the palsy's aetiology. A step-by-step clinical examination, if necessary MRI imaging and electromyographic examination allow a classification of the palsy's aetiology as well as the determination of the severity of the palsy and the functional deficits. Considering the patient's desire, age and life expectancy, an individual surgical concept is applicable using three main approaches: a early extratemporal reconstruction, b early reconstruction of proximal lesions if extratemporal reconstruction is not possible, c late reconstruction or in cases of congenital palsy. Twelve to 24 months after the last step of surgical reconstruction a standardized evaluation of the therapeutic results is recommended to evaluate the necessity for adjuvant surgical procedures or other adjuvant procedures, e.g. botulinum toxin application. Up to now controlled trials on the value of physiotherapy and other adjuvant measures are missing to give recommendation for optimal application of adjuvant therapies.

  15. Total Facial Nerve Decompression for Severe Traumatic Facial Nerve Paralysis: A Review of 10 Cases

    Directory of Open Access Journals (Sweden)

    Sertac Yetiser

    2012-01-01

    Full Text Available Management of traumatic facial nerve disorders is challenging. Facial nerve decompression is indicated if 90–95% loss of function is seen at the very early period on ENoG or if there is axonal degeneration on EMG lately with no sign of recovery. Middle cranial or translabyrinthine approach is selected depending on hearing. The aim of this study is to present retrospective review of 10 patients with sudden onset complete facial paralysis after trauma who underwent total facial nerve decompression. Operation time after injury is ranging between 16 and105 days. Excitation threshold, supramaximal stimulation, and amplitude on the paralytic side were worse than at least %85 of the healthy side. Six of 11 patients had HBG-II, one patient had HBG-I, 3 patients had HBG-III, and one patient had HBG-IV recovery. Stretch, compression injuries with disruption of the endoneurial tubules undetectable at the time of surgery and lack of timely decompression may be associated with suboptimal results in our series.

  16. Facial nerve image enhancement from CBCT using supervised learning technique.

    Science.gov (United States)

    Ping Lu; Barazzetti, Livia; Chandran, Vimal; Gavaghan, Kate; Weber, Stefan; Gerber, Nicolas; Reyes, Mauricio

    2015-08-01

    Facial nerve segmentation plays an important role in surgical planning of cochlear implantation. Clinically available CBCT images are used for surgical planning. However, its relatively low resolution renders the identification of the facial nerve difficult. In this work, we present a supervised learning approach to enhance facial nerve image information from CBCT. A supervised learning approach based on multi-output random forest was employed to learn the mapping between CBCT and micro-CT images. Evaluation was performed qualitatively and quantitatively by using the predicted image as input for a previously published dedicated facial nerve segmentation, and cochlear implantation surgical planning software, OtoPlan. Results show the potential of the proposed approach to improve facial nerve image quality as imaged by CBCT and to leverage its segmentation using OtoPlan.

  17. A Cadaveric Study of the Communication Patterns Between the Buccal Trunks of the Facial Nerve and the Infraorbital Nerve in the Midface.

    Science.gov (United States)

    Tansatit, Tanvaa; Phanchart, Piyaporn; Chinnawong, Dawinee; Apinuntrum, Prawit; Phetudom, Thavorn; Sahraoui, Yasmina M E

    2016-01-01

    Most nerve communications reported in the literature were found between the terminal branches. This study aimed to clarify and classify patterns of proximal communications between the buccal branches (BN) of the facial nerve and the infraorbital nerve (ION).The superficial musculoaponeurotic system protects any communication sites from conventional dissections. Based on this limitation, the soft tissues of each face were peeled off the facial skull and the facial turn-down flap specimens were dissected from the periosteal view. Dissection was performed in 40 hemifaces to classify the communications in the sublevator space. Communication site was measured from the ala of nose.A double communication was the most common type found in 62.5% of hemifaces. Triple and single communications existed in 25% and 10% of 40 hemiface specimens, respectively. One hemiface had no communication. The most common type of communication occurred between the lower trunk of the BN of the facial nerve and the lateral labial (fourth) branch of the ION (70% in 40 hemifaces). Communication site was deep to the levator labii superioris muscle at 16.2 mm from the nasal ala. Communications between the motor and the sensory nerves in the midface may be important to increase nerve endurance and to compensate functional loss from injury.Proximal communications between the main trunks of the facial nerve and the ION in the midface exist in every face. This implies some specific functions in normal individuals. Awareness of these nerves is essential in surgical procedure in the midface.

  18. Management of peripheral facial nerve palsy.

    Science.gov (United States)

    Finsterer, Josef

    2008-07-01

    Peripheral facial nerve palsy (FNP) may (secondary FNP) or may not have a detectable cause (Bell's palsy). Three quarters of peripheral FNP are primary and one quarter secondary. The most prevalent causes of secondary FNP are systemic viral infections, trauma, surgery, diabetes, local infections, tumor, immunological disorders, or drugs. The diagnosis of FNP relies upon the presence of typical symptoms and signs, blood chemical investigations, cerebro-spinal-fluid-investigations, X-ray of the scull and mastoid, cerebral MRI, or nerve conduction studies. Bell's palsy may be diagnosed after exclusion of all secondary causes, but causes of secondary FNP and Bell's palsy may coexist. Treatment of secondary FNP is based on the therapy of the underlying disorder. Treatment of Bell's palsy is controversial due to the lack of large, randomized, controlled, prospective studies. There are indications that steroids or antiviral agents are beneficial but also studies, which show no beneficial effect. Additional measures include eye protection, physiotherapy, acupuncture, botulinum toxin, or possibly surgery. Prognosis of Bell's palsy is fair with complete recovery in about 80% of the cases, 15% experience some kind of permanent nerve damage and 5% remain with severe sequelae.

  19. Delayed presentation of traumatic facial nerve (CN VII) paralysis.

    Science.gov (United States)

    Napoli, Anthony M; Panagos, Peter

    2005-11-01

    Facial nerve paralysis (Cranial Nerve VII, CN VII) can be a disfiguring disorder with profound impact upon the patient. The etiology of facial nerve paralysis may be congenital, iatrogenic, or result from neoplasm, infection, trauma, or toxic exposure. In the emergency department, the most common cause of unilateral facial paralysis is Bell's palsy, also known as idiopathic facial paralysis (IFP). We report a case of delayed presentation of unilateral facial nerve paralysis 3 days after sustaining a traumatic head injury. Re-evaluation and imaging of this patient revealed a full facial paralysis and temporal bone fracture extending into the facial canal. Because cranial nerve injuries occur in approximately 5-10% of head-injured patients, a good history and physical examination is important to differentiate IFP from another etiology. Newer generation high-resolution computed tomography (CT) scans are commonly demonstrating these fractures. An understanding of this complication, appropriate patient follow-up, and early involvement of the Otolaryngologist is important in management of these patients. The mechanism as well as the timing of facial nerve paralysis will determine the proper evaluation, consultation, and management for the patient. Patients with total or immediate paralysis as well as those with poorly prognostic audiogram results are good candidates for surgical repair.

  20. Schwann Cells Overexpressing FGF-2 Alone or Combined with Manual Stimulation Do Not Promote Functional Recovery after Facial Nerve Injury

    Directory of Open Access Journals (Sweden)

    Kirsten Haastert

    2009-01-01

    Full Text Available Purpose. To determine whether transplantation of Schwann cells (SCs overexpressing different isoforms of fibroblast growth factor 2 (FGF-2 combined with manual stimulation (MS of vibrissal muscles improves recovery after facial nerve transection in adult rat. Procedures. Transected facial nerves were entubulated with collagen alone or collagen plus naïve SCs or transfected SCs. Half of the rats received daily MS. Collateral branching was quantified from motoneuron counts after retrograde labeling from 3 facial nerve branches. Quality assessment of endplate reinnervation was combined with video-based vibrissal function analysis. Results. There was no difference in the extent of collateral axonal branching. The proportion of polyinnervated motor endplates for either naïve SCs or FGF-2 over-expressing SCs was identical. Postoperative MS also failed to improve recovery. Conclusions. Neither FGF-2 isoform changed the extent of collateral branching or polyinnervation of motor endplates; furthermore, this motoneuron response could not be overridden by MS.

  1. Decompression of the facial nerve in cases of hemifacial spasm

    Directory of Open Access Journals (Sweden)

    Karsten Kettel

    1954-12-01

    Full Text Available Among 11 patients a complete cure was obtained in one case, a fair result in 4 cases, while in 6 cases the effect of the operation has only been temporary and full recurrence has taken place. Even if decompression has thus resulted in a few recoveries and improvements, the results in the majority of cases have been disappointing. Everything points to hemifacial spasm being due to a disorder of the lower motor neuron. Intracranial lesions in the vicinity of the facial nerve are known to have resulted in irritation and spasm. It may be perfectly true that the majority of cases of hemifacial spasm are due to a lesion, the nature of which may vary, in the Fallopian canal near the stylomastoid foramen, not least the postparalytic following Bell's palsy. But the disappointing results of decompression seems to indicate that at the time of operation irreparable damage to the nerve has in the majority of cases been already done. Consequently I gave up decompression in cases of hemifacial spasm some years ago. Good results from injections of alcohol into the nerve have been reported13 but I prefer selective sections of the branches to the muscles involved as described by German and Greenwood8.

  2. Facial nerve palsy: Evaluation by contrast-enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kinoshita, T.; Ishii, K.; Okitsu, T.; Okudera, T.; Ogawa, T

    2001-11-01

    AIM: The purpose of this study was to investigate the value of contrast-enhanced magnetic resonance (MR) imaging in patients with peripheral facial nerve palsy. MATERIALS AND METHODS: MR imaging was performed in 147 patients with facial nerve palsy, using a 1.0 T unit. All of 147 patients were evaluated by contrast-enhanced MR imaging and the pattern of enhancement was compared with that in 300 control subjects evaluated for suspected acoustic neurinoma. RESULTS: The intrameatal and labyrinthine segments of the normal facial nerve did not show enhancement, whereas enhancement of the distal intrameatal segment and the labyrinthine segment was respectively found in 67% and 43% of patients with Bell's palsy. The geniculate ganglion or the tympanic-mastoid segment was enhanced in 21% of normal controls versus 91% of patients with Bell's palsy. Abnormal enhancement of the non-paralyzed facial nerve was found in a patient with bilateral temporal bone fracture. CONCLUSION: Enhancement of the distal intrameatal and labyrinthine segments is specific for facial nerve palsy. Contrast-enhanced MR imaging can reveal inflammatory facial nerve lesions and traumatic nerve injury, including clinically silent damage in trauma. Kinoshita T. et al. (2001)

  3. Preserving the pulmonary vagus nerve branches during thoracoscopic esophagectomy

    NARCIS (Netherlands)

    Weijs, Teus J.; Ruurda, Jelle P.; Luyer, Misha D P; Nieuwenhuijzen, Grard A P; van der Horst, Sylvia; Bleys, Ronald L A W; van Hillegersberg, Richard

    2016-01-01

    Background: Pulmonary vagus branches are transected as part of a transthoracic esophagectomy and lymphadenectomy for cancer. This may contribute to the development of postoperative pulmonary complications. Studies in which sparing of the pulmonary vagus nerve branches during thoracoscopic esophagect

  4. Intraparotid Neurofibroma of the Facial Nerve: A Case Report

    Directory of Open Access Journals (Sweden)

    Ahmed Nofal

    2016-05-01

    Full Text Available Introduction: Intraparotid neurofibromas of the facial nerve are extremely rare and mostly associated with neurofibromatosis type 1 (NF1. Case Report: This is a case of a healthy 40-year-old man, which underwent surgery for a preoperatively diagnosed benign parotid gland lesion. After identification of the facial nerve main trunk, a single large mass (6 x 3 cm incorporating the upper nerve division was observed. The nerve portion involved in the mass could not be dissected and was inevitably sacrificed with immediate neuroraphy of the upper division of the facial nerve with 6/0 prolene. The final histopathology revealed the presence of a neurofibroma. Complete left side facial nerve paralysis was observed immediately postoperatively but the function of the lower half was returned within 4 months and the upper half was returned after 1 year. Currently, after 3 years of follow up, there are no signs of recurrence and normal facial nerve function is observed. Conclusion:  Neurofibroma should be considered as the diagnosis in a patient demonstrating a parotid mass. In cases where it is diagnosed intraoperatively, excision of part of the nerve with the mass will be inevitable though it can be successfully repaired by end to end anastomosis.

  5. High resolution computed tomography for peripheral facial nerve paralysis

    Energy Technology Data Exchange (ETDEWEB)

    Koester, O.; Straehler-Pohl, H.J.

    1987-01-01

    High resolution computer tomographic examinations of the petrous bones were performed on 19 patients with confirmed peripheral facial nerve paralysis. High resolution CT provides accurate information regarding the extent, and usually regarding the type, of pathological process; this can be accurately localised with a view to possible surgical treatments. The examination also differentiates this from idiopathic paresis, which showed no radiological changes. Destruction of the petrous bone, without facial nerve symptoms, makes early suitable treatment mandatory.

  6. Bilateral Facial Nerve Paralysis as First Presentation of Lung Cancer

    Directory of Open Access Journals (Sweden)

    Shadi Hamouri

    2016-11-01

    Full Text Available Leptomeningeal carcinomatosis is rare, and its precise incidence is unknown. It is associated with a wide spectrum of solid and hematological malignancies. To complicate its diagnosis, the clinical presentation of leptomeningeal carcinomatosis can be variable. We report a case of a 38-year-old male with bilateral facial nerve paralysis as first presentation of lung adenocarcinoma. To our knowledge, this is the only case describing bilateral facial nerve palsy as the first and only manifestation of lung adenocarcinoma.

  7. A rare variation of the branching pattern of radial nerve

    Directory of Open Access Journals (Sweden)

    Jamuna M

    2011-02-01

    Full Text Available Variation in the branching pattern of posterior cord of the brachial plexus is common but variation in the branching pattern of the radial nerve is rare. A rare and unreported variation in the branching pattern of the radial nerve was noted in the left sided axilla of an embalmed adult male cadaver during the regular gross anatomical dissection for undergraduate students. The radial nerve was having its origin from the posterior cord as a terminal branch and it split into anterior and posterior divisions. Branches of the radial nerve in the arm were given off from the posterior division and the anterior division continued as the main radial nerve with normal course and relations. These variations are important in evaluating post-traumatic injuries and repair of peripheral nerve injuries and during flap dissections.

  8. Facial Nerve Paralysis seen in Pseudomonas sepsis with ecthyma gangrenosum

    Directory of Open Access Journals (Sweden)

    Suleyman Ozdemir

    2013-02-01

    Full Text Available Ecthyma gangrenosum is a skin lesion which is created by pseudomonas auriginosa. Peripheral facial paralysis and mastoiditis as a rare complication of otitis media induced by pseudomonas auriginosa.In this study, 4 months child who has ecthyma gangrenosum and facial nerve paralysis was reported. [Cukurova Med J 2013; 38(1.000: 126-130

  9. Facial Nerve Paralysis: A Rare Complication of Parotid Abscess

    OpenAIRE

    2009-01-01

    Benign parotid neoplasm and inflammatory processes of the parotid resulting in facial paralysis are extremely rare. We report a 72-year-old Malay female with poorly-controlled diabetes mellitus who presented with a painful right parotid swelling associated with right facial nerve palsy. The paralysis (Grade VI, House and Brackmann classification) remained after six months.

  10. Extratemporal Malignant Nerve Sheath Tumor of Facial Nerve with Coexistent Intratemporal Neurofibroma Mimicking Malignant Intratemporal Extension

    Directory of Open Access Journals (Sweden)

    Mitsuhiko Nakahira

    2015-01-01

    Full Text Available We present an extremely unusual case of an extratemporal facial nerve malignant peripheral nerve sheath tumor (MPNST arising from preexistent intratemporal neurofibroma, illustrating a difficulty in discriminating between perineural spread of the MPNST and the preexistent intratemporal neurofibroma on preoperative radiographic images. The most interesting point was that preoperative CT scan and MR images led to misinterpretation that MPNST extended proximally along the facial nerve canal. It is important to recognize that the intratemporal perineural spread of neurofibromas and MPNST share common imaging characteristics. This is the first report (to our knowledge of these 2 lesions coexisting in the facial nerve, leading to misinterpretation on preoperative images.

  11. Application of Shape Memory Alloys in Facial Nerve Paralysis

    Directory of Open Access Journals (Sweden)

    M Vloeberghs

    2009-11-01

    Full Text Available The Facial Nerve can be damaged at a peripheral level by a stroke or, for example by trauma or infection within the faceor the ear. In these cases the facial muscles are paralysed with little or no chance of spontaneous recovery. This research focuses on the potential utilisation of a Shape Memory Alloy(SMA to replace the function of the Facial Nerve, which willallow in conjunction with passive reconstructive methods, a patient to regain limited but active movement of the mouthcorner. Paralysis of the mouth corner is a very disabling bothfunctionally and cosmetically, speech and swallowing are hampered and the patient loses saliva, with presents a social problem.

  12. Facial nerve neuromas: MR imaging. Report of four cases

    Energy Technology Data Exchange (ETDEWEB)

    Martin, N. (G.H. Pitie-Salpetriere, 75 - Paris (France). Dept. of Neuroradiology); Sterkers, O. (Hospital Beaujon, Clichy (France). Dept. of Otorhinolaryngology); Mompoint, D.; Nahum, H. (Hopital Beaujon, Clichy (France). Dept. of Radiology)

    1992-02-01

    Four cases of facial nerve neuroma were evaluated by computed tomographic (CT) scan and magnetic resonance imaging (MRI). The extension of the tumor in the petrous bone or the parotid gland was well defined by MRI in all cases. CT scan was useful to demonstrate bone erosions and the relation of the tumor to inner ear structures. In cases of progressive facial palsy, CT and MRI should be combined to detect a facial neuroma and to plan the surgical approach for tumor removal and nerve grafting. (orig.).

  13. Facial nerve schwannoma in revision stapedotomy surgery.

    Science.gov (United States)

    Schmerber, Sébastien; Lavieille, Jean-Pierre

    2004-05-01

    We describe a male patient who presented a progressive conductive unilateral hearing loss 20 years after otosclerosis surgery. Computed tomography (CT) scan and magnetic resonance imaging (MRI) findings suggested a facial schwannoma in its tympanic segment. At the time of revision surgery, a facial schwannoma was found to originate at the tympanic segment, pushing the prosthesis out of the oval window fenestration. The Teflon-piston was repositioned with difficulties in the central platinotomy, and the facial schwannoma was left intact.

  14. [Peripheral paralysis of facial nerve in children].

    Science.gov (United States)

    Steczkowska-Klucznik, Małgorzata; Kaciński, Marek

    2006-01-01

    Peripheral facial paresis is one of the most common diagnosed neuropathies in adults and also in children. Many factors can trigger facial paresis and most frequent are infectious, carcinoma and demyelinisation diseases. Very important and interesting problem is an idiopathic facial paresis (Bell's palsy). Actually the main target of scientific research is to assess the etiology (infectious, genetic, immunologic) and to find the most appropriate treatment.

  15. Intratemporal and extratemporal facial nerve schwannoma: CT and MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Keum Won [Pohang Medical Center, Pohang (Korea, Republic of); Lee, Ho Kyu; Shin, Ji Hoon; Choi, Choong Gon; Suh, Dae Chul [Asan Medical Center, Ulsan Univ. College of Medicine, Seoul (Korea, Republic of); Cheong, Hae Kwan [Dongguk Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-05-01

    To analyze the characteristics of CT and MRI findings of facial nerve schwannoma in ten patients. Ten patients with pathologically confirmed facial nerve schwannoma, underwent physical and radilolgic examination. The latter involved MRI in all ten and CT scanning in six. We analyzed the location (epicenter), extent and number of involved segments of tumors, tuumor morphology, and changes in adjacent bony structures. The major symptoms of facial nerve schwannoma were facial nerve paralysis in seven cases and hearing loss in six. Epicenters were detected at the intraparotid portion in five cases, the intracanalicular portion in two, the cisternal portion in one, and the intratemporal portion in two. The segment most frequently involved was the mastoid (n=6), followed by the parotid (n=5), intracanalicular (n=4), cisternal (n=2), the labyrinthine/geniculate ganglion (n=2) and the tympanic segment (n=1). Tumors affected two segments of the facial nerve in eight cases, only one segment in one, and four continuous segments in one. Morphologically, tumors were ice-cream cone shaped in the cisternal segment tumor (1/1), cone shaped in intracanalicular tumors (2/2), oval shaped in geniculate ganglion tumors (1/1), club shaped in intraparotid tumors (5/5) and bead shaped in the diffuse-type tumor (1/1). Changes in adjacent bony structures involved widening of the stylomastoid foramen in intraparotid tumors (5/5), widening of the internal auditary canal in intracanalicular and cisternal tumors (3/3), bony erosion of the geniculate fossa in geniculate ganglion tumors (2/2), and widening of the facial nerve canal in intratemporal and intraparotid tumors (6/6). The characteristic location, shape and change in adjacent bony structures revealed by facial schwannomas on CT and MR examination lead to correct diagnosis.

  16. [Application of fibrin glue in facial nerve repair].

    Science.gov (United States)

    Wang, Qinying; Hua, Qingquan; Wang, Shenqing

    2007-06-01

    This animal experiment was aimed to apply fibrin in facial nerve repair and to quest for technical improvements in facial surgery. In each of 15 healthy large ear white rabbits, a unilateral 5 mm intratemporal facial nerve gap was created, the proximal and distal stumps were inserted into chitin tube, 1 ml autologous fibrin glue was applied around the anastomotic zone, and no suture was employed. At 3 months and 5 months after opertion, electrophysioligical study was performed. Compared with normal nerves, the regenerating nerves in both the chitin tube bridged group and the perineurium suture group had longer incubation period, lower amplitude, slower nerve-muscle conduction velocity at 3 months postoperatively. The differences were distinctly significant (P < 0.01). Although being decreased at 5 months after operation, the differences were still statistically significant (P < 0.05). There were no significant differences between the chitin tube bridged group and perineurium suture group at 3 months and 5 months, respectively. The study suggests that facial nerve repair using fibrin glue and chitin tube has the advantages of being easier,faster and more stable.

  17. Using an end-to-side interposed sural nerve graft for facial nerve reinforcement after vestibular schwannoma resection. Technical note.

    Science.gov (United States)

    Samii, Madjid; Koerbel, Andrei; Safavi-Abbasi, Sam; Di Rocco, Federico; Samii, Amir; Gharabaghi, Alireza

    2006-12-01

    Increasing rates of facial and cochlear nerve preservation after vestibular schwannoma surgery have been achieved in the last 30 years. However, the management of a partially or completely damaged facial nerve remains an important issue. In such a case, several immediate or delayed repair techniques have been used. On the basis of recent studies of successful end-to-side neurorrhaphy, the authors applied this technique in a patient with an anatomically preserved but partially injured facial nerve during vestibular schwannoma surgery. The authors interposed a sural nerve graft to reinforce the facial nerve whose partial anatomical continuity had been preserved. On follow-up examinations 18 months after surgery, satisfactory cosmetic results for facial nerve function were observed. The end-to-side interposed nerve graft appears to be a reasonable alternative in cases of partial facial nerve injury, and might be a future therapeutic option for other cranial nerve injuries.

  18. Mime therapy improves facial symmetry in people with long-term facial nerve paresis: a randomised controlled trial.

    NARCIS (Netherlands)

    Beurskens, C.H.G.; Heymans, P.G.

    2006-01-01

    QUESTION: What is the effect of mime therapy on facial symmetry and severity of paresis in people with facial nerve paresis? DESIGN: Randomised controlled trial. PARTICIPANTS: 50 people recruited from the Outpatient department of two metropolitan hospitals with facial nerve paresis for more than nin

  19. Unusual complication of otitis media with effusion: facial nerve paralysis.

    Science.gov (United States)

    Vayisoglu, Yusuf; Gorur, Kemal; Ozcan, Cengiz; Korlu, Savaş

    2011-07-01

    Facial nerve paralysis (FNP) is a very rare complication of otitis media with effusion (OME). There are few patients with OME and FNP in the literature. A 5-year-old girl was admitted to our department with right facial weakness. Right FNP and right OME were diagnosed on the examination. After medical treatment and ventilation tube insertion, FNP completely resolved. The symptoms, signs, and management of this patient are presented.

  20. Amblyopia Associated with Congenital Facial Nerve Paralysis.

    Science.gov (United States)

    Iwamura, Hitoshi; Kondo, Kenji; Sawamura, Hiromasa; Baba, Shintaro; Yasuhara, Kazuo; Yamasoba, Tatsuya

    2016-01-01

    The association between congenital facial paralysis and visual development has not been thoroughly studied. Of 27 pediatric cases of congenital facial paralysis, we identified 3 patients who developed amblyopia, a visual acuity decrease caused by abnormal visual development, as comorbidity. These 3 patients had facial paralysis in the periocular region and developed amblyopia on the paralyzed side. They started treatment by wearing an eye patch immediately after diagnosis and before the critical visual developmental period; all patients responded to the treatment. Our findings suggest that the incidence of amblyopia in the cases of congenital facial paralysis, particularly the paralysis in the periocular region, is higher than that in the general pediatric population. Interestingly, 2 of the 3 patients developed anisometropic amblyopia due to the hyperopia of the affected eye, implying that the periocular facial paralysis may have affected the refraction of the eye through yet unspecified mechanisms. Therefore, the physicians who manage facial paralysis should keep this pathology in mind, and when they see pediatric patients with congenital facial paralysis involving the periocular region, they should consult an ophthalmologist as soon as possible. © 2016 S. Karger AG, Basel.

  1. Peripheral facial nerve paralysis after upper third molar extraction.

    Science.gov (United States)

    Cakarer, Sirmahan; Can, Taylan; Cankaya, Burak; Erdem, Mehmet Ali; Yazici, Sinem; Ayintap, Emre; Özden, Ali Veysel; Keskin, Cengizhan

    2010-11-01

    Peripheral facial nerve paralysis (PFNP) after mandibular interventions has been reported in the literature. In most cases, paralysis begins immediately after the injection of the mandibular anesthesia, and duration of facial weakness is less than 12 hours. However, there are few documented cases of PFNP after maxillary dental or surgical procedures. A variety of mechanisms have been associated to PFNP, including viral reactivation, demyelination, edema, vasospasm, and trauma. The purpose of this presentation was to report a rare case of facial paralysis that occurred after an upper third molar extraction. The cause of the PFNP and the importance of the multidisciplinary approach in the management are emphasized.

  2. [Treatment of idiopathic peripheral facial nerve paralysis (Bell's palsy)].

    Science.gov (United States)

    Meyer, Martin Willy; Hahn, Christoffer Holst

    2013-01-28

    Bell's palsy is defined as an idiopathic peripheral facial nerve paralysis of sudden onset. It affects 11-40 persons per 100,000 per annum. Many patients recover without intervention; however, up to 30% have poor recovery of facial muscle control and experience facial disfigurement. The aim of this study was to make an overview of which pharmacological treatments have been used to improve outcomes. The available evidence from randomized controlled trials shows significant benefit from treating Bell's palsy with corticosteroids but shows no benefit from antivirals.

  3. Facial nerve palsy: Providing eye comfort and cosmesis

    Directory of Open Access Journals (Sweden)

    Alsuhaibani Adel

    2010-01-01

    Full Text Available Development of facial nerve palsy (FNP may lead to dramatic change in the patient′s facial function, expression, and emotions. The ophthalmologist may play an important role in the initial evaluation, and the long-term management of patients with new-onset of FNP. In patients with expected temporary facial weakness, no efforts should be wasted to ensure proper corneal protection. Patients with permanent functional deficit may require combination of surgical procedures tailored to the patient′s clinical findings that may require good eye comfort and cosmesis.

  4. Facial Nerve Palsy: Providing Eye Comfort and Cosmesis

    Science.gov (United States)

    Alsuhaibani, Adel H.

    2010-01-01

    Development of facial nerve palsy (FNP) may lead to dramatic change in the patient's facial function, expression, and emotions. The ophthalmologist may play an important role in the initial evaluation, and the long-term management of patients with new-onset of FNP. In patients with expected temporary facial weakness, no efforts should be wasted to ensure proper corneal protection. Patients with permanent functional deficit may require combination of surgical procedures tailored to the patient's clinical findings that may require good eye comfort and cosmesis. PMID:20616921

  5. Laser facial nerve welding in a rabbit model.

    Science.gov (United States)

    Bloom, Jason D; Bleier, Benjamin S; Goldstein, Stephen A; Carniol, Paul J; Palmer, James N; Cohen, Noam A

    2012-01-01

    To assess the feasibility of laser tissue welding for repair of facial nerve injury. In a prospective in vivo animal survival surgery model, rabbit facial nerve injury was followed by either standard suture neurorrhaphy or laser tissue welding using a diode laser (808 ± 1 nm) to weld biological solder. Rabbits were evaluated at 4, 8, 12, and 16 weeks by facial videography and electromyography. Histopathological analysis of the repair was performed at 4 and 16 weeks. Videographic analysis demonstrated the laser tissue welding repair trended toward superior outcomes compared with suture neurorrhaphy at all 4 time points. Electrophysiological analysis demonstrated similar or better results, with statistically significant improvement at week 16 (P laser nerve repair created a greater initial inflammatory reaction. An analysis of operative time demonstrated significantly decreased time and ease of use for laser tissue welding. This pilot study demonstrates that laser nerve welding may be an expedient, feasible, and safe method for facial nerve repair in a rabbit model. Further experiments with larger numbers are needed to provide additional evidence that laser tissue welding produces a neurorrhaphy that has functional, electrophysiological, and histological results that could rival traditional suture neurorrhaphy.

  6. Masseteric-facial nerve transposition for reanimation of the smile in incomplete facial paralysis.

    Science.gov (United States)

    Hontanilla, Bernardo; Marre, Diego

    2015-12-01

    Incomplete facial paralysis occurs in about a third of patients with Bell's palsy. Although their faces are symmetrical at rest, when they smile they have varying degrees of disfigurement. Currently, cross-face nerve grafting is one of the most useful techniques for reanimation. Transfer of the masseteric nerve, although widely used for complete paralysis, has not to our knowledge been reported for incomplete palsy. Between December 2008 and November 2013, we reanimated the faces of 9 patients (2 men and 7 women) with incomplete unilateral facial paralysis with transposition of the masseteric nerve. Sex, age at operation, cause of paralysis, duration of denervation, recipient nerves used, and duration of follow-up were recorded. Commissural excursion, velocity, and patients' satisfaction were evaluated with the FACIAL CLIMA and a questionnaire, respectively. The mean (SD) age at operation was 39 (±6) years and the duration of denervation was 29 (±19) months. There were no complications that required further intervention. Duration of follow-up ranged from 6-26 months. FACIAL CLIMA showed improvement in both commissural excursion and velocity of more than two thirds in 6 patients, more than one half in 2 patients and less than one half in one. Qualitative evaluation showed a slight or pronounced improvement in 7/9 patients. The masseteric nerve is a reliable alternative for reanimation of the smile in patients with incomplete facial paralysis. Its main advantages include its consistent anatomy, a one-stage operation, and low morbidity at the donor site.

  7. Exacerbation of facial motoneuron loss after facial nerve axotomy in CCR3-deficient mice

    Directory of Open Access Journals (Sweden)

    Derek A Wainwright

    2009-12-01

    Full Text Available We have previously demonstrated a neuroprotective mechanism of FMN (facial motoneuron survival after facial nerve axotomy that is dependent on CD4+ Th2 cell interaction with peripheral antigen-presenting cells, as well as CNS (central nervous system-resident microglia. PACAP (pituitary adenylate cyclase-activating polypeptide is expressed by injured FMN and increases Th2-associated chemokine expression in cultured murine microglia. Collectively, these results suggest a model involving CD4+ Th2 cell migration to the facial motor nucleus after injury via microglial expression of Th2-associated chemokines. However, to respond to Th2-associated chemokines, Th2 cells must express the appropriate Th2-associated chemokine receptors. In the present study, we tested the hypothesis that Th2-associated chemokine receptors increase in the facial motor nucleus after facial nerve axotomy at timepoints consistent with significant T-cell infiltration. Microarray analysis of Th2-associated chemokine receptors was followed up with real-time PCR for CCR3, which indicated that facial nerve injury increases CCR3 mRNA levels in mouse facial motor nucleus. Unexpectedly, quantitative- and co-immunofluorescence revealed increased CCR3 expression localizing to FMN in the facial motor nucleus after facial nerve axotomy. Compared with WT (wild-type, a significant decrease in FMN survival 4 weeks after axotomy was observed in CCR3−/− mice. Additionally, compared with WT, a significant decrease in FMN survival 4 weeks after axotomy was observed in Rag2−/− (recombination activating gene-2-deficient mice adoptively transferred CD4+ T-cells isolated from CCR3−/− mice, but not in CCR3−/− mice adoptively transferred CD4+ T-cells derived from WT mice. These results provide a basis for further investigation into the co-operation between CD4+ T-cell- and CCR3-mediated neuroprotection after FMN injury.

  8. Exacerbation of Facial Motoneuron Loss after Facial Nerve Axotomy in CCR3-Deficient Mice

    Directory of Open Access Journals (Sweden)

    Derek A Wainwright

    2009-11-01

    Full Text Available We have previously demonstrated a neuroprotective mechanism of FMN (facial motoneuron survival after facial nerve axotomy that is dependent on CD4+ Th2 cell interaction with peripheral antigen-presenting cells, as well as CNS (central nervous system-resident microglia. PACAP (pituitary adenylate cyclase-activating polypeptide is expressed by injured FMN and increases Th2-associated chemokine expression in cultured murine microglia. Collectively, these results suggest a model involving CD4+ Th2 cell migration to the facial motor nucleus after injury via microglial expression of Th2-associated chemokines. However, to respond to Th2-associated chemokines, Th2 cells must express the appropriate Th2-associated chemokine receptors. In the present study, we tested the hypothesis that Th2-associated chemokine receptors increase in the facial motor nucleus after facial nerve axotomy at timepoints consistent with significant T-cell infiltration. Microarray analysis of Th2-associated chemokine receptors was followed up with real-time PCR for CCR3, which indicated that facial nerve injury increases CCR3 mRNA levels in mouse facial motor nucleus. Unexpectedly, quantitative- and co-immunofluorescence revealed increased CCR3 expression localizing to FMN in the facial motor nucleus after facial nerve axotomy. Compared with WT (wild-type, a significant decrease in FMN survival 4 weeks after axotomy was observed in CCR3–/– mice. Additionally, compared with WT, a significant decrease in FMN survival 4 weeks after axotomy was observed in Rag2 –/– (recombination activating gene-2-deficient mice adoptively transferred CD4+ T-cells isolated from CCR3–/– mice, but not in CCR3–/– mice adoptively transferred CD4+ T-cells derived from WT mice. These results provide a basis for further investigation into the co-operation between CD4+ T-cell- and CCR3-mediated neuroprotection after FMN injury.

  9. Rat whisker movement after facial nerve lesion: Evidence for autonomic contraction of skeletal muscle.

    NARCIS (Netherlands)

    Heaton, J.T.; Sheu, S.H.; Hohman, M.H.; Knox, C.J.; Weinberg, J.S.; Kleiss, I.J.; Hadlock, T.A.

    2014-01-01

    Vibrissal whisking is often employed to track facial nerve regeneration in rats; however, we have observed similar degrees of whisking recovery after facial nerve transection with or without repair. We hypothesized that the source of non-facial nerve-mediated whisker movement after chronic denervati

  10. 3D-FT MRI of the facial nerve

    Energy Technology Data Exchange (ETDEWEB)

    Girard, N. (Neuroradiology, Hopital Nord, 13 Marseille (France)); Raybaud, C. (Neuroradiology, Hopital Nord, 13 Marseille (France)); Poncet, M. (Neuroradiology, Hopital Nord, 13 Marseille (France))

    1994-08-01

    Contrast-enhanced 3D-FT MRI of the intrapetrous facial nerve was obtained in 38 patients with facial nerve disease, using a 1.0 T magnet and fast gradient-echo acquisition sequences. Contiguous millimetric sections were obtained, which could be reformatted in any desired plane. Acutely ill patients, were examined within the first 2 months, included: 24 with Bell's palsy and 6 with other acute disorders (Herpes zoster, trauma, neuroma, meningeal metastasis, middle ear granuloma). Six patients investigated more than a year after the onset of symptoms included 3 with congenital cholesteatoma, 2 with neuromas and one with a chronic Bell's palsy. The lesion was found incidentally in two cases (a suspected neurofibroma and a presumed drop metastasis from an astrocytoma). Patients with tumours had nodular, focally-enhancing lesions, except for the leptomeningeal metastasis in which the enhancement was linear. Linear, diffuse contrast enhancement of the facial nerve was found in trauma, and in the patient with a middle ear granuloma. Of the 24 patients with an acute Bell's palsy 15 exhibited linear contrast enhancement of the facial nerve. Three of these were lost to follow-up, but correlation of clinical outcome and contrast enhancement showed that only 4 of the 11 patients who made a complete recovery and all 10 patients with incomplete recovery demonstrated enhancement. Possible explanations for these findings are suggested by pathological data from the literature. 3D-FT imaging of the facial nerve thus yields direct information about the of the nerve condition and defines the morphological abnormalities. It can also demonstrate contrast enhancement which seems to have some prognostic value in acute idiopathic Bell's palsy. (orig.)

  11. Comparison of hemihypoglossal-facial nerve transposition with a cross-facial nerve graft and muscle transplant for the rehabilitation of facial paralysis using the facial clima method.

    Science.gov (United States)

    Hontanilla, Bernardo; Vila, Antonio

    2012-02-01

    To compare quantitatively the results obtained after hemihypoglossal nerve transposition and microvascular gracilis transfer associated with a cross facial nerve graft (CFNG) for reanimation of a paralysed face, 66 patients underwent hemihypoglossal transposition (n = 25) or microvascular gracilis transfer and CFNG (n = 41). The commissural displacement (CD) and commissural contraction velocity (CCV) in the two groups were compared using the system known as Facial clima. There was no inter-group variability between the groups (p > 0.10) in either variable. However, intra-group variability was detected between the affected and healthy side in the transposition group (p = 0.036 and p = 0.017, respectively). The transfer group had greater symmetry in displacement of the commissure (CD) and commissural contraction velocity (CCV) than the transposition group and patients were more satisfied. However, the transposition group had correct symmetry at rest but more asymmetry of CCV and CD when smiling.

  12. 两种激光并超短波治疗周围性面神经麻痹的疗效%Effect of two kinds of laser combined with ultrashort wave on peripheral facial nerve paralysis

    Institute of Scientific and Technical Information of China (English)

    甘青

    2002-01-01

    Background: Peripheral facial nerve paralysis referred to injury of peripheral nerve trunk and its branches due to direct or indirect force.Physiotherapy could decrease ischemia.Swelling of nerve tissue and degeneration of myelin sheath and axon.Helium neon laser.Semiconductor laser and ultrashort wave were adopted in this group of peripheral nerve paralysis, effect was obvious.

  13. Hansen's disease and HIV coinfection with facial nerve palsy.

    Science.gov (United States)

    Yadav, Nidhi; Kar, Sumit; Madke, Bhushan; Gangane, Nitin

    2015-01-01

    There are very few published reports of HIV leprosy co infection in India in spite of having a large burden of both leprosy and HIV. Herein we are reporting a case of co-infection of Hansen's disease and HIV with facial nerve palsy.

  14. Intra—Operative Facial Nerve Monitoring in Acoustic Neurinoma Surgery

    Institute of Scientific and Technical Information of China (English)

    YANGZhengming; ZHANGZhifeng; 等

    2002-01-01

    Objective To determine the method and significance of facial nerve preservation during acoustic neurinoma surgery by intra-operative facial nerve monitoring(IFNM).Methods 62 patients were randomly assigned to the IFNM or the control group.Facial nerve function(FNF)was assessed by a modified House-Brackmann grading(HB)before the operation,10 days and every two months after surgery and com,pared between the two groups. Results Ten days after surgery,26/32 patients in the IFNM group and 15/30 patients in the control group had FNF HB grade,Ⅰ-Ⅲ;FNF HB gradeⅣ-Ⅴ was prestent in 6/32 in the IFNM group and 15/30 in the control group.During follow-up,29/32 patients in the IFNM group and 20/20 patients in the control group had FNF HB gradeⅠ-Ⅲ;FNF HB gradeⅣ-Ⅴ was present in 3/32 in the IFNM group and 10/30 in the control group.All differnces were statistcally significant.Conclusion IFNM significantly improved anatomic and functional facial nerve preservation as well as the quality of life.

  15. Normal and pathological findings for the facial nerve on magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Al-Noury, K., E-mail: Kalnoury@kau.edu.sa [Department of Otolaryngology, King Abdulaziz University, Jeddah (Saudi Arabia); Lotfy, A. [Radiology Department, King Abdulaziz University Hospital and International Medical Centre, Jeddah (Saudi Arabia)

    2011-08-15

    Aim: To demonstrate the enhanced radiological anatomy and common pathological conditions of the facial nerve by using magnetic resonance imaging (MRI). Materials and methods: A retrospective review of the MRI findings of the facial nerve of 146 patients who visited a tertiary academic referral center was conducted. Results: The radiological anatomy of the facial nerve was well illustrated using MRI, as were most of the common pathological conditions of the facial nerve. Conclusions: Enhancement of the facial nerve in MRI should be correlated with the clinical data. Normal individuals can show enhancement of the tympanic or vertical segments of the facial nerve. Enhancement of the labyrinthine portion of the nerve is almost diagnostic of Bell's palsy. No specific enhancement patterns were observed for tumours or for infections of the middle or external ear. A larger population study is required for the accurate assessment of facial nerve enhancement in multiple sclerosis patients.

  16. Lateral skull base chondroblastoma resected with facial nerve posterior transposition.

    Science.gov (United States)

    Adnot, J; Langlois, O; Tollard, E; Crahes, M; Auquit-Auckbur, I; Marie, J-P

    2017-05-01

    Chondroblastoma is a rare tumor that can involve the temporal bone. Because it is a benign tumor, functional surgery must be proposed. We report a case of a patient with a massive chondroblastoma operated on with preservation of the facial nerve, and description of the surgical technique. A 37-year-old man presented with a 9-month history of a growing left pre-auricular mass and hearing loss. Neuroimaging showed an osteolytic mass invading the temporal bone and temporomandibular joint. Excision was performed via a transpetrosal and transcochlear approach with posterior transposition of the facial nerve. EMG monitoring was effective in preventing facial palsy. Four years later, no sign of recurrence was observed. Chondroblastoma is a locally aggressive tumor, especially when located in the petrous bone and temporomandibular joint. The suggested treatment is a complete excision. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  17. Facial reanimation with gracilis muscle transfer neurotized to cross-facial nerve graft versus masseteric nerve: a comparative study using the FACIAL CLIMA evaluating system.

    Science.gov (United States)

    Hontanilla, Bernardo; Marre, Diego; Cabello, Alvaro

    2013-06-01

    Longstanding unilateral facial paralysis is best addressed with microneurovascular muscle transplantation. Neurotization can be obtained from the cross-facial or the masseter nerve. The authors present a quantitative comparison of both procedures using the FACIAL CLIMA system. Forty-seven patients with complete unilateral facial paralysis underwent reanimation with a free gracilis transplant neurotized to either a cross-facial nerve graft (group I, n=20) or to the ipsilateral masseteric nerve (group II, n=27). Commissural displacement and commissural contraction velocity were measured using the FACIAL CLIMA system. Postoperative intragroup commissural displacement and commissural contraction velocity means of the reanimated versus the normal side were first compared using the independent samples t test. Mean percentage of recovery of both parameters were compared between the groups using the independent samples t test. Significant differences of mean commissural displacement and commissural contraction velocity between the reanimated side and the normal side were observed in group I (p=0.001 and p=0.014, respectively) but not in group II. Intergroup comparisons showed that both commissural displacement and commissural contraction velocity were higher in group II, with significant differences for commissural displacement (p=0.048). Mean percentage of recovery of both parameters was higher in group II, with significant differences for commissural displacement (p=0.042). Free gracilis muscle transfer neurotized by the masseteric nerve is a reliable technique for reanimation of longstanding facial paralysis. Compared with cross-facial nerve graft neurotization, this technique provides better symmetry and a higher degree of recovery. Therapeutic, III.

  18. CT and MR imaging of the normal and pathologic conditions of the facial nerve

    Energy Technology Data Exchange (ETDEWEB)

    Jaeger, Lorenz E-mail: jaeger@ikra.med.uni-muenchen.de; Reiser, Maximilian

    2001-11-01

    Computed tomography (CT) and magnetic resonance imaging (MRI) are well established imaging modalities to examine the facial nerve as well as the course of the facial nerve itself. High spatial resolution is guaranteed not only in the x- and y-axis, but also in the z-axis using multislice spiral CT. With this technique, reformatted multiplanar images in oblique planes, avoiding additional examinations in the coronal plane, facilitate the delineation of the facial nerve canal. This is beneficial in patients with temporal bone trauma, malformation or osseous changes. MR has a superior soft-tissue contrast to CT that enables imaging of the facial nerve itself. Therefore the normal facial nerve as well as pathologic changes of the facial nerve is readily visualized from the brain stem to the parotid gland. This review article presents anatomy, pathology and imaging strategies in the diagnostics of the facial nerve.

  19. What Is Expected of the Facial Nerve in Michel Aplasia? Anatomic Variation

    OpenAIRE

    2010-01-01

    We sought better understanding about the facial nerve anatomy in the rare inner ear Michel anomaly to help better define this aplasia and prevent potential complications in surgery on these patients. The data from computed tomography scans and magnetic resonance images of six Michel aplastic ears (three patients) were evaluated for a facial nerve course. Facial nerve course and anatomic landmarks were noted. Based on data obtained from this group of very rare patients, three different facial ...

  20. Guillain-Barre Syndrome Presenting With Bilateral Facial Nerve Palsy

    Directory of Open Access Journals (Sweden)

    Soroor INALOO

    2014-01-01

    Full Text Available How to Cite This Article: Inaloo S, Katibeh P. Guillain-Barre Syndrome Presenting With Bilateral Facial Nerve Palsy. Iran J Child Neurol. 2014 Winter;8(1:69-71.ObjectiveThis case study is about an 11-year-old girl with bilateral facial weakness, abnormal taste sensation, and deep tendon reflexes of both knees and ankles were absent. However, the muscle power of the lower and upper extremities across all muscle groups was normal. After 2 days, she developed paresthesia and numbness in the lower extremities. Other neurologic examinations, such as fundoscopic evaluation of the retina were normal with the muscle power of both upper- and lower-extremities intact. A lumbar puncture revealed albumincytological dissociation. EMG and NCV were in favor of Guillain-Barre syndrome, for which IVIG was prescribed and the abnormal sensations in the lower limbs rapidly improved. Bilateral facial diplegia without weakness and paresthesia is a variant of Guillain-Barre syndrome that mostly presents withacute onset, rapid progression with or without limb weakness, paresthesia, and decreased or absent DTR and albumin-cytological dissociation.References:Barbi F, Ariatti A, Funakoshi K, Meacci M, Odaka M, Galassi G. Parvovirus B19 infection antedating Guillain-Barre’ syndrome variant with prominent facial diplegia. J Neurol 2011 Aug; 258(8:1551-2. doi: 10.1007/s00415-011-5949-5. Epub 2011 Feb 15.Yardimci N, Avci AY, Kayhan E, Benli S. Bilateral facial nerve enhancement demonstrated by magnetic resonance imaging in Guillain-Barré syndrome. Neurol Sci 2009 Oct; 30(5:431-3. doi:10.1007/s10072-009-0120-0.Lim TC, Yeo WS, Loke KY, Quek SC. Bilateral facial nerve palsy in Kawasaki disease. Ann Acad Med Singapore 2009; 38(8:737-8.Quintas E, Silva A, Sarmento A. Bilateral facial palsy in a young patient after meningococcal meningitis, associated to herpetic infection. Arq Neuro-Psiquiatr 2009; 67(3a: 712-14.Jain V, Deshmukh A, Gollomp S. Bilateral facial

  1. The zygomaticotemporal branch of the trigeminal nerve: an anatomical study.

    Science.gov (United States)

    Totonchi, Ali; Pashmini, Nazly; Guyuron, Bahman

    2005-01-01

    This study was conducted to determine the site of emergence of the zygomaticotemporal branch of the trigeminal nerve from the temporalis muscle and to identify the number of its accessory branches and their locations. A pilot study, conducted on the same number of patients, concluded that the main zygomaticotemporal branch emerges from the deep temporal fascia at a point on average 17 mm lateral and 6 mm cephalad to the lateral palpebral commissure, commonly referred to as the lateral canthus. These measurements, however, were obtained after dissection of the temporal area, rendering the findings less reliable. The current study included 20 consecutive patients, 19 women and one man, between the ages of 26 and 85 years, with an average age of 47.6 years. Those who had a history of previous trauma or surgery in the temple area were excluded. Before the start of the endoscopic forehead procedure, the likely topographic site of the zygomaticotemporal branch was marked 17 mm lateral and 6 mm cephalad to the lateral orbital commissure on the basis of the information extrapolated from the pilot study. The surface mark was then transferred to the deeper layers using a 25-gauge needle stained with brilliant green. After endoscopic exposure of the marked site, the distance between the main branch of the trigeminal nerve or its accessory branches and the tattoo mark was measured in posterolateral and cephalocaudal directions. In addition, the number and locations of the accessory branches of the trigeminal nerve were recorded. On the left side, the average distance of the emergence site of the main zygomaticotemporal branch of the trigeminal nerve from the palpebral fissure was 16.8 mm (range, 12 to 31 mm) in the posterolateral direction and an average of 6.4 mm (range, 4 to 11 mm) in the cephalad direction. On the right side, the average measurements for the main branch were 17.1 mm (range, 15 to 21 mm) in the lateral direction and 6.65 mm (range, 5 to 11 mm) in the

  2. Application of a venous conduit as a stent for repairing rabbit facial nerve injury

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND:Recently,many investigators have tried to use natural biomaterials,such as,artery,vein,decalcified bone,etc.,as conduits for nerve repair.However,immunological rejection of conduits made of natural biomaterials limits their application.Therefore,it is essential to identify more suitable types of biomaterials.OBJECTIVE:To observe the characteristics of a bioengineering processing method using venous conduit as a stent for repairing facial nerve injury.DESIGN:A controlled observational experiment.SETTING:Animal Laboratories of the Third Hospital Affiliated to Sun Yat-sen University and the 157 Hospital.MATERIALS:Thirty-three male New Zealand rabbits of pure breed,weighing 1.5 to 2.0 kg,were provided by Medical Experimental Animal Room of Sun Yat-sen University.The protocol was carried out in accordance with animal ethics guidelines for the use and care of animals.Venous conduits and autogenous nerves were transplanted into the left and right cheeks,respectively.Eleven animals were chosen for anatomical observations at 5,10 and 15 weeks after surgery.METHODS:This experiment was carried out in the Animal Laboratories of the Third Hospital Affiliated to Sun Yat-sen University and the 157 Hospital between May and November 2006.After animals were anesthetized,15 mm of retromandibular vein was harvested for preparing a venous conduit.Approximately 3 cm of low buccal branch of facial nerve was exposed.A segment of 1.2 cm nerve was resected from the middle,and a gap of 1.5 cm formed due to bilateral retraction.The prepared venous conduit of 1.5 cm was sutured to the outer membrane of the severed ends of the nerve.Muscle and skin were sutured layer by layer.Using the same above-mentioned method,the low buccal branch of right autogenous facial nerve was resected,and the left facial nerve segment from the same animal was transplanted using end-to-end neurorrhaphy for control.MAIN OUTCOME MEASURES:①Post-operatively,food intake,vibrissae activity and wound healing of

  3. Rabbit facial nerve regeneration in NGF-containing silastic tubes.

    Science.gov (United States)

    Spector, J G; Lee, P; Derby, A; Frierdich, G E; Neises, G; Roufa, D G

    1993-05-01

    Previous reports suggest that exogenous nerve growth factor (NGF) enhanced nerve regeneration in rabbit facial nerves. Rabbit facial nerve regeneration in 10-mm Silastic tubes prefilled with NGF was compared to cytochrome C (Cyt. C), bridging an 8-mm nerve gap. Three weeks following implantation, NGF-treated regenerates exhibited a more mature fascicular organization and more extensive neovascularization than cytochrome-C-treated controls. Morphometric analysis at the midtube of 3- and 5-week regenerates revealed no significant difference in the mean number of myelinated or unmyelinated axons between NGF- and cytochrome-C-treated implants. However, when the number of myelinated fibers in 5-week regenerates were compared to their respective preoperative controls, NGF-treated regenerates had recovered a significantly greater percentage of myelinated axons than cytochrome-C--treated implants (46% vs. 18%, respectively). In addition, NGF-containing chambers reinnervated a higher percentage of myelinated axons in the distal transected neural stumps (49% vs. 34%). Behavioral and electrophysiologic studies demonstrated spontaneous and induced activities in the target muscles when approximately one third of the myelinated axons were recovered in the midchamber (1280 axons). Horseradish peroxidase (HRP) studies demonstrated retrograde axonal transport to the midchamber and proximal transected neural stump. PC12 bioassay demonstrated persistent NGF activity in the intrachamber fluids at 3 (5:1 dilution) and 5 (2:1 dilution) weeks of entubation. Electrophysiologic tests demonstrated a slow conduction velocity of a propagated electrical impulse (43.5 m/s-1 vs. 67 m/s-1) and shallow wide compound action potential. In wider defects (15-mm chambers) and longer entubation periods (7 weeks), no regeneration or NGF activity was seen. Therefore, exogenous NGF provides an early but limited neurotrophic effect on the regeneration of the rabbit buccal division of the facial nerve and a

  4. Applied anatomy of the superficial branch of the radial nerve.

    Science.gov (United States)

    Robson, A J; See, M S; Ellis, H

    2008-01-01

    The superficial branch of the radial nerve (SBRN) is highly vulnerable to trauma and iatrogenic injury. This study aimed to map the course of the SBRN in the context of surgical approaches and identify a safe area of incision for de Quervain's tenosynovitis. Twenty-five forearms were dissected. The SBRN emerged from under brachioradialis by a mean of 8.31 cm proximal to the radial styloid (RS), and remained radial to the dorsal tubercle of the radius by a mean of 1.49 cm. The nerve divided into a median of four branches. The first branch arose a mean of 4.92 cm proximal to the RS, traveling 0.49 cm radial to the first compartment of the extensor retinaculum, while the main nerve remained ulnar to it by 0.64 cm. All specimens had branches underlying the traditional transverse incision for de Quervain's release. A 2.5-cm longitudinal incision proximal from the RS avoided the SBRN in 17/25 cases (68%). In 20/25 specimens (80%), the SBRN underlay the cephalic vein. In 18/25 (72%), the radial artery was closely associated with a sensory nerve branch near the level of the RS (SBRN 12/25, lateral cutaneous nerve of the forearm (LCNF) 6/25.) A longitudinal incision in de Quervain's surgery may be preferable. Cannulation of the cephalic vein in the distal third of the forearm is best avoided. The close association between the radial artery and first branch of the SBRN or the LCNF may explain the pain often experienced during arterial puncture. Particular care should be taken during radial artery harvest to avoid nerve injury.

  5. Blunt Facial Trauma Causing Isolated Optic Nerve Hematoma

    Directory of Open Access Journals (Sweden)

    R. Parab

    2013-01-01

    Full Text Available Traumatic optic neuropathy is an uncommon, yet serious, result of facial trauma. The authors present a novel case of a 59-year-old gentleman who presented with an isolated blunt traumatic left optic nerve hematoma causing vision loss. There were no other injuries or fractures to report. This case highlights the importance of early recognition of this rare injury and reviews the current literature and management of traumatic optic neuropathy.

  6. Facial Nerve Schwannoma of Parotid Gland: Difficulties in Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Murat Damar

    2016-01-01

    Full Text Available Facial nerve schwannomas (FNS are encapsulated benign tumors arising from Schwann cells of seventh cranial nerve. Most of the facial nerve schwannomas are localized in intratemporal region; only 9% of cases involve a portion of the extratemporal segment. Preoperative diagnosis is often unclear; diagnosis is often made intraoperatively. Management of intraparotid FNS is troublesome because of the facial nerve paralysis. In this report we presented a case of intraparotid schwannoma in a 55-year-old male patient complaining of a painless mass without peripheral facial nerve palsy in left parotid gland. Clinical features, preoperative and intraoperative diagnosis, and difficulties during management are discussed with the review of the literature.

  7. [Clinical-electroneuromyographical characteristics of facial nerve paralysis in children].

    Science.gov (United States)

    Gribova, N P; Galitskaia, O S

    2009-01-01

    A clinical-electroneuromyographical study of 40 children (32 (80%) of them aged from 12 to 17 years, mean age 13,9+/-1,8 years, and 8 (20%) - from 1 to 8 years, mean age 4,4+/-2,1 years) were studied in the acute period of facial nerve paralysis (FNP). Six (15%) children had FNP in the anamnesis. Among precipitating factors were the cold exposure the day before disease onset (20 (50%) patients), symptoms of flu (13 (32,5%) patients) and psycho-emotional tension (3 (7,5%) patients). No precipitation was noted in 4 (10%) children. The degree of muscle paresis was 81,9+/-7% that corresponded to clinical stages III-IV according to K. Rosler. An electroneuromyographical analysis of motor ortho- and antidromic response to the facial nerve stimulation on the side of paresis and on the contralateral side in patients and controls revealed the presence of proximal axon- and myelinopathy of facial nerve with the involvement of its own motorneurons and brain stem interneurons. The maintenance of wink reflex and F-wave blocks in the period over 3 weeks are prognostically unfavorable factors for restoration of mimic muscle function in the early stage of disease.

  8. CLINICAL AND EXPERIMENTAL STUDIES OF LARGE AMPLITUDE ACTION POTENTIAL OF THE SUFFERED FACIAL MUSCLES IN INTRATEMPORAL FACIAL NERVE PARALYSIS

    Institute of Scientific and Technical Information of China (English)

    任重; 惠莲

    1999-01-01

    Objctive. To testify the phenomenon that large amplitude action potential appears at the early stage oil facial paralysis, and to search for the mechanism through clinical and experimental studies. Patients(aninmls) and methods. The action potentials of the orbicular ocular and oral museles were recorded in 34 normal persons by electromyogram instrtiments. The normal range of amplitude percentage was found out according to the normal distribution, One hundred patients with facial paralysis were also studied. The action potentials of facial muscles were recorded ia 17 guinea pigs before and after the facial nerve was comp~ and the facial nerve was examined under electromicroscope before and after the compression.Results. The amplitude percentage of the suffered side to the healthy side was more than 153 percent in 6 of the 100 patients. Large amplitude action potential occured in 35 per cent guinea pigs which were performed the experiment of facial nerve compression. Electromicroscopic examination revealed separation of the lammae of the facial nerve's myelin sheath in the guinea pigs which exhibited large amplitude action potential Conclusion. The facial nerve exhibited a temporary over-excitability at the early stage of facial nerve injury in scane patients and guinea pigs. If the injury was limited in the myelin sheath, the prognods was relatively good.

  9. The Trigeminal (V) and Facial (VII) Cranial Nerves: Head and Face Sensation and Movement

    OpenAIRE

    Sanders, Richard D.

    2010-01-01

    There are close functional and anatomical relationships between cranial nerves V and VII in both their sensory and motor divisions. Sensation on the face is innervated by the trigeminal nerves (V) as are the muscles of mastication, but the muscles of facial expression are innervated mainly by the facial nerve (VII) as is the sensation of taste. This article briefly reviews the anatomy of these cranial nerves, disorders of these nerves that are of particular importance to psychiatry, and some ...

  10. MRI enhancement of the facial nerve with Gd-DTPA, 1; Experimental study on the enhancement mechanism used in viewing vascular permeability of the facial nerve

    Energy Technology Data Exchange (ETDEWEB)

    Yanagida, Masahiro (Kansai Medical School, Moriguchi, Osaka (Japan))

    1993-08-01

    Although there have recently been numerous reports of enhanced MRI in patients with facial palsy, the mechanism of enhancement remains largely unknown. In the present study, animal models with experimentally induced facial paralysis were prepared, and the vascular permeabilities of normal and damaged facial nerves were assessed using Evans blue albumin (EBA) as a tracer. The Gd-DTPA contents in normal and compressively damaged facial nerves were also investigated. In the normal intratemporal facial nerve, EBA remained in the vessels, and did not leak into the endoneurium. In contrast, vascular permeability was very high in the epineurium and the geniculate ganglion which showed leakage of large amounts of EBA from vessels. At the site of compression in the damaged nerve, EBA leakage was also seen in the endoneurism, indicating accentuated vascular permeability. This accentuation of vascular permeability shifted toward the distal side. However, no EBA leakage was seen on the side proximal to the site of compression. Significantly higher Gd-DTPA contents were obtained in the facial nerve on the paralytic side than in that on the normal side (p<0.001). As for differences between the distal and proximal sides, the distal side had a significantly higher Gd-DTPA content (p<0.01). Assessment of vascular permeability with EBA revealed accentuated vascular permeability on the side distal to the site of compression. These results showed the presence of a blood nerve barrier (BNB) in the facial nerve. Furthermore, the present findings suggest that the enhancement of the facial nerve on the affected side is caused by BNB destruction due to nerve damage and subsequent Gd-DTPA leakage from the vessels. Furthermore, it is suggested that the facial nerve enhancement appears to occur mainly on the distal side of the damaged portion of the nerve. (author).

  11. CLINICAL AND EXPERIMENTAL STUDIES OF LARGE AMPLITUDE ACTION POTENTIAL OF THE SUFFERED FACIAL MUSCLES IN INTRATEMPORAL FACIAL NERVE PARALYSIS

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    Ojective. To testify the phenomenon that large amplitude action potential appears at the early stage of facial paralysis, and to search for the mechanism through clinical and experimental studies. Patients(animals) and methods. The action potentials of the orbicular ocular and oral muscles were recorded in 34 normal persons by electromyogram instruments. The normal range of amplitude percentage was found out according to he normal distribution. One hundred patients with facial paralysis were also studied. The action potentials of facial muscles were recorded in 17 guinea pigs before and after the facial nerve was compressed and the facial nerve was examined under electromicroscope before and after the compression.Results. The amplitude percentage of the suffered ide to the healthy side was more than 153 percent in 6 of the 100 patients. Lare amplitude action potential ocured in 35 per cent guinea pigs which were performed the experiment of facial nrve compression. Electromicroscopic examination revealed separation of the lammae of the facial nerve's myelin sheath in the guinea pigs which exhibited large amplitude action potential.Conclusion. The facial nerve exhibited a temporary over-exciability at the early stage of facial nerve injury in some patients and guinea pigs. If the injury waslimited in the myelin sheath, te prognosis was relatively good.

  12. Neuro-ophthalmological approach to facial nerve palsy

    Science.gov (United States)

    Portelinha, Joana; Passarinho, Maria Picoto; Costa, João Marques

    2014-01-01

    Facial nerve palsy is associated with significant morbidity and can have different etiologies. The most common causes are Bell’s palsy, Ramsay–Hunt syndrome and trauma, including surgical trauma. Incidence varies between 17 and 35 cases per 100,000. Initial evaluation should include accurate clinical history, followed by a comprehensive investigation of the head and neck, including ophthalmological, otological, oral and neurological examination, to exclude secondary causes. Routine laboratory testing and diagnostic imaging is not indicated in patients with new-onset Bell’s palsy, but should be performed in patients with risk factors, atypical cases or in any case without resolution within 4 months. Many factors are involved in determining the appropriate treatment of these patients: the underlying cause, expected duration of nerve dysfunction, anatomical manifestations, severity of symptoms and objective clinical findings. Systemic steroids should be offered to patients with new-onset Bell’s palsy to increase the chance of facial nerve recovery and reduce synkinesis. Ophthalmologists play a pivotal role in the multidisciplinary team involved in the evaluation and rehabilitation of these patients. In the acute phase, the main priority should be to ensure adequate corneal protection. Treatment depends on the degree of nerve lesion and on the risk of the corneal damage based on the amount of lagophthalmos, the quality of Bell’s phenomenon, the presence or absence of corneal sensitivity and the degree of lid retraction. The main therapy is intensive lubrication. Other treatments include: taping the eyelid overnight, botulinum toxin injection, tarsorrhaphy, eyelid weight implants, scleral contact lenses and palpebral spring. Once the cornea is protected, longer term planning for eyelid and facial rehabilitation may take place. Spontaneous complete recovery of Bell’s palsy occurs in up to 70% of cases. Long-term complications include aberrant regeneration

  13. Homozygous hemoglobin S (HbSS) presenting with bilateral facial nerve palsy: a case report

    OpenAIRE

    Ogundunmade, Babatunde Gbolahan; Jasper, Unyime Sunday

    2014-01-01

    Background Bilateral facial nerve palsy is a relatively rare presentation and often points to a serious underlying medical condition. Several studies have reported presentation of bilateral facial nerve palsy in association with Lyme disease, Guillain-Barre syndrome, systemic lupus erythematosus, human immunodeficiency virus, sarcoidosis, diabetes and Hanson disease. While unilateral facial nerve palsy is sometimes associated with hemiplegia in sickle cell patients, no case of bilateral facia...

  14. Facial nerve palsy: incidence of different ethiologies in a tertiary ambulatory

    OpenAIRE

    Atolini Junior, Nédio; Jorge Junior, José Jarjura; Gignon, Vinícius de Faria; Kitice, Adriano Tomio; Prado, Letícia Suriano de Almeida; Santos, Vânia Gracia Wolff

    2009-01-01

    Introduction: The ethiologic diferencial diagnostic for facial nerve paralisis is still a challenge and the literature has shown conflictive results concerning its epidemiology. Objective: To outline the incidence of the different ethiologies and the profile of peripheral facial nerve paralysis patients in the otolaryngology ambulatory of the Faculdade de Ciencias Medicas e Biologicas da PUC-SP - campus Sorocaba. Method: The records of 54 patients with facial nerve paralysis seen during the y...

  15. Middle ear osteoma causing progressive facial nerve weakness: a case report

    OpenAIRE

    Curtis, Kate; Bance, Manohar; Carter, Michael; Hong, Paul

    2014-01-01

    Introduction Facial nerve weakness is most commonly due to Bell’s palsy or cerebrovascular accidents. Rarely, middle ear tumor presents with facial nerve dysfunction. Case presentation We report a very unusual case of middle ear osteoma in a 49-year-old Caucasian woman causing progressive facial nerve deficit. A subtle middle ear lesion was observed on otoscopy and computed tomographic images demonstrated an osseous middle ear tumor. Complete surgical excision resulted in the partial recovery...

  16. Preauricular transparotid approach to mandibular condylar fractures without dissecting facial nerves.

    Science.gov (United States)

    Yabe, Tetsuji; Tsuda, Tomoyuki; Hirose, Shunsuke; Ozawa, Toshiyuki

    2013-07-01

    Preauricular transparotid approach without dissecting the facial nerve was used for surgical treatment of 15 condylar fractures in 14 patients. The parotid fascia was opened just above the fracture site, and by dissecting the parotid gland and masseter muscle, the fracture was directly exposed. The facial nerve itself was not dissected expressly. All fractures could be reduced accurately and fixed firmly with miniplates. A direct approach just above the fracture site provided good vision of the fracture, avoiding facial nerve palsy caused by strong retraction. Moreover, by not dissecting the facial nerve, the operation time was shortened. This approach was useful for surgical treatment of both condylar neck and subcondylar fractures.

  17. Facial nerve paralysis and frey syndrome in an infant following removal of an internal mandibular distraction device.

    Science.gov (United States)

    Kapadia, Sameer Mehbub; Golinko, Michael Samuel; Williams, Joseph Kerwin

    2013-05-01

    Mandibular distraction using an implantable device has become a widely accepted and utilized procedure for the treatment of retrognathia. Although excellent results have been reported and observed with distraction osteogenesis, complications such as facial nerve injury have been previously reported. Often, this injury is usually temporary and corrects over the course of time. Frey syndrome has been classically described as an injury or severance of the auricotemporal branch of the trigeminal nerve. It is commonly seen as a complication of parotid surgery and has never been reported in association with mandibular distraction. The authors report a unique case of both facial nerve paralysis and Frey syndrome in a patient following the removal of an internal mandibular distraction device. A review of the literature along with diagnosis and management are discussed.

  18. Artificial facial nerve reflex restores eyelid closure following orbicularis oculi muscle denervation

    Institute of Scientific and Technical Information of China (English)

    Yujuan Wang; Keyong Li; Jingquan Liu; Dongyue Xu; Yuefeng Rui; Chunsheng Yang

    2010-01-01

    To date, treatment of peripheral facial paralysis has focused on preservation of facial nerve integrity. However, with seriously damaged facial nerve cases, it is difficult to recover anatomical and functional integrity using present therapies. Therefore, the present study utilized artificial facial nerve reflex to obtain orbicularis oculi muscle (OOM) electromyography signals on the uninjured side through the use of implanted recording electrodes. The implanted electrical chips analyzed facial muscle motion on the uninjured side and triggered an electrical stimulator to emit current pulses, which resulted in stimulation of injured OOM contraction and maintained bilateral symmetry and consistency. Following signal recognition, extraction, and computer analysis, electromyography signals in the uninjured OOM resulted in complete eyelid closure, which was consistent with the voltage threshold for eye closure. These findings suggested that artificial facial nerve reflex through the use of implanted microelectronics in unilateral peripheral facial paralysis could restore eyelid closure following orbicularis oculi muscle denervation.

  19. Occipital nerve block is effective in craniofacial neuralgias but not in idiopathic persistent facial pain.

    Science.gov (United States)

    Jürgens, T P; Müller, P; Seedorf, H; Regelsberger, J; May, A

    2012-04-01

    Occipital nerve block (ONB) has been used in several primary headache syndromes with good results. Information on its effects in facial pain is sparse. In this chart review, the efficacy of ONB using lidocaine and dexamethasone was evaluated in 20 patients with craniofacial pain syndromes comprising 8 patients with trigeminal neuralgia, 6 with trigeminal neuropathic pain, 5 with persistent idiopathic facial pain and 1 with occipital neuralgia. Response was defined as an at least 50% reduction of original pain. Mean response rate was 55% with greatest efficacy in trigeminal (75%) and occipital neuralgia (100%) and less efficacy in trigeminal neuropathic pain (50%) and persistent idiopathic facial pain (20%). The effects lasted for an average of 27 days with sustained benefits for 69, 77 and 107 days in three patients. Side effects were reported in 50%, albeit transient and mild in nature. ONBs are effective in trigeminal pain involving the second and third branch and seem to be most effective in craniofacial neuralgias. They should be considered in facial pain before more invasive approaches, such as thermocoagulation or vascular decompression, are performed, given that side effects are mild and the procedure is minimally invasive.

  20. Comparison of trophic factors' expression between paralyzed and recovering muscles after facial nerve injury. A quantitative analysis in time course.

    Science.gov (United States)

    Grosheva, Maria; Nohroudi, Klaus; Schwarz, Alisa; Rink, Svenja; Bendella, Habib; Sarikcioglu, Levent; Klimaschewski, Lars; Gordon, Tessa; Angelov, Doychin N

    2016-05-01

    After peripheral nerve injury, recovery of motor performance negatively correlates with the poly-innervation of neuromuscular junctions (NMJ) due to excessive sprouting of the terminal Schwann cells. Denervated muscles produce short-range diffusible sprouting stimuli, of which some are neurotrophic factors. Based on recent data that vibrissal whisking is restored perfectly during facial nerve regeneration in blind rats from the Sprague Dawley (SD)/RCS strain, we compared the expression of brain derived neurotrophic factor (BDNF), fibroblast growth factor-2 (FGF2), insulin growth factors 1 and 2 (IGF1, IGF2) and nerve growth factor (NGF) between SD/RCS and SD-rats with normal vision but poor recovery of whisking function after facial nerve injury. To establish which trophic factors might be responsible for proper NMJ-reinnervation, the transected facial nerve was surgically repaired (facial-facial anastomosis, FFA) for subsequent analysis of mRNA and proteins expressed in the levator labii superioris muscle. A complicated time course of expression included (1) a late rise in BDNF protein that followed earlier elevated gene expression, (2) an early increase in FGF2 and IGF2 protein after 2 days with sustained gene expression, (3) reduced IGF1 protein at 28 days coincident with decline of raised mRNA levels to baseline, and (4) reduced NGF protein between 2 and 14 days with maintained gene expression found in blind rats but not the rats with normal vision. These findings suggest that recovery of motor function after peripheral nerve injury is due, at least in part, to a complex regulation of lesion-associated neurotrophic factors and cytokines in denervated muscles. The increase of FGF-2 protein and concomittant decrease of NGF (with no significant changes in BDNF or IGF levels) during the first week following FFA in SD/RCS blind rats possibly prevents the distal branching of regenerating axons resulting in reduced poly-innervation of motor endplates.

  1. Traumatic lesions of internal saphenous nerve and branches.

    Science.gov (United States)

    Rodrigues, Flávio Freinkel; Skartz, Issac; Dozza, Diego Cassol; Moscovici, Maurício; Suchmacher, Mendel

    2009-09-01

    To show a rare lesion that sometimes simulates vascular disorder of the lower extremities. Three patients were operated and the follow-up period was eight months, the surgical technique was neurotomy of the infrapatellar and descendent branches. In two cases there were almost total pain resolution, and in other case improvement only. Surgical treatment yields good results in this type of internal saphenous nerve lesion, and could be useful as an alternative to conservative treatment.

  2. Hypoglossal-Facial Nerve Reconstruction Using a Y-Tube-Conduit Reduces Aberrant Synkinetic Movements of the Orbicularis Oculi and Vibrissal Muscles in Rats

    Directory of Open Access Journals (Sweden)

    Yasemin Kaya

    2014-01-01

    Full Text Available The facial nerve is the most frequently damaged nerve in head and neck trauma. Patients undergoing facial nerve reconstruction often complain about disturbing abnormal synkinetic movements of the facial muscles (mass movements, synkinesis which are thought to result from misguided collateral branching of regenerating motor axons and reinnervation of inappropriate muscles. Here, we examined whether use of an aorta Y-tube conduit during reconstructive surgery after facial nerve injury reduces synkinesis of orbicularis oris (blink reflex and vibrissal (whisking musculature. The abdominal aorta plus its bifurcation was harvested (N = 12 for Y-tube conduits. Animal groups comprised intact animals (Group 1, those receiving hypoglossal-facial nerve end-to-end coaptation alone (HFA; Group 2, and those receiving hypoglossal-facial nerve reconstruction using a Y-tube (HFA-Y-tube, Group 3. Videotape motion analysis at 4 months showed that HFA-Y-tube group showed a reduced synkinesis of eyelid and whisker movements compared to HFA alone.

  3. Multivariate Analysis of Factors Influencing Facial Nerve Outcome following Microsurgical Resection of Vestibular Schwannoma.

    Science.gov (United States)

    Torres, Renato; Nguyen, Yann; Vanier, Antoine; Smail, Mustapha; Ferrary, Evelyne; Sterkers, Olivier; Kalamarides, Michel; Bernardeschi, Daniele

    2017-03-01

    Objective To assess through multivariate analysis the clinical pre- and intraoperative factors of facial nerve outcomes at day 8 and 1-year recovery of facial palsy, as compared with day 8 status among patients who underwent total resection of unilateral vestibular schwannoma. Study Design Case series with chart review. Setting Tertiary referral center. Subjects and Methods This study included 229 patients with preoperative normal facial function and anatomic preservation of the facial nerve. Clinical, radiologic, and intraoperative factors were assessed according to facial nerve function at day 8 and 1 year. Results We observed that 74% and 84% of patients had good facial function (House-Brackmann [HB] I-II) at day 8 and 1 year, respectively. Of 60 patients, 26 (43%) who had impaired facial function (HB III-VI) at day 8 recovered good facial function (HB I-II) 1 year after surgery. A structured equation model showed that advanced tumor stage and strong facial nerve adhesion were independently associated with facial nerve conduction block at day 8. No predictive factor of impaired facial function recovery was seen at 1 year. In terms of the extracanalicular diameter of the tumor, the cutoff point to minimize the risk of impaired facial function was 16 mm. Conclusion At day 8 after vestibular schwannoma resection, facial function was impaired in the case of large tumors or strong facial nerve adhesion to the tumor. After 1 year, less than half of the patients recovered good facial function, and no predictive factor was found to be associated with this possible recovery.

  4. The Dilator Naris Muscle as a Reporter of Facial Nerve Regeneration in a Rat Model

    NARCIS (Netherlands)

    Weinberg, J.S.; Kleiss, I.J.; Knox, C.J.; Heaton, J.T.; Hadlock, T.A.

    2016-01-01

    OBJECTIVE: Many investigators study facial nerve regeneration using the rat whisker pad model, although widely standardized outcomes measures of facial nerve regeneration in the rodent have not yet been developed. The intrinsic whisker pad "sling" muscles producing whisker protraction, situated at t

  5. What is expected of the facial nerve in michel aplasia? Anatomic variation.

    Science.gov (United States)

    Zarandy, Masoud Motasaddi; Kouhi, Ali; Kashany, Shervin Sharif; Rabiei, Sohrab; Hajimohamadi, Fatemeh; Rabbani-Anari, Mahtab

    2010-11-01

    We sought better understanding about the facial nerve anatomy in the rare inner ear Michel anomaly to help better define this aplasia and prevent potential complications in surgery on these patients. The data from computed tomography scans and magnetic resonance images of six Michel aplastic ears (three patients) were evaluated for a facial nerve course. Facial nerve course and anatomic landmarks were noted. Based on data obtained from this group of very rare patients, three different facial nerve anatomies were encountered. The first patient had normal-looking mastoid cells, normal middle ear ossicles, and a completely formed facial nerve canal through the middle ear. The second patient had pneumatized mastoid air cells despite an anomalous ossicular chain. This patient also had a facial nerve canal but not through the middle ear. In the third patient, although mastoid cells were present, neither ossicles nor a definite facial nerve canal could be detected. With guidance provided by the anatomy of the other parts of the ear, such as air cells and the ossicular chain, the danger zones posing a high probability of facial nerve injury can be predicted. Although all Michel aplasias may have aplastic petrous bone in common, there are some degrees of variation.

  6. Guillain-Barre Syndrome Presenting With Bilateral Facial Nerve Palsy

    Directory of Open Access Journals (Sweden)

    Soroor INALOO

    2013-12-01

    Full Text Available Abstract How to Cite This Article: Inaloo S, Katibeh P. Guillain-Barre Syndrome Presenting With Bilateral Facial Nerve Palsy. Iran J Child Neurol. 2014 Winter;8(1:69-71. Objective This case study is about an 11-year-old girl with bilateral facial weakness, abnormal taste sensation, and deep tendon reflexes of both knees and ankles were absent. However, the muscle power of the lower and upper extremities across all muscle groups was normal. After 2 days, she developed paresthesia and numbness in the lower extremities. Other neurologic examinations, such as fundoscopic evaluation of the retina were normal with the muscle power of both upper- and lower-extremities intact. A lumbar puncture revealed albumincytological dissociation. EMG and NCV were in favor of Guillain-Barre syndrome, for which IVIG was prescribed and the abnormal sensations in the lower limbs rapidly improved. Bilateral facial diplegia without weakness and paresthesia is a variant of Guillain-Barre syndrome that mostly presents with acute onset, rapid progression with or without limb weakness, paresthesia, and decreased or absent DTR and albumin-cytological dissociation.

  7. Characteristics of the perception for unilateral facial nerve palsy.

    Science.gov (United States)

    Mun, Sue Jean; Park, Kyung Tae; Kim, Yoonjoong; Park, Joo Hyun; Kim, Young Ho

    2015-11-01

    Patients with facial nerve palsy (FNP) are actually evaluated by other people rather than doctors or the patients themselves. This study was performed to investigate the characteristics of the perception of unilateral FNP in Korean people. A questionnaire using photographs of four patients with four different grades (House-Brackmann) of FNP was given to two hundred people with no FNP. Subjects of each gender, ranging from 20 to 69 years of age, participated. The questionnaire, showing facial expressions of resting, smiling, whistling, eye closing, and frowning, consisted of questions concerning the identification and the involved side of FNP, the unnatural areas of the face, and the unnaturalness of the facial expressions. The overall identification rate of FNP was 75.0%. The identification rate increased according to the increase in the grade of the patient's FNP (p FNP according to education level. However, the overall detection rate of the involved side was higher in the high-education group (p FNP was lower than the rate of identification of FNP and was significantly low in the middle-aged/elderly and low-education level groups.

  8. Aberrant course of a communicating branch of the ulnar nerve to the median nerve contributing to hypothenar Hammer syndrome.

    Science.gov (United States)

    Richards, Winston T; Bullocks, Jamal M; Norris, Morgan E

    2007-06-01

    This presentation represents a unique anatomic predisposition to the development of hypothenar hammer syndrome (HHS). In this case, a communicating branch of the ulnar nerve to the median common digital nerve of the ring finger was identified crossing volar to the superficial palmar arch. This relationship caused thrombosis of the superficial palmar arch proximal to this crossing nerve branch. The aberrant course of this nerve created a structural anomaly contributing to HHS, which ultimately mandated surgical intervention.

  9. Rare Presentation of Rhino-Orbital-Cerebral Zygomycosis: Bilateral Facial Nerve Palsy

    Directory of Open Access Journals (Sweden)

    Alireza Mohebbi

    2011-01-01

    Full Text Available Rhino-orbital-cerebral zygomycosis afflicts primarily diabetics and immunocompromised individual, but can also occur in normal hosts rarely. We here presented an interesting case of facial nerve palsy and multiple cold abscesses of neck due to rhino-orbital-cerebral zygomycosis in an otherwise healthy man. Although some reports of facial nerve paralysis in conjunction with rhino-orbital-cerebral zygomycosis exist, no case of bilateral complete facial paralysis has been reported in the literature to date.

  10. Multiple dental anomalies accompany unilateral disturbances in abducens and facial nerves: A case report

    Directory of Open Access Journals (Sweden)

    Elham Talatahari

    2016-01-01

    Full Text Available This article describes the oral rehabilitation of an 8-year-old girl with extensively affected primary and permanent dentition. This report is unique in which distinct dental anomalies including enamel hypoplasia, irregular dentin formation, taurodontism, hpodontia and dens in dente accompany unilateral disturbance of abducens and facial nerves which control the lateral eye movement, and facial expression, respectively.   Keywords: enamel hypoplasia; irregular dentin formation; taurodontism; hypodontia; dens in dente; abducens and facial nerves;

  11. Facial nerve neurinoma presenting as middle cranial fossa and cerebellopontine angle mass : a case report.

    Directory of Open Access Journals (Sweden)

    Devi B

    2000-10-01

    Full Text Available Facial nerve neurinomas are rare. The tumours arising from the geniculate ganglion may grow anteriorly and superiorly and present as a mass in the middle cranial fossa. Only a few cases of facial nerve neurinomas presenting as middle cranial fossa mass have so far been reported. These tumours present with either long standing or intermittent facial palsy along with cerebellopontine angle syndrome.

  12. Facial nerve intra parotid neuromas. Report of 2 cases; Tumeurs neurogenes intraparotidiennes du nerf facial. Interet de l`IRM

    Energy Technology Data Exchange (ETDEWEB)

    Fisch-Ponsot, C.; Sigal, R.; Schmutz, G.; Dacher, J.N.; Brazeau-Lamontagne, L.; Marchand, F.; Dorion, D. [Centre Universitaire de sante de l`Estrie, Shebrooke (Canada)

    1997-09-01

    Facial nerve intra-parotid neuromas are rare. We report two cases with no facial paralysis. In the first case, the clinical protocol for the evaluation of a parotid mass did not suggest the intra-mastoid tumor extension. This tumor extension was shown by CT and MRI and confirmed by gross and microscopic appearance. In the second case, no intrapretrous extension was observed with MRI. The diagnosis of neuroma was made during surgery. With a literature review, we discuss the diagnostic difficulties encountered in the investigation of parotid facial nerve tumors, emphasizing on the usefulness of CT and MRI in its diagnosis. (authors). 14 refs.

  13. Nicotine effects on muscarinic receptor-mediated free Ca[Formula: see text] level changes in the facial nucleus following facial nerve injury.

    Science.gov (United States)

    Sun, Dawei; Zhou, Rui; Dong, Anbing; Sun, Wenhai; Zhang, Hongmei; Tang, Limin

    2016-06-01

    It was suggested that muscarinic, and nicotinic receptors increase free Ca[Formula: see text] levels in the facial nerve nucleus via various channels following facial nerve injury. However, intracellular Ca[Formula: see text] overload can trigger either necrotic or apoptotic cell death. It is assumed that, following facial nerve injury, the interactions of nicotinic and muscarinic acetylcholine receptors in facial nerve nucleus may negatively regulate free Ca[Formula: see text] concentrations in the facial nerve nucleus, which provide important information for the repair and regeneration of the facial nerve. The present study investigated the regulatory effects of nicotine on muscarinic receptor-mediated free calcium ion level changes in the facial nucleus in a rat model of facial nerve injury at 7, 30, and 90 days following facial nerve injury using laser confocal microscopy. The dose-dependent regulation of nicotine on muscarinic receptor-mediated free calcium ion level changes in the facial nucleus may decrease the range of free Ca[Formula: see text] increases following facial nerve injury, which is important for nerve cell regeneration. It is concluded that the negative effects of nicotine on muscarinic receptors are related to the [Formula: see text] subtype of nicotinic receptors.

  14. Recovery of Facial Nerve Paralysis After Temporal Nerve Reconstruction: A Case Report

    OpenAIRE

    Emamhadi; Mahmoudi

    2015-01-01

    Introduction Facial paralysis is common following accidents, trauma, viral infection or tumors. Case Presentation A 24-year-old male patient was referred to us with a history of sharp penetrating trauma to the right temporal region causing unilateral paralysis of the muscles of the right forehead. He was unable to scowl or elevate his right eyebrow and there were no folds on his right forehead. Anastomosis of branches of the tempo...

  15. Negative regulation of gamma-aminobutyric acid type A receptor on free calcium ion levels following facial nerve injury

    Institute of Scientific and Technical Information of China (English)

    Fugao Zhu; Dawei Sun; Yanqing Wang; Rui Zhou; Junfeng Wen; Xiuming Wan; Yanjun Wang; Banghua Liu

    2010-01-01

    Previous studies have demonstrated that muscarinic, and nicotinic receptors increase free Ca2+ levels in the facial nerve nucleus via various channels following facial nerve injury. However, intracellular Ca2+ overload can trigger either necrotic or apoptotic cell death. Gamma-aminobutyric acid (GABA), an important inhibitory neurotransmitter in the central nervous system, exists in the facial nerve nucleus. It is assumed that GABA negatively regulates free Ca2+ levels in the facial nerve nucleus. The present study investigated GABA type A (GABAA) receptor expression in the facial nerve nucleus in a rat model of facial nerve injury using immunohistochemistry and laser confocal microscopy, as well as the regulatory effects of GABAA receptor on nicotinic receptor response following facial nerve injury. Subunits α1, α3, α5, β1, β2, δ, and γ3 of GABAA receptors were expressed in the facial nerve nucleus following facial nerve injury. In addition, GABAA receptor expression significantly inhibited the increase in nicotinic receptor-mediated free Ca2+ levels in the facial nerve nucleus following facial nerve injury in a concentration-dependent fashion. These results suggest that GABAA receptors exhibit negative effects on nicotinic receptor responses following facial nerve injury.

  16. Prediction of facial nerve position in large vestibular schwannomas using diffusion tensor imaging tractography and its intraoperative correlation

    Directory of Open Access Journals (Sweden)

    Sachin Anil Borkar

    2016-01-01

    Conclusion: This study validates the reliability of facial nerve DTI-based fiber tracking for prediction of the facial nerve position in patients with large VSs. The reliable preoperative visualization of facial nerve location in relation to the VS will allow surgeons to plan tumor removal accordingly and may increase the safety of surgery.

  17. Comparison of hemihypoglossal nerve versus masseteric nerve transpositions in the rehabilitation of short-term facial paralysis using the Facial Clima evaluating system.

    Science.gov (United States)

    Hontanilla, Bernardo; Marré, Diego

    2012-11-01

    Masseteric and hypoglossal nerve transfers are reliable alternatives for reanimating short-term facial paralysis. To date, few studies exist in the literature comparing these techniques. This work presents a quantitative comparison of masseter-facial transposition versus hemihypoglossal facial transposition with a nerve graft using the Facial Clima system. Forty-six patients with complete unilateral facial paralysis underwent reanimation with either hemihypoglossal transposition with a nerve graft (group I, n = 25) or direct masseteric-facial coaptation (group II, n = 21). Commissural displacement and commissural contraction velocity were measured using the Facial Clima system. Postoperative intragroup commissural displacement and commissural contraction velocity means of the reanimated versus the normal side were first compared using a paired sample t test. Then, mean percentages of recovery of both parameters were compared between the groups using an independent sample t test. Onset of movement was also compared between the groups. Significant differences of mean commissural displacement and commissural contraction velocity between the reanimated side and the normal side were observed in group I but not in group II. Mean percentage of recovery of both parameters did not differ between the groups. Patients in group II showed a significantly faster onset of movement compared with those in group I (62 ± 4.6 days versus 136 ± 7.4 days, p = 0.013). Reanimation of short-term facial paralysis can be satisfactorily addressed by means of either hemihypoglossal transposition with a nerve graft or direct masseteric-facial coaptation. However, with the latter, better symmetry and a faster onset of movement are observed. In addition, masseteric nerve transfer avoids morbidity from nerve graft harvesting. Therapeutic, III.

  18. Intratemporal facial nerve neuromas and their mimics: CT and MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Han, Moon Hee; Chang, Kee Hyun; Lee, Kyung Hwan; Cha, Sang Hoon; Kim, Chong Sun [Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Sang Joon [Chungang Gil General Hospital, Seoul (Korea, Republic of)

    1992-05-15

    CT and MR findings of nine cases with intra temporal facial nerve neuromas were described and compared with CT findings of 3 cases with facial nerve palsy and facial nerve canal erosion which may mimic facial nerve neuroma. The tympanic segment of the facial nerve was involved in 8 cases, mastoid segment in 7 cases and labyrinthine segment in 5 cases. The lesions were easily diagnosed with high resolution CT with bone algorithms by showing the expansion of bony structures along the course of the facial nerves. In 4 cases with large vertical segment tumors, extensive destruction of mastoid air cells and external auditory canals posed difficulty in making a diagnosis. Two out of 5 cases with labyrinthine segment involvement were presented as middle cranial fossa masses. MRI with enhancement was performed in 4 cases and was useful in characterizing the lesion as a tumor with its superior sensitivity to enhancement. Three cases of facial neuroma-mimicking lesion including post-inflammatory peri neural thickening, peri neural extension from parotid adenoid cystic carcinoma, and congenita; cholesteatoma showed irregular erosion or mild expansion of the facial nerve canal which may be helpful for differential diagnosis from neuromas.

  19. Bilateral abducens nerve and right facial nerve palsy occuring after head trauma

    Directory of Open Access Journals (Sweden)

    ismail Boyraz

    2016-06-01

    Full Text Available Lesions of the nervus abducens, the 6th cranial nerve tend to be rare, usually occur suddenly following head injuries. A 43-year-old male patient presented with a history of fall from a height due to an occupational accident on the date of 11.01.2014. Cranial tomography demonstrated bilateral epidural hematoma. The epidural hematoma was drained during the operation. After the surgery, eye examination showed no vision loss, except limited bilateral lateral gaze. When the patient was unable to walk due to diplopia, he was advised to close one eye. On the right side, there were findings suggesting central facial paralysis. There may be multiple cranial nerve damage following head injury. Therefore, all cranial nerves should be thoroughly examined. [J Contemp Med 2016; 6(2.000: 110-113

  20. Iatrogenic facial nerve palsy "Prevention is better than cure": Analysis of four cases

    Directory of Open Access Journals (Sweden)

    Rakesh Kumar

    2011-01-01

    Full Text Available Iatrogenic facial nerve palsy in mastoid surgery is considered a crime or a taboo in the present scenario of medical science. But one has to accept the fact that every otologist encounters this entity at some point in his/her career. Hence it is of prime importance to be equipped to detect and to manage these cases. The obvious and disfiguring facial deformity it causes makes this a dreaded complication. Our article here discusses our experience in managing four cases of iatrogenic facial palsy. The etiology in all the cases was mastoidectomy for cholesteatoma. The detection of the site and repair was performed by the same surgeon in all cases. The facial nerve was transected completely in three cases, and in one case there was partial loss (>50% of fibers. Cable nerve grafting was utilized in three patients. There was grade 4 improvement in three patients who underwent cable nerve grafting, and one patient had grade 2 recovery after end-to-end anastomosis. A good anatomical knowledge and experience with temporal bone dissection is of great importance in preventing facial nerve injury. If facial nerve injury is detected, it should be managed as early as possible. An end-to-end anastomosis provides better results in final recovery as opposed to cable nerve grafting for facial nerve repair.

  1. The tympanic segment of the facial nerve: anatomical study.

    Science.gov (United States)

    Nikolaidis, Vasilios; Nalbadian, Meri; Psifidis, Anestis; Themelis, Christos; Kouloulas, Athanasios

    2009-04-01

    There is a conroversy in the literature about the length of the proximal tympanic segment of the facial nerve (PTSFN). The objective of the current study is to measure the length of the tympanic segment of the facial nerve (TSFN) and of its proximal (PTSFN) and distal (DTSFN) segments, in normal human temporal bones. Moreover, we will explore if these lengths are correlated. If a form of a functional relationship can be established, it could offer insights in partially predicting or estimating the length of the TSFN as well as of its proximal and distal portions. Direct measurements were obtained in 40 normal human temporal bones, which were examined by surgical dissection. Relationships between these measurements were established using Pearson's correlation method (two-tailed). The length of the TSFN was on average 10.97 mm. The length of the PTSFN was on average 5.25 mm and of the DTSFN was 5.72 mm. No significant statistical differences according to gender or side (right or left) were detected. It was determined that the length of the TSFN was in linear correlation with positive direction with its proximal (PTSFN) and distal (DTSFN) segments. Also the PTSFN length was in linear correlation with positive direction with the DTSFN length. The length of the PTSFN comprises about one-half of the TSFN length. The existence of a definite correlation between the lengths of the TSFN, PTSFN, and DTSFN implies the existence of a form of functional interrelationship. This could facilitate prediction and identification of the TSFN and PTSFN lengths from the easily identifiable DTSFN length during surgery.

  2. EXPRESSION OF CALCITONIN GENE-RELATED PEPTIDE IN FACIAL NERVE OF HEMIFACIAL SPASM

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective To study the immunoreactivity of Calcitonin gene-related peptide (CGRP) in the facial nerve when Hemifacial Spasm is occurring. Methods The electrophysiological technique was used to explore abnormal muscle response (AMR) which was characteristic of Hemifacial Spasm.The animal models of Hemifacial Spasm in New Zealand white rabbits were established by compressing the main trunk of artificial demyelinated facial nerve with the temporal superficial artery. At 6 weeks after surgery, the facial nerves were taken from the experimental group and control one, the immunohistochemistry for CGRP using polyclonal antibody with ABC kit was performed in the facial nerves; at the same time, the observation for the facial nerves of light and transmission electron microscope was performed. Results The facial nerve demyelinated and the axons retrogressively changed, CGRP immunoreactive positive fibers were significantly detected in experimental groups; whereas this phenomenon was not found in control group. Conclusion CGRP can nutrien the injured facial nerve and plays an important role in the pathogenesis of Hemifacial Spasm.

  3. [Correlation between facial nerve functional evaluation and efficacy evaluation of acupuncture treatment for Bell's palsy].

    Science.gov (United States)

    Zhou, Zhang-ling; Li, Cheng-xin; Jiang, Yue-bo; Zuo, Cong; Cai, Yun; Wang, Rui

    2012-09-01

    To assess and grade facial nerve dysfunction according to the extent of facial paralysis in the clinical course of acupuncture treatment for Bell's palsy, and to observe the interrelationship between the grade, the efficacy and the period of treatment, as well as the effect on prognosis. The authors employed the House-Brackmann scale, a commonly used evaluation scale for facial paralysis motor function, and set standards for eye fissure and lips. According to the improved scale, the authors assessed and graded the degree of facial paralysis in terms of facial nerve dysfunction both before and after treatment. The grade was divided into five levels: mild, moderate, moderately severe, severe dysfunction and complete paralysis. The authors gave acupuncture treatment according to the state of the disease without artificially setting the treatment period. The observation was focused on the efficacy and the efficacy was evaluated throughout the entire treatment process. Fifty-three cases out of 68 patients with Bell's palsy were cured and the overall rate of efficacy was 97%. Statistically significant differences (Pfacial nerve dysfunction. Efficacy was correlated with the damage level of the disease (correlation coefficient r=0.423, Pfacial nerve dysfunction (Pfacial nerve dysfunction. Efficacy is reduced in correlation with an increase in facial nerve dysfunction, and the period of treatment varies in need of different levels of facial nerve dysfunction. It is highly necessary to assess and grade patients before observation and treatment in clinical study, and choose corresponding treatment according to severity of damage of the disease.

  4. Microanatomy and histological features of central myelin in the root exit zone of facial nerve.

    Science.gov (United States)

    Yee, Gi-Taek; Yoo, Chan-Jong; Han, Seong-Rok; Choi, Chan-Young

    2014-05-01

    The aim of this study was to evaluate the microanatomy and histological features of the central myelin in the root exit zone of facial nerve. Forty facial nerves with brain stem were obtained from 20 formalin fixed cadavers. Among them 17 facial nerves were ruined during preparation and 23 root entry zone (REZ) of facial nerves could be examined. The length of medial REZ, from detach point of facial nerve at the brain stem to transitional area, and the thickness of glial membrane of central myelin was measured. We cut brain stem along the facial nerve and made a tissue block of facial nerve REZ. Each tissue block was embedded with paraffin and serially sectioned. Slices were stained with hematoxylin and eosin (H&E), periodic acid-Schiff, and glial fibrillary acid protein. Microscopy was used to measure the extent of central myelin and thickness of outer glial membrane of central myelin. Thickness of glial membrane was examined at two different points, the thickest area of proximal and distal REZ. Special stain with PAS and GFAP could be differentiated the central and peripheral myelin of facial nerve. The length of medial REZ was mean 2.6 mm (1.6-3.5 mm). The glial limiting membrane of brain stem is continued to the end of central myelin. We called it glial sheath of REZ. The thickness of glial sheath was mean 66.5 µm (40-110 µm) at proximal REZ and 7.4 µm (5-10 µm) at distal REZ. Medial REZ of facial nerve is mean 2.6 mm in length and covered by glial sheath continued from glial limiting membrane of brain stem. Glial sheath of central myelin tends to become thin toward transitional zone.

  5. Surgical outcomes of lateral approach for jugular foramen schwannoma: postoperative facial nerve and lower cranial nerve functions.

    Science.gov (United States)

    Cho, Yang-Sun; So, Yoon Kyoung; Park, Kwan; Baek, Chung-Hwan; Jeong, Han-Sin; Hong, Sung Hwa; Chung, Won-Ho

    2009-01-01

    The lateral surgical approach to jugular foramen schwannomas (JFS) may result in complications such as temporary facial nerve palsy (FNP) and hearing loss due to the complicated anatomical location. Ten patients with JFS surgically treated by variable methods of lateral approach were retrospectively reviewed with emphasis on surgical methods, postoperative FNP, and lower cranial nerve status. Gross total removal of the tumors was achieved in eight patients. Facial nerves were rerouted at the first genu (1G) in six patients and at the second genu in four patients. FNP of House-Brackmann (HB) grade III or worse developed immediately postoperatively in six patients regardless of the extent of rerouting. The FNP of HB grade III persisted for more than a year in one patient managed with rerouting at 1G. Among the lower cranial nerves, the vagus nerve was most frequently paralyzed preoperatively and lower cranial nerve palsies were newly developed in two patients. The methods of the surgical approach to JFS can be modified depending on the size and location of tumors to reduce injury of the facial nerve and loss of hearing. Careful manipulation and caution are also required for short facial nerve rerouting as well as for long rerouting to avoid immediately postoperative FNP.

  6. Undifferentiated and differentiated adipose-derived stem cells improve nerve regeneration in a rat model of facial nerve defect.

    Science.gov (United States)

    Watanabe, Yorikatsu; Sasaki, Ryo; Matsumine, Hajime; Yamato, Masayuki; Okano, Teruo

    2017-02-01

    Autologous nerve grafting is the current procedure used for repairing facial nerve gaps. As an alternative to this method, tissue engineering cell-based therapy using induced pluripotent stem cells, Schwann cells and bone marrow-derived mesenchymal stem cells has been proposed. However, these cells have major problems, including tumorigenesis in induced pluripotent stem cells and invasiveness and limited tissue associated with harvesting for the other cells. Here, we investigated the therapeutic potential of adipose-derived stem cells (ASCs), which can be harvested easily and repeatedly by a minimally invasive liposuction procedure. The ASCs had characteristics of mesenchymal tissue lineages and could differentiate into Schwann-like cells that were relatively simple to isolate and expand in culture. In an in vivo study, a silicone conduit containing undifferentiated ASCs, differentiated ASCs or Schwann cells were transplanted, embedded in a collagen gel and the efficacy of repair of a 7 mm-gap in the rat facial nerve examined. Morphometric quantification analysis of regenerated facial nerves after a regeneration period of 13 weeks showed that undifferentiated ASCs, differentiated ASCs, and Schwann cells had similar potential for nerve regeneration. Furthermore, the functional recovery of facial nerve regeneration using a rat facial palsy scoring system in the three groups was close to that in autologous nerve graft positive controls. These findings suggest that undifferentiated and differentiated ASCs may both have therapeutic potential in facial nerve regeneration as a source of Schwann cells in cell-based therapy performed as an alternative to autologous nerve grafts. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

  7. Effects of Electroacupuncture on Facial Nerve Function and HSV-1 DNA Quantity in HSV-1 Induced Facial Nerve Palsy Mice.

    Science.gov (United States)

    Tang, Hongzhi; Feng, Shuwei; Chen, Jiao; Yang, Jie; Yang, Mingxiao; Zhong, Zhendong; Li, Ying; Liang, Fanrong

    2014-01-01

    Acupuncture is a common and effective therapeutic method to treat facial nerve palsy (FNP). However, its underlying mechanism remains unclear. This study was aimed to investigate the effects of electroacupuncture on symptoms and content of HSV-1 DNA in FNP mice. Mice were randomized into four groups, an electroacupuncture treatment group, saline group, model animal group, and blank control group. Electroacupuncture was applied at Jiache (ST6) and Hegu (LI4) in electroacupuncture group once daily for 14 days, while electroacupuncture was not applied in model animal group. In electroacupuncture group, mice recovered more rapidly and HSV-1 DNA content also decreased more rapidly, compared with model animal group. We conclude that electroacupuncture is effective to alleviate symptoms and promote the reduction of HSV-1 in FNP.

  8. Effects of Electroacupuncture on Facial Nerve Function and HSV-1 DNA Quantity in HSV-1 Induced Facial Nerve Palsy Mice

    Directory of Open Access Journals (Sweden)

    Hongzhi Tang

    2014-01-01

    Full Text Available Acupuncture is a common and effective therapeutic method to treat facial nerve palsy (FNP. However, its underlying mechanism remains unclear. This study was aimed to investigate the effects of electroacupuncture on symptoms and content of HSV-1 DNA in FNP mice. Mice were randomized into four groups, an electroacupuncture treatment group, saline group, model animal group, and blank control group. Electroacupuncture was applied at Jiache (ST6 and Hegu (LI4 in electroacupuncture group once daily for 14 days, while electroacupuncture was not applied in model animal group. In electroacupuncture group, mice recovered more rapidly and HSV-1 DNA content also decreased more rapidly, compared with model animal group. We conclude that electroacupuncture is effective to alleviate symptoms and promote the reduction of HSV-1 in FNP.

  9. Results of hemihypoglossal-facial nerve anastomosis in the treatment of facial nerve paralysis after failed stereotactic radiosurgery for vestibular schwannoma.

    Science.gov (United States)

    Dziedzic, Tomasz A; Kunert, Przemysław; Marchel, Andrzej

    2017-04-01

    Vestibular schwannoma treatment with stereotactic radiosurgery (SRS) carries a risk of facial nerve (CNVII) palsy that is lower than that with microneurosurgery. The results of hemihypoglossal-facial nerve anastomosis (HHFA) have not been described yet in CNVII palsy after failed stereotactic radiosurgery (SRS). Here we report a case series of the first four consecutive patients (three women; average age 58.5, age range: 46-74), who underwent HHFA due to failed SRS. All patients were admitted because of progressive peripheral facial nerve palsy. Three patients received retrosigmoid craniotomy due to tumor enlargement that resulted in facial nerve paralysis. All patients achieved satisfactory (House-Brackmann grade III) CNVII regeneration. No or minimal tongue atrophy occurred on the side of the anastomosis. Patients reported no problems with phonation or swallowing, except for the patients with preexisting lower cranial nerve deficits. HHFA effectively treats facial palsy after failed SRS with minimal risk of tongue atrophy and minimal morbidity. The results of the treatment are comparable to those achieved with patients without previous SRS.

  10. Contrast enhancement of the facial nerve on MRI: normal or pathological?

    Energy Technology Data Exchange (ETDEWEB)

    Martin-Duverneuil, N. [Neuroradiologie Charcot, La Salpetriere, 75 - Paris (France); Sola-Martinez, M.T. [Neuroradiologie Charcot, La Salpetriere, 75 - Paris (France); Miaux, Y. [Neuroradiologie Charcot, La Salpetriere, 75 - Paris (France); Cognard, C. [Neuroradiologie Charcot, La Salpetriere, 75 - Paris (France); Weil, A. [Neuroradiologie Charcot, La Salpetriere, 75 - Paris (France); Mompoint, D. [Neuroradiologie Charcot, La Salpetriere, 75 - Paris (France); Chiras, J. [Neuroradiologie Charcot, La Salpetriere, 75 - Paris (France)

    1997-03-01

    We prospectively analysed the normal contrast-enhanced MRI features of the facial nerve and determined criteria for pathological contrast enhancement. We studied 31 patients with clinically normal facial nerves with T1-weighted images before and after contrast medium. The intensity, thickness and right-left symmetry of enhancement were assessed in each segment and correlated with MRI features observed in abnormal facial nerves. Enhancement along at least one segment of the facial nerve was seen in 98% of cases, but only within the facial canal: Labyrinthine segment: 78.2%; geniculate ganglion: 96.9%; tympanic: 88.4%; mastoid: 66.6%. Marked (++) to intense (+++) enhancement was seen in the labyrinthine segment in 17.4%, the geniculate ganglion in 36.3%, and the tympanic (25.6%) and mastoid (7.1%) segments, whereas intense enhancement was only seen in the geniculate ganglion (6%) and the tympanic segment (11.6%). A right-left asymmetry was noted in 69% of cases. No correlation was found between enhancement and the thickness of the nerve. No enhancement of the eighth nerve was seen. We suggest three criteria for pathological enhancement: Enhancement outside the facial canal; extension of enhancement to the eighth nerve; and intense enhancement in the labyrinthine and/or mastoid segments. (orig.)

  11. Anterior Approach Total Ankle Arthroplasty: Superficial Peroneal Nerve Branches at Risk.

    Science.gov (United States)

    McAlister, Jeffrey E; DeMill, Shyler L; Hyer, Christopher F; Berlet, Gregory C

    2016-01-01

    In ankle arthroplasty, little attention has been given to intraoperative nerve injury and its postoperative sequelae. The aim of the present anatomic study was to determine the relationship of the superficial peroneal nerve to the standard anterior approach for total ankle arthroplasty. The superficial peroneal nerve was dissected in 10 below-the-knee cadaver specimens. The medial and intermediate dorsal cutaneous branches were identified. A needle was placed at the ankle joint. The following measurements were recorded: bifurcation into the medial and intermediate dorsal cutaneous branches, reference needle to the branches of the medial and intermediate superficial peroneal nerve, and the crossing branches of the medial dorsal cutaneous nerve. Two specimens (20%) had a medial dorsal cutaneous branch cross from medially to laterally. Eight specimens (80%) had a crossing branch of the medial dorsal cutaneous branch within 5 cm of the incision. No intermediate dorsal cutaneous branches were within the incision. The results from the present cadaver study suggest that during an anterior ankle approach, aberrant branches of the superficial peroneal nerve could require transection in 20% of patients at the joint level and ≤80% of patients with distal extension >35 mm from the ankle joint. The risk of injury to branches of the superficial peroneal nerve is substantial. The risk of nerve injury can be decreased with meticulous operative technique, smaller incisions, and the avoidance of aggressive retraction.

  12. The truth is in the water: metastatic prostate cancer presenting as an intermittent facial nerve palsy.

    Science.gov (United States)

    Wooles, N; Gupta, S; Wilkin-Crowe, H; Juratli, A

    2015-04-24

    An elderly man presented to the acute ear, nose and throat (ENT) services with a history of intermittent, self-limiting facial nerve palsy. Full ENT examination was normal, with all cranial nerves and peripheral neurology intact. Multiple imaging modalities suggested an aggressive bony lesion, secondary to locally advanced prostate malignancy with extensive metastatic infiltration. Prostate cancer is known to preferentially metastasise to bone and has been known to cause multiple cranial nerve palsies and ophthalmoplegia. This is the first case described in the literature of metastatic prostate cancer presenting with intermittent facial nerve palsy.

  13. Comparison of rabbit facial nerve regeneration in nerve growth factor-containing silicone tubes to that in autologous neural grafts.

    Science.gov (United States)

    Spector, J G; Lee, P; Derby, A; Roufa, D G

    1995-11-01

    Previous reports suggest that nerve growth factor (NGF) enhanced nerve regeneration in rabbit facial nerves. We compared rabbit facial nerve regeneration in 10-mm silicone tubes prefilled with NGF or cytochrome C (Cyt C), bridging an 8-mm nerve gap, to regeneration of 8-mm autologous nerve grafts. Three weeks following implantation, NGF-treated regenerates exhibited a more mature fascicular organization and more extensive neovascularization than Cyt C-treated controls. Morphometric analysis at the middle of the tube of 3- and 5-week regenerates revealed no significant difference in the mean number of myelinated or unmyelinated axons between NGF- and Cyt C-treated implants. However, when the numbers of myelinated fibers in 5-week regenerates were compared to those in their respective preoperative controls, NGF-treated regenerates had recovered a significantly greater percentage of myelinated axons than Cyt C-treated implants (46% versus 18%, respectively). The number of regenerating myelinated axons in the autologous nerve grafts at 5 weeks was significantly greater than the number of myelinated axons in the silicone tubes. However, in the nerve grafts the majority of the axons were found in the extrafascicular connective tissue (66%). The majority of these myelinated fibers did not find their way into the distal nerve stump. Thus, although the number of regenerating myelinated axons within the nerve grafts is greater than that of axons within silicone tube implants, functional recovery of autologous nerve graft repairs may not be superior to that of intubational repairs.

  14. The masseteric nerve: a versatile power source in facial animation techniques.

    Science.gov (United States)

    Bianchi, B; Ferri, A; Ferrari, S; Copelli, C; Salvagni, L; Sesenna, E

    2014-03-01

    The masseteric nerve has many advantages including low morbidity, its proximity to the facial nerve, the strong motor impulse, its reliability, and the fast reinnervation that is achievable in most patients. Reinnervation of a neuromuscular transplant is the main indication for its use, but it has been used for the treatment of recent facial palsies with satisfactory results. We have retrospectively evaluated 60 patients who had facial animation procedures using the masseteric nerve during the last 10 years. The patients included those with recent, and established or congenital, unilateral and bilateral palsies. The masseteric nerve was used for coaptation of the facial nerve either alone or in association with crossfacial nerve grafting, or for the reinnervation of gracilis neuromuscular transplants. Reinnervation was successful in all cases, the mean (range) time being 4 (2-5) months for facial nerve coaptation and 4 (3-7) months for neuromuscular transplants. Cosmesis was evaluated (moderate, n=10, good, n=30, and excellent, n=20) as was functional outcome (no case of impairment of masticatory function, all patients able to smile, and achievement of a smile independent from biting). The masseteric nerve has many uses, including in both recent, and established or congenital, cases. In some conditions it is the first line of treatment. The combination of combined techniques gives excellent results in unilateral palsies and should therefore be considered a valid option.

  15. Facial nerve palsy as a primary presentation of advanced carcinoma of the prostate: An unusual occurrence

    Directory of Open Access Journals (Sweden)

    A. Abdulkadir

    2017-03-01

    Conclusion: Facial nerve palsy as a primary presentation of advanced cancer of the prostate is unusual, thus, a high index of suspicion is required to establish the diagnosis. ADT provided adequate palliation.

  16. Overview of pediatric peripheral facial nerve paralysis: analysis of 40 patients.

    Science.gov (United States)

    Özkale, Yasemin; Erol, İlknur; Saygı, Semra; Yılmaz, İsmail

    2015-02-01

    Peripheral facial nerve paralysis in children might be an alarming sign of serious disease such as malignancy, systemic disease, congenital anomalies, trauma, infection, middle ear surgery, and hypertension. The cases of 40 consecutive children and adolescents who were diagnosed with peripheral facial nerve paralysis at Baskent University Adana Hospital Pediatrics and Pediatric Neurology Unit between January 2010 and January 2013 were retrospectively evaluated. We determined that the most common cause was Bell palsy, followed by infection, tumor lesion, and suspected chemotherapy toxicity. We noted that younger patients had generally poorer outcome than older patients regardless of disease etiology. Peripheral facial nerve paralysis has been reported in many countries in America and Europe; however, knowledge about its clinical features, microbiology, neuroimaging, and treatment in Turkey is incomplete. The present study demonstrated that Bell palsy and infection were the most common etiologies of peripheral facial nerve paralysis.

  17. Facial nerve palsy: analysis of cases reported in children in a suburban hospital in Nigeria

    National Research Council Canada - National Science Library

    Folayan, M O; Arobieke, R I; Eziyi, E; Oyetola, E O; Elusiyan, J

    2014-01-01

    The study describes the epidemiology, treatment, and treatment outcomes of the 10 cases of facial nerve palsy seen in children managed at the Obafemi Awolowo University Teaching Hospitals Complex, Ile...

  18. Ultrasound-guided trigeminal nerve block via the pterygopalatine fossa: an effective treatment for trigeminal neuralgia and atypical facial pain.

    Science.gov (United States)

    Nader, Antoun; Kendall, Mark C; De Oliveria, Gildasio S; Chen, Jeffry Q; Vanderby, Brooke; Rosenow, Joshua M; Bendok, Bernard R

    2013-01-01

    Patients presenting with facial pain often have ineffective pain relief with medical therapy. Cases refractory to medical management are frequently treated with surgical or minimally invasive procedures with variable success rates. We report on the use of ultrasound-guided trigeminal nerve block via the pterygopalatine fossa in patients following refractory medical and surgical treatment. To present the immediate and long-term efficacy of ultrasound-guided injections of local anesthetic and steroids in the pterygopalatine fossa in patients with unilateral facial pain that failed pharmacological and surgical interventions. Academic pain management center. Prospective case series. Fifteen patients were treated with ultrasound-guided trigeminal nerve block with local anesthetic and steroids placed into the pterygopalatine fossa. All patients achieved complete sensory analgesia to pin prick in the distribution of the V2 branch of the trigeminal nerve and 80% (12 out of 15) achieved complete sensory analgesia in V1, V2, V3 distribution within 15 minutes of the injection. All patients reported pain relief within 5 minutes of the injection. The majority of patients maintained pain relief throughout the 15 month study period. No patients experienced symptoms of local anesthetic toxicity or onset of new neurological sequelae. Prospective case series. We conclude that the use of ultrasound guidance for injectate delivery in the pterygopalatine fossa is a simple, free of radiation or magnetization, safe, and effective percutaneous procedure that provides sustained pain relief in trigeminal neuralgia or atypical facial pain patients who have failed previous medical interventions.

  19. Facial nerve regeneration after facial allotransplantation: A longitudinal clinical and electromyographic follow-up of lip movements during speech.

    Science.gov (United States)

    De Letter, Miet; Vanhoutte, Sarah; Aerts, Annelies; Santens, Patrick; Vermeersch, Hubert; Roche, Nathalie; Stillaert, Filip; Blondeel, Philip; Van Lierde, Kristiane

    2017-06-01

    Facial allotransplantation constitutes a reconstructive option after extensive damage to facial structures. Functional recovery has been reported but remains an issue. A patient underwent facial allotransplantation after a ballistic injury with extensive facial tissue damage. Speech motor function was sequentially assessed clinically, along with repeated electromyography of lip movements during a follow-up of 3 years. Facial nerve recovery could be demonstrated within the first month, followed by a gradual increase in electromyographic amplitude and decrease in reaction times. These were accompanied by gradual improvement of clinical assessments. Axonal recovery starts early after transplantation. Electromyographic testing is sensitive in demonstrating this early recovery, which ultimately results in clinical improvements. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. Electromyographic monitoring of facial nerve under different levels of neuromuscular blockade during middle ear microsurgery

    Institute of Scientific and Technical Information of China (English)

    CAI Yi-rong; XU Jing; CHEN Lian-hua; CHI Fang-lu

    2009-01-01

    Background The evoked electromyography (EMG) is frequently used to identify facial nerve in order to prevent its damage during surgeries. Partial neuromuscular blockade (NMB) has been suggested to favor EMG activity and insure patients' safety. The aim of this study was to determine an adequate level of NMB correspondent to sensible facial nerve identification by evaluating the relationship between facial EMG responses and peripheral NMB levels during the middle ear surgeries.Methods Facial nerve evoked EMG and NMB monitoring were performed simultaneously in 40 patients who underwent tympanoplasty. Facial electromyographic responses were recorded by insertion of needle electrodes into the orbicularis oris and orbicularis oculi muscles after electrical stimulation on facial nerve. The NMB was observed objectively with the hypothenar muscle's twitching after electrical stimulation of ulnar nerve, and the intensity of blockade was adjusted at levels of 0, 25%, 50%, 75%, 90%, and 100% respectively with increased intravenous infusion of Rocuronium (muscle relaxant).Results All of the patients had detectable EMG responses at the levels of NMB ≤50%. Four out of forty patients had no EMG response at the levels of NMB ≥75%. A significant linear positive correlation was present between stimulation thresholds and NMB levels while a linear negative correlation was present between EMG amplitudes and NMB levels.Conclusions The facial nerve monitoring via facial electromyographic responses can be obtained when an intraoperative partial neuromuscular blockade is induced to provide an adequate immobilization of the patient. The 50% NMB should be considered as the choice of anesthetic management for facial nerve monitoring in otologic microsurgery based on the relationship of correlation.

  1. [Multiple erythema migrans and facial nerve paralysis: clinical manifestations of early disseminated Lyme borreliosis].

    Science.gov (United States)

    Braun, S A; Baran, A M; Boettcher, C; Kieseier, B C; Reifenberger, J

    2014-04-01

    Lyme borreliosis is a common vector-borne disease in Europe. The infection follows different stages with a broad variability of clinical symptoms and manifestations in different organs. A 49-year-old man presented with flu-like symptoms, facial nerve paralysis and multiple erythematous macular on his trunk and extremities. We diagnosed Lyme disease (stage II) with facial nerve paralysis and multiple erythema migrans. Intravenous ceftriaxone led to complete healing of hissymptoms within 2 weeks.

  2. An imaging study of the facial nerve canal in congenital aural atresia.

    Science.gov (United States)

    Zhao, Shouqin; Han, Demin; Wang, Zhenchang; Li, Jie; Qian, Yanni; Ren, Yuanyuan; Dong, Jiyong

    2015-01-01

    We conducted a prospective study to investigate the abnormalities of the facial nerve canal in patients with congenital aural atresia by computed tomography (CT). Our study population was made up of 99 patients--68 males and 31 females, aged 6 to 22 years (mean: 13.5)--who had unilateral congenital aural atresia without any inner ear malformations. We compared our findings in these patients with those in 50 controls-33 males and 17 females, aged 5 to 22 years (mean: 15.0)-who had normal ears. We classified the congenital aural atresia patients into three groups (A, B, and C) according to their Jahrsdoerfer grading scale score (≥8; 6 or 7; and ≤5, respectively). The course of the facial nerve canal in both the controls and the study patients was determined by temporal bone CT with multiplanar reconstruction. The distances from different parts of the facial nerve canal to surrounding structures were also measured. The course of the facial nerve canal in the normal ears did not vary much, and there were no statistically significant differences according to head side and sex. In groups B and C, the tympanic segment, mastoid segment, and angle of the second genu of the facial nerve canal were all significantly smaller than those of the controls (p < 0.01 in all cases). Statistically, the tympanic segment of the facial nerve canal in patients with congenital aural atresia was downwardly displaced. The mastoid segment of the facial nerve canal in these patients was more anterior than that of the controls. We conclude that congenital aural atresia is often accompanied by abnormalities of the facial nerve canal, especially in the tympanic segment, the mastoid segment, and the second genu. We found that the lower the Jahrsdoerfer score was, the shorter the tympanic segment was and the more forward the mastoid segment was.

  3. Post-traumatic acute bilateral facial nerve palsy - a management dilemma

    Directory of Open Access Journals (Sweden)

    Kumar Rakesh

    2015-03-01

    Full Text Available Acute bilateral facial nerve paralysis is a rare clinical entity, and its management remains very controversial (operative or conservative. Here we are presenting a case of acute onset bilateral facial nerve palsy following head injury with bilateral temporal bone fracture with clinico-radiographic contrary. Patient was managed conservatively with complete recovery. By this article, authors want to stress on combining clinical examination and radiological findings for decision making of this rare entity and tried to evaluate the management.

  4. Pontine stroke presenting as isolated facial nerve palsy mimicking Bell's palsy: a case report

    OpenAIRE

    Saluja Paramveer; Manandhar Lochana; Agarwal Rishi; Grandhi Bala

    2011-01-01

    Abstract Introduction Isolated facial nerve palsy usually manifests as Bell's palsy. Lacunar infarct involving the lower pons is a rare cause of solitary infranuclear facial paralysis. The present unusual case is one in which the patient appeared to have Bell's palsy but turned out to have a pontine infarct. Case presentation A 47-year-old Asian Indian man with a medical history of hypertension presented to our institution with nausea, vomiting, generalized weakness, facial droop, and slurred...

  5. Facial nerve palsy: Analysis of cases reported in children in a ...

    African Journals Online (AJOL)

    2013-02-28

    Feb 28, 2013 ... Methodology: This was a retrospective cohort review of pediatric cases of facial ... Key words: Children, facial nerve, malaria, mumps, Nigeria, palsy ... Lyme disease has surpassed otitis media as a cause of the ..... reactions and unknown infectious agents. .... The associated fever makes this a possibility.

  6. Bilateral facial nerve palsy in a newly diagnosed diabetic patient with associated herpes labialis

    Directory of Open Access Journals (Sweden)

    Manish Gupta

    2014-01-01

    Full Text Available Bilateral facial nerve palsy is a very rare condition, usually following neurologic, neoplastic, traumatic, infective or metabolic causes. We present here a case of 29-year-old male, diagnosed on admission as diabetic with herpes labialis and bilateral facial paralysis. As the differentials are extensive, diagnostic workup and subsequent treatment should be done keeping various etiological factors in mind.

  7. Functional and anatomical basis for brain plasticity in facial palsy rehabilitation using the masseteric nerve.

    Science.gov (United States)

    Buendia, Javier; Loayza, Francis R; Luis, Elkin O; Celorrio, Marta; Pastor, Maria A; Hontanilla, Bernardo

    2016-03-01

    Several techniques have been described for smile restoration after facial nerve paralysis. When a nerve other than the contralateral facial nerve is used to restore the smile, some controversy appears because of the nonphysiological mechanism of smile recovering. Different authors have reported natural results with the masseter nerve. The physiological pathways which determine whether this is achieved continue to remain unclear. Using functional magnetic resonance imaging, brain activation pattern measuring blood-oxygen-level-dependent (BOLD) signal during smiling and jaw clenching was recorded in a group of 24 healthy subjects (11 females). Effective connectivity of premotor regions was also compared in both tasks. The brain activation pattern was similar for smile and jaw-clenching tasks. Smile activations showed topographic overlap though more extended for smile than clenching. Gender comparisons during facial movements, according to kinematics and BOLD signal, did not reveal significant differences. Effective connectivity results of psychophysiological interaction (PPI) from the same seeds located in bilateral facial premotor regions showed significant task and gender differences (p facial nerve and masseter nerve areas is supported by the broad cortical overlap in the representation of facial and masseter muscles.

  8. Collagen scaffolds modified with CNTF and bFGF promote facial nerve regeneration in minipigs.

    Science.gov (United States)

    Cui, Yi; Lu, Chao; Meng, Danqing; Xiao, Zhifeng; Hou, Xianglin; Ding, Wenyong; Kou, Depeng; Yao, Yao; Chen, Bing; Zhang, Zhen; Li, Jiayin; Pan, Juli; Dai, Jianwu

    2014-09-01

    Most experiments of peripheral nerve repair after injury have been conducted in the rodent model but the translation of findings from rodent studies to clinical practice is needed partly because the nerve regeneration must occur over much longer distances in humans than in rodents. The reconstruction of long distance nerve injuries still represents a great challenge to surgeons who is engaged in peripheral nerve surgery. Here we used the functional nerve conduit (collagen scaffolds incorporated with neurocytokines CNTF and bFGF) to bridge a 35 mm long facial nerve gap in minipig models. At 6 months after surgery, electrophysiology assessment and histological examination were conducted to evaluate the regeneration of peripheral facial nerves. Based on functional and histological observations, the results indicated that the functional collagen scaffolds promoted nerve reconstruction. The number and arrangement of regenerated nerve fibers, myelination, and nerve function reconstruction was better in the CNTF + bFGF conduit group than the single factor CNTF or bFGF conduit group. The functional composite conduit, which exhibited favorable mechanical properties, may promote facial nerve regeneration in minipigs effectively. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Facial nerve paralysis after super-selective intra-arterial chemotherapy for oral cancer.

    Science.gov (United States)

    Sugiyama, S; Iwai, T; Oguri, S; Koizumi, T; Mitsudo, K; Tohnai, I

    2017-02-10

    Facial nerve paralysis (FNP) after super-selective intra-arterial chemotherapy (SSIAC) is a relatively rare local side effect of SSIAC to the maxillary artery (MA) or the middle meningeal artery (MMA). The incidence and prognosis of FNP after SSIAC in 381 patients with oral cancer (133 with catheterization of the MA, 248 without) was investigated retrospectively. Only three patients (two male and one female) had FNP, for an incidence of 0.8%. All patients with FNP had undergone catheterization of the MA, and the incidence of FNP in this group was 2.3% (3/133). One of the three patients with FNP had paralysis of the third branch of the trigeminal nerve. FNP occurred a mean of 8.7 days (range 5-11 days) after initial SSIAC, and the mean total dose of cisplatin was 55.8mg (range 42.5-67.2mg) and of docetaxel was 25.4mg (range 17.0-33.6mg). FNP resolved completely a mean of 12.7 months (range 6-19 months) after onset. Because the administration of anticancer agents via the MA or MMA carries a risk of FNP, this information will be useful when obtaining informed consent from patients before treatment.

  10. Iatrogenic cushing syndrome to facial nerve palsy: via intracranial tuberculoma-an interesting journey.

    Science.gov (United States)

    Chakrabarti, Subrata

    2014-12-01

    Isolated Facial nerve palsy is a less common neurological manifestation of intracranial tuberculoma. Again, tuberculoma can arise following development of Cushing syndrome after prolonged intake of steroids due to origin of immunosuppressed state. Thus exogenous steroid administration leading to iatrogenic Cushing Syndrome which again causing tuberculoma, with facial nerve palsy developing as a manifestation of tuberculoma is not unnatural but definitely a unique scenario. The author reports an interesting case where a patient developed left sided facial palsy following development of intracranial tuberculoma from iatrogenic Cushing syndrome after longterm intake of Dexamethasone as a treatment for low back pain. This situation is rarely reported before.

  11. Aspects referring to the morphological variability of the abdominal branches of pneumogastric nerve (nervus vagus).

    Science.gov (United States)

    Niculescu, M C; Niculescu, V; Dăescu, Ecaterina; Ciobanu, Iulia-Camelia; Sişu, Alina-Maria; Jianu, Adelina; Petrescu, Codruţa-Ileana; Bolintineanu, S

    2005-01-01

    Terminal part and the abdominal branches of pneumogastric nerve were and still is an up-to-date problem not only through the anatomic importance but also through its implications in surgical practice. The study was done on 50 corpses using the dissection method. We are looking after torsion variants of pneumogastric nerves around the esophagus, morphological variability of the periesophageal pnemogastric plexus among witch the pnemogastric nerves loose theirs individuality through the mixture and the anastomoses of the fibers and the morphological variability of abdominal branches of the nerve, grouped by us in anterior and posterior branches.

  12. Agmatine promotes expression of brain-derived neurotrophic factor in brainstem facial nucleus in the rat facial nerve injury model

    Institute of Scientific and Technical Information of China (English)

    Li Fang; Wenlong Luo

    2008-01-01

    BACKGROUND: Studies have shown that agmatine can reduce inhibition of neuronal regeneration by increasing cyclic adenosine monophosphate and brain-derived neurotrophic factor (BDNF) in the hippocampus of morphine-dependent rats. The hypothesis that agmatine exerts similar effects on facial nerve injury deserves further analysis.OBJECTIVE: To study the effects of peritoneal agmatine injection on BDNF levels in the rat brainstem after facial nerve injury.DESIGN, TIME AND SETTING: A controlled animal experiment was performed at the Department of Otolaryngology-Head and Neck Surgery at the Second Affiliated Hospital, Chongqing University of Medical Sciences (Chongqing, China), between October and December in 2007.MATERIALS: Twenty-four male Sprague-Dawley rats were randomly divided into a control, a lesion, and an agmatine treatment group, with eight rats in each group. Bilateral facial nerve anastomosis was induced in the lesion and agmatine treatment groups, while the control group remained untreated. A rat BDNF Enzyme-linked immunosorbent assay kit was used to measure BDNF levels in the brainstem facial nucleus.METHODS: Starting on the day of lesion, the agmatine group received a peritoneal injection of 100 mg/kg agmatine, once per day, for a week, whereas rats in the lesion group received saline injections.MAIN OUTCOME MEASURES: BDNF levels in the brainstem containing facial nucleus were measured by ELISA.RESULTS: Twenty-four rats were included in the final analysis without any loss. Two weeks after lesion, BDNF levels were significantly higher in the lesion group than in the control group (P<0.01). A significant increase was noted in the agmatine group compared to the lesion group (P<0.01).CONCLUSION: Agmatine can substantially increase BDNF levels in the rat brainstem after facial nerve injury.

  13. Vitamin D3 potentiates myelination and recovery after facial nerve injury.

    Science.gov (United States)

    Montava, Marion; Garcia, Stéphane; Mancini, Julien; Jammes, Yves; Courageot, Joël; Lavieille, Jean-Pierre; Feron, François

    2015-10-01

    Roles of vitamin D on the immune and nervous systems are increasingly recognized. Two previous studies demonstrated that ergocalciferol (vitamin D2) or cholecalciferol (vitamin D3) induced functional recovery and increased myelination in a rat model of peroneal nerve transection. The current report assessed whether cholecalciferol was efficient in repairing transected rabbit facial nerves. Animals were randomized into two groups of rabbits with an unilateral facial nerve surgery: the vitamin D group included animals receiving a weekly oral bolus of vitamin D3 (200 IU/kg/day), from day 1 post-surgery; the control group included animals receiving a weekly oral bolus of vehicle (triglycerides). Contralateral unsectioned facial nerves from all experimental animals were used as controls for the histological study. The facial functional index was measured every week while the inner diameter of myelin sheath and the G ratio were quantified at the end of the 3 month experiment. The current report indicates that cholecalciferol significantly increases functional recovery and myelination, after 12 weeks of treatment. To the best of our knowledge, this is the first study investigating the therapeutic benefit of vitamin D supplementation in an animal model of facial paralysis. It paves further the way for clinical trials based on the administration of this steroid in individuals with injured facial nerves.

  14. [Neuroanatomy of the optic, trigeminal, facial, glossopharyngeal, vagus, accessory and hypoglossal nerves (author's transl)].

    Science.gov (United States)

    Lang, J

    1981-01-01

    1. The intracranial and intraorbital course of the optic nerve is described concisely, the intracanicular one in full details. Apart from the wide and small sections of the optic canal, its axis opposite to the cranial planes, the coating of the canal and the adjacency to the paranasal sinuses and arteries are exactly described. 2. At the trigeminal nerve the trigeminal ganglion, its roots and also the mandibular nerve have great importance in the practical medicine considering thermo-coagulation or surgery of the trigeminal nerve. This segments and also the adjacency of the fifth nerve to the internal carotid artery and subarachinoid brain vessels are exactly, the nuclei areas and central tracts are briefly explained. 3. The nuclei of the facial nerve the intracerebral and intracisternal course and its development, the facial canal and its narrow passes are described. Also the position of the internal acoustic pore in the skull, the dimensions of the internal acoustic meatus and the relations between nerves and vessels are explained. In addition to the geniculate ganglion and the chorda tympani the communications of the facial nerve inside the temporal bone, the tympanic intumescentia (ganglion) and the nervus intermedius, also the petrosal nerves are included in the description. The sheaths of the segments of the seventh cranial nerve and also the fasciculation are exactly, the somatotopic organization is briefly described. 4. The extracranial course of the glossopharyngeal nerve is briefly, its intracranial sections are included exactly in the investigation. 5. The nuclei of the vagus nerve and the intra- und extracranial course are described. 6. The accessory nerve, its nucleus and the intra- and extracranial course are concisely explained. 7. The hypoglossal nerve, its nucleus, the emergence of the fibres and also the relations of nerves and vessels in the posterior cranial fossa are described. The hypoglossal canal and also the extracranial course are

  15. Concomitant abducens and facial nerve palsies following blunt head trauma associated with bone fracture.

    Science.gov (United States)

    Ji, Min-Jeong; Han, Sang-Beom; Lee, Seung-Jun; Kim, Moosang

    2015-07-15

    A 22-year-old man was referred for horizontal diplopia that worsened on left gaze. He had been admitted for a head trauma caused by a traffic accident. Brain CT scan showed a longitudinal fracture of the left temporal bone with extension to the left carotid canal and central skull base, including sphenoid lateral wall and roof, and left orbit medial wall non-displaced fracture. Prism cover test revealed 20 prism diopters of esotropia and abduction limitation in the left eye. Hess screening test results were compatible with left abducens nerve paralysis. Symptoms suggesting complete lower motor neuron palsy of the left facial nerve, such as unilateral facial drooping, inability to raise the eyebrow and difficulty closing the eye, were present. As there was no improvement in facial paralysis, the patient received surgical intervention using a transmastoidal approach. Three months postoperatively, prism cover test showed orthotropia, however, the facial nerve palsy persisted.

  16. Palpebral spring in the management of lagophthalmos and exposure keratopathy secondary to facial nerve palsy.

    Science.gov (United States)

    Demirci, Hakan; Frueh, Bartley R

    2009-01-01

    To evaluate the use of a palpebral spring, a dynamic facial reanimation technique, in the management of lagophthalmos and exposure keratopathy secondary to facial nerve palsy. A palpebral spring was placed in 29 eyelids of 28 patients with symptomatic facial nerve palsy. Preoperative and postoperative symptoms, upper eyelid margin to midpupil distance, lagophthalmos, and exposure keratopathy were evaluated. At an average of 83 months follow-up, preoperative symptoms improved or resolved in 26 (90%) eyes. The upper eyelid margin to midpupil distance decreased and lagophthalmos and exposure keratopathy significantly improved after palpebral spring placement (p lagophthalmos and exposure keratopathy in patients with facial nerve palsy who do not receive adequate relief from the static procedures of lower eyelid tightening and upper eyelid lowering. This technique significantly improved symptoms and signs in these patients while allowing some of the blink reflex.

  17. Intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation for preservation of facial nerve function in patients with large acoustic neuroma

    Institute of Scientific and Technical Information of China (English)

    LIU Bai-yun; TIAN Yong-ji; LIU Wen; LIU Shu-ling; QIAO Hui; ZHANG Jun-ting; JIA Gui-jun

    2007-01-01

    Background Although various monitoring techniques have been used routinely in the treatment of the lesions in the skull base, iatrogenic facial paresis or paralysis remains a significant clinical problem. The aim of this study was to investigate the effect of intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation on preservation of facial nerve function.Method From January to November 2005, 19 patients with large acoustic neuroma were treated using intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation (TCEMEP) for preservation of facial nerve function. The relationship between the decrease of MEP amplitude after tumor removal and the postoperative function of the facial nerve was analyzed.Results MEP amplitude decreased more than 75% in 11 patients, of which 6 presented significant facial paralysis (H-B grade 3), and 5 had mild facial paralysis (H-B grade 2). In the other 8 patients, whose MEP amplitude decreased less than 75%, 1 experienced significant facial paralysis, 5 had mild facial paralysis, and 2 were normal.Conclusions Intraoperative TCEMEP can be used to predict postoperative function of the facial nerve. The decreased MEP amplitude above 75 % is an alarm point for possible severe facial paralysis.

  18. A successful double-layer facial nerve repair: A case presentation

    Directory of Open Access Journals (Sweden)

    Mehmet Dadaci

    2015-04-01

    Full Text Available The best method to repair the facial nerve is to perform the primary repair soon after the injury, without any tension in the nerve ends. We present a case of patient who had a full-thickness facial nerve cut at two different levels. The patient underwent primary repair, recovered almost completely in the fourth postoperative month, and had full movement in mimic muscles. Despite lower success rates in double-level cuts, performing appropriate primary repair at an appropriate time can reverse functional losses at early stages, and lead to recovery without any complications. [Hand Microsurg 2015; 4(1.000: 24-27

  19. Autogenous standard versus inside-out vein graft to repair facial nerve in rabbits

    Institute of Scientific and Technical Information of China (English)

    TANG Jie; WANG Xue-mei; HU Jing; LUO En; QI Meng-chun

    2008-01-01

    To evaluate autogenous vein grafts and inside-out vein grafts as conduits for the defects repair in the rabbit facial nerves.Methods:The 10 mm segments of buccal division of facial nerve were transected for 48 rabbits in this study.Then the gaps were immediately repaired by autogenous vein grafts or inside-out vein grafts in different groups. All the animals underwent the whisker movement test and electrophysiologic test during the following 16 weeks at different time points postoperatively. Subsequently,the histological examination was performed to observe the facial nerve regeneration morphologically.Results:At 8 weeks after operation,the facial nerve regeneration has significant difference between the experimental group and the control group in electrophysiologic test and histological observation. However,at the end of this study,16 weeks after operation,there was no significant difference between inside-out vein grafts and standard vein grafts in enhancing peripheral nerve regeneration.Conclusion:This study suggest that both kinds of vein grafts play positive roles in facial nerve regeneration after being repaired immediately,but the autogenous inside-out vein grafts might accelerate and facilitate axonal regeneration as compared with control.

  20. Stem cells and related factors involved in facial nerve function regeneration

    Directory of Open Access Journals (Sweden)

    Kamil H. Nelke

    2015-09-01

    Full Text Available The facial nerve (VII is one of the most important cranial nerves for head and neck surgeons. Its function is closely related to facial expressions that are individual for every person. After its injury or palsy, its functions can be either impaired or absent. Because of the presence of motor, sensory and parasympathetic fibers, the biology of its repair and function restoration depends on many factors. In order to achieve good outcome, many different therapies can be performed in order to restore as much of the nerve function as possible. When rehabilitation and physiotherapy are not sufficient, additional surgical procedures and therapies are taken into serious consideration. The final outcome of many of them is discussable, depending on nerve damage etiology. Stem cells in facial nerve repair are used, but long-term outcomes and results are still not fully known. In order to understand this therapeutic approach, clinicians and surgeons should understand the immunobiology of nerve repair and regeneration. In this review, potential stem cell usage in facial nerve regeneration procedures is discussed.

  1. Pontine stroke presenting as isolated facial nerve palsy mimicking Bell's palsy: a case report

    Directory of Open Access Journals (Sweden)

    Saluja Paramveer

    2011-07-01

    Full Text Available Abstract Introduction Isolated facial nerve palsy usually manifests as Bell's palsy. Lacunar infarct involving the lower pons is a rare cause of solitary infranuclear facial paralysis. The present unusual case is one in which the patient appeared to have Bell's palsy but turned out to have a pontine infarct. Case presentation A 47-year-old Asian Indian man with a medical history of hypertension presented to our institution with nausea, vomiting, generalized weakness, facial droop, and slurred speech of 14 hours' duration. His physical examination revealed that he was conscious, lethargic, and had mildly slurred speech. His blood pressure was 216/142 mmHg. His neurologic examination showed that he had loss of left-sided forehead creases, inability to close his left eye, left facial muscle weakness, rightward deviation of the angle of the mouth on smiling, and loss of the left nasolabial fold. Afferent corneal reflexes were present bilaterally. MRI of the head was initially read as negative for acute stroke. Bell's palsy appeared less likely because of the acuity of his presentation, encephalopathy-like imaging, and hypertension. The MRI was re-evaluated with a neurologist's assistance, which revealed a tiny 4 mm infarct involving the left dorsal aspect of the pons. The final diagnosis was isolated facial nerve palsy due to lacunar infarct of dorsal pons and hypertensive encephalopathy. Conclusion The facial nerve has a predominant motor component which supplies all muscles concerned with unilateral facial expression. Anatomic knowledge is crucial for clinical localization. Bell's palsy accounts for around 72% of facial palsies. Other causes such as tumors and pontine infarcts can also present as facial palsy. Isolated dorsal infarct presenting as isolated facial palsy is very rare. Our case emphasizes that isolated facial palsy should not always be attributed to Bell's palsy. It can be a presentation of a rare dorsal pontine infarct as observed

  2. Effect of the Steindler procedure on the median nerve branches to the medial epicondylar muscles.

    Science.gov (United States)

    Chantelot, C; Feugas, C; Migaud, H; Guillem, F; Chapnikoff, D; Fontaine, C

    2000-06-01

    Usually the median nerve gives off six branches to the muscles arising from the medial epicondyle, which could be tightened during Steindler's procedure. We studied these branches before and after Steindler's procedure in 20 fresh cadavers and observed a considerable variation in the origin of the branches. The muscular branches arising from the median nerve did not seem to limit the mobilization of the medial epicondyle when performing Steindler's transfer. The limitation of the flexion observed after Steindler's procedure was mainly related to the tension of the transferred forearm flexor muscles. The variability of the origin of the branch to the flexor digitorum superficialis muscle could explain a lesion of this branch when Steindler's procedure is carried out with Brunelli's modification. The lateral transfer and the anterior transfer on to the humeral shaft did not influence the limitation of elbow flexion or result in tightness in any nerve branch to the transferred muscles.

  3. Orthodromic Transfer of the Temporalis Muscle in Incomplete Facial Nerve Palsy

    Directory of Open Access Journals (Sweden)

    Jae Ho Aum

    2013-07-01

    Full Text Available Background Temporalis muscle transfer produces prompt surgical results with a one-stage operation in facial palsy patients. The orthodromic method is surgically simple, and the vector of muscle action is similar to the temporalis muscle action direction. This article describes transferring temporalis muscle insertion to reconstruct incomplete facial nerve palsy patients.Methods Between August 2009 and November 2011, 6 unilateral incomplete facial nerve palsy patients underwent surgery for orthodromic temporalis muscle transfer. A preauricular incision was performed to expose the mandibular coronoid process. Using a saw, the coronoid process was transected. Three strips of the fascia lata were anchored to the muscle of the nasolabial fold through subcutaneous tunneling. The tension of the strips was adjusted by observing the shape of the nasolabial fold. When optimal tension was achieved, the temporalis muscle was sutured to the strips. The surgical results were assessed by comparing pre- and postoperative photographs. Three independent observers evaluated the photographs.Results The symmetry of the mouth corner was improved in the resting state, and movement of the oral commissure was enhanced in facial animation after surgery.Conclusions The orthodromic transfer of temporalis muscle technique can produce prompt results by applying the natural temporalis muscle vector. This technique preserves residual facial nerve function in incomplete facial nerve palsy patients and produces satisfying cosmetic outcomes without malar muscle bulging, which often occurs in the turn-over technique.

  4. Different sensitivities to rocuronium of the neuromuscular junctions innervated by normal/damaged facial nerves and somatic nerve in rats: the role of the presynaptic acetylcholine quantal release

    Institute of Scientific and Technical Information of China (English)

    CHEN Jun-liang; LI Shao-qin; CHI Fang-lu; CHEN Lian-hua; LI Shi-tong

    2012-01-01

    Background Muscles present different responses to muscle relaxants,a mechanism of importance in surgeries requiring facial nerve evoked electromyography under general anaesthesia.The non-depolarizing muscle relaxants have multiple reaction formats in the neuromuscular junction,in which pre-synaptic quantal release of acetylcholine was one of the important mechanisms.This study was to compare the pre-synaptic quantal release of acetylcholine from the neuromuscular junctions innervated by normal/damaged facial nerves and somatic nerve under the effect of rocuronium in rats in vitro.Methods Acute right-sided facial nerve injury was induced by nerve crush axotomies.Both sided facial nerve connected orbicularis oris strips and tibial nerve connected gastrocnemius strips were isolated to measure endplate potentials (EPP) and miniature endplate potentials (MEPP) using an intracellular microelectrode gauge under different rocuronium concentrations.Then,the pre-synaptic quantal releases of acetylcholine were calculated by the ratios of the EPPs and the MEPPs,and compared among the damaged or normal facial nerve innervated orbicularis oris and tibial nerve innervated gastrocnemius.Results The EPP/MEPP ratios of the three neuromuscular junctions decreased in a dose dependent manner with the increase of the rocuronium concentration.With the concentrations of rocuronium being 5 μg/ml,7.5 μg/ml and 10 μg/ml,the decrease of the EPP/MEPP ratio in the damaged facial nerve group was greater than that in the normal facial nerve group.The decrease in the somatic nerve group was the biggest,with significant differences.Conclusions Rocuronium presented different levels of inhibition on the pre-synaptic quantal release of acetylcholine in the three groups of neuromuscular junctions.The levels of the inhibition showed the following sequence:somatic nerve >damaged facial nerve > normal facial nerve.The difference may be one of the reasons causing the different sensitivities to

  5. The Relationship of the Facial Nerve to the Condylar Process: A Cadaveric Study with Implications for Open Reduction Internal Fixation.

    Science.gov (United States)

    Barham, H P; Collister, P; Eusterman, V D; Terella, A M

    2015-01-01

    Introduction. The mandibular condyle is the most common site of mandibular fracture. Surgical treatment of condylar fractures by open reduction and internal fixation (ORIF) demands direct visualization of the fracture. This project aimed to investigate the anatomic relationship of the tragus to the facial nerve and condylar process. Materials and Methods. Twelve fresh hemicadavers heads were used. An extended retromandibular/preauricular approach was utilized, with the incision being based parallel to the posterior edge of the ramus. Measurements were obtained from the tragus to the facial nerve and condylar process. Results. The temporozygomatic division of the facial nerve was encountered during each approach, crossing the mandible at the condylar neck. The mean tissue depth separating the facial nerve from the condylar neck was 5.5 mm (range: 3.5 mm-7 mm, SD 1.2 mm). The upper division of the facial nerve crossed the posterior border of the condylar process on average 2.31 cm (SD 0.10 cm) anterior to the tragus. Conclusions. This study suggests that the temporozygomatic division of the facial nerve will be encountered in most approaches to the condylar process. As visualization of the relationship of the facial nerve to condyle is often limited, recognition that, on average, 5.5 mm of tissue separates condylar process from nerve should help reduce the incidence of facial nerve injury during this procedure.

  6. The Relationship of the Facial Nerve to the Condylar Process: A Cadaveric Study with Implications for Open Reduction Internal Fixation

    Directory of Open Access Journals (Sweden)

    H. P. Barham

    2015-01-01

    Full Text Available Introduction. The mandibular condyle is the most common site of mandibular fracture. Surgical treatment of condylar fractures by open reduction and internal fixation (ORIF demands direct visualization of the fracture. This project aimed to investigate the anatomic relationship of the tragus to the facial nerve and condylar process. Materials and Methods. Twelve fresh hemicadavers heads were used. An extended retromandibular/preauricular approach was utilized, with the incision being based parallel to the posterior edge of the ramus. Measurements were obtained from the tragus to the facial nerve and condylar process. Results. The temporozygomatic division of the facial nerve was encountered during each approach, crossing the mandible at the condylar neck. The mean tissue depth separating the facial nerve from the condylar neck was 5.5 mm (range: 3.5 mm–7 mm, SD 1.2 mm. The upper division of the facial nerve crossed the posterior border of the condylar process on average 2.31 cm (SD 0.10 cm anterior to the tragus. Conclusions. This study suggests that the temporozygomatic division of the facial nerve will be encountered in most approaches to the condylar process. As visualization of the relationship of the facial nerve to condyle is often limited, recognition that, on average, 5.5 mm of tissue separates condylar process from nerve should help reduce the incidence of facial nerve injury during this procedure.

  7. MRI enhancement of the facial nerve with Gd-DTPA, 2; Investigation of enhanced nerve portions in patients with facial palsy

    Energy Technology Data Exchange (ETDEWEB)

    Yanagida, Masahiro (Kansai Medical School, Moriguchi, Osaka (Japan))

    1993-08-01

    We performed enhanced MRI using Gd-DTPA in 84 patients with facial palsy. After assessing enhancement of the normal facial nerve, we examined enhancement in patients with Bell's palsy and Ramsay Hunt syndrome. In 95% of patients with Bell's palsy, enhancement was obtained in the distal IAC and labyrinthine portions. In 72%, enhancement was significant from the distal IAC portion through the vertical portion. In some of the patients who underwent enhanced MRI twice, increased signal intensity was observed in distal portions such as the vertical portion. In many cases of Ramsay Hunt syndrome, enhancement was seen extensively in the IAC portion through the vertical portion. In the subjects with internal auditory symptoms such as vertigo and tinnitus, enhancement of the IAC portion was seen not only in the facial nerve but also in the vestibular and the cochlear nerves. These results suggest that the vascular permeability of lesions in Bell's palsy may be increased from the distal IAC portion to the vertical portion. Judging from the present findings with Ramsay Hunt syndrome, symptoms related to the enhanced portions suggest that accompanying internal auditory symptoms occur due to inflammation of the IAC portions of cochlear and vestibular nerves. (author).

  8. Effects of gamma-aminobutyric acid receptors on muscarinic receptor-mediated free calcium ion levels in the facial nucleus following facial nerve injury

    Institute of Scientific and Technical Information of China (English)

    Guangfeng Jiang; Dawei Sun; Rui Zhou; Fugao Zhu; Yanqing Wang; Xiuming Wan; Banghua Liu

    2011-01-01

    Muscarinic receptors and nicotine receptors can increase free calcium ion levels in the facial nucleus via different channels following facial nerve injury. In addition, γ-aminobutyric acid A (GABAA) receptors have been shown to negatively regulate free calcium ion levels in the facial nucleus by inhibiting nicotine receptors. The present study investigated the influence of GABAA, γ-aminobutyric acid B (GABAB) and C (GABAC) receptors on muscarinic receptors in rats with facial nerve injury by confocal laser microscopy. GABAA and GABAB receptors exhibited significant dose-dependent inhibitory effects on increased muscarinic receptor-mediated free calcium ion levels following facial nerve injury. Results showed that GABAA and GABAB receptors negatively regulate muscarinic receptor effects and interplay with cholinergic receptors to regulate free calcium ion levels for facial neural regeneration.

  9. Occipital nerve block is effective in craniofacial neuralgias but not in idiopathic persistent facial pain

    OpenAIRE

    Jürgens, T. P.; Müller, P.; Seedorf, H; Regelsberger, J; May, A

    2012-01-01

    Occipital nerve block (ONB) has been used in several primary headache syndromes with good results. Information on its effects in facial pain is sparse. In this chart review, the efficacy of ONB using lidocaine and dexamethasone was evaluated in 20 patients with craniofacial pain syndromes comprising 8 patients with trigeminal neuralgia, 6 with trigeminal neuropathic pain, 5 with persistent idiopathic facial pain and 1 with occipital neuralgia. Response was defined as an at least 50% reduction...

  10. Gd-DTPA enhancement of the facial nerve in Ramsay Hunt's syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Tsutomu; Yanagida, Masahiro; Yamauchi, Yasuo (Kansai Medical School, Moriguchi, Osaka (Japan)) (and others)

    1992-10-01

    A total of 21 MR images in 16 Ramsay Hunt's syndrome were evaluated. In all images, the involved side of peripheral facial nerve were enhanced in intensity after Gd-DTPA. However, 2 cases had recovered facial palsy when MR images were taken. Nine of 19 cases with the enhancement of internal auditory canal portion had vertigo or tinnitus. Thus, it was suggested that the enhancement of internal auditory canal portion and clinical feature are closely related. (author).

  11. Transient facial nerve paralysis (Bell's palsy) following administration of hepatitis B recombinant vaccine: a case report.

    Science.gov (United States)

    Paul, R; Stassen, L F A

    2014-01-01

    Bell's palsy is the sudden onset of unilateral transient paralysis of facial muscles resulting from dysfunction of the seventh cranial nerve. Presented here is a 26-year-old female patient with right lower motor neurone facial palsy following hepatitis B vaccination. Readers' attention is drawn to an uncommon cause of Bell's palsy, as a possible rare complication of hepatitis B vaccination, and steps taken to manage such a presentation.

  12. Facial anatomy.

    Science.gov (United States)

    Marur, Tania; Tuna, Yakup; Demirci, Selman

    2014-01-01

    Dermatologic problems of the face affect both function and aesthetics, which are based on complex anatomical features. Treating dermatologic problems while preserving the aesthetics and functions of the face requires knowledge of normal anatomy. When performing successfully invasive procedures of the face, it is essential to understand its underlying topographic anatomy. This chapter presents the anatomy of the facial musculature and neurovascular structures in a systematic way with some clinically important aspects. We describe the attachments of the mimetic and masticatory muscles and emphasize their functions and nerve supply. We highlight clinically relevant facial topographic anatomy by explaining the course and location of the sensory and motor nerves of the face and facial vasculature with their relations. Additionally, this chapter reviews the recent nomenclature of the branching pattern of the facial artery.

  13. Evaluation of facial nerve and its landmarks in adult temporal bones

    Directory of Open Access Journals (Sweden)

    Saeid Soheilipour

    2010-06-01

    Full Text Available Introduction: The aim of this study was to identify variations of different segments of facial nerve in temporal bone. Materials and Methods: In this descriptive study that conducted on drilled bones in the temporal bone center of the Al-Zahra Hospital of Isfahan University of Medical Sciences, the landmarks of facial nerve in temporal bone were identified as separate variables and their distances from outer cortex of temporal bone and Henles spine and distances between different segments of nerve were recorded. Results: In the 50 temporal bones dissected, the distance between the tip of incus short process to the cortex was 14.2±1.96 mm, the distance between the facial recess from the facial nerve to the cortex was 14.5±2.58 mm, the distance between the stylomastoid foramen to the cortex was 20.6±2.49 mm, the distance between the lateral semicircular canal to the cortex was 15.9±2.31 mm and the distance between the sigmoid sinus dome to the cortex was 14.08±2.83 mm. The mean length of tympanic and mastoid segments (2nd and 3rd segments of facial nerve were 11.35±0.68 mm and 13.28±1.11mm, respectively. Conclusion: The mean lengths of segment of facial nerve and distant of landmarks from outer cortex of temporal bone are partially similar compared to those described in the western literature and text books, but different compared to eastern researches.

  14. Facial Nerve Neuroma in the Mastoid Segment of the Temporal Bone: A Case Report

    Directory of Open Access Journals (Sweden)

    Shishehgar

    2016-01-01

    Full Text Available Introduction Facial nerve neuroma is a rare disease that comprises less than 1% of all intrapetrous mass lesions. Diagnosis of the lesions of the tumor is difficult, as these tumors have relationships with other structures of the lateral skull base, such as nerves. In addition, surgical treatment is difficult because the risk of injury after the intervention is high. In this case report, we describe the clinical findings, diagnosis, and treatment of a 55-year-old man with facial nerve neuroma in the mastoid portion, a rare type of neuroma who underwent surgical operation at Khalili Hospital, Shiraz, Iran. Case Presentation In this report, we describe a rare facial nerve neuroma in the mastoid portion in a 55-year-old man with a history of hypertension (HTN and diabetes mellitus (DM. The patient also had otalgia related to the periauricular area, otorrhea, and tympanic membrane retraction on the left side. In addition, the patient had facial palsy (Brackmann grade V and often suffered from headaches. Magnetic resonance imaging (MRI with contrast, biopsy from the external ear canal region, and tympanometry were carried out. Then, the patient underwent surgical treatment, and the mass was successfully totally removed. The result of the patient’s pathology test was margin free. At a recent follow-up, the patient was still symptom-free (otalgia and headache. Conclusions In surgery for facial nerve neuroma in the mastoid segment, it is better not to rely on imaging alone; all facial nerves from the geniculate ganglion to the styloid foramen become exposed for tumor removal.

  15. Efficacy of glial growth factor and nerve growth factor on the recovery of traumatic facial paralysis.

    Science.gov (United States)

    Yildiz, Mucahit; Karlidag, Turgut; Yalcin, Sinasi; Ozogul, Candan; Keles, Erol; Alpay, Hayrettin Cengiz; Yanilmaz, Muhammed

    2011-08-01

    The aim of this study was to assess the effects of Glial growth factor (GGF) and nerve growth factor (NGF) on nerve regeneration in facial nerve anastomosis. In this study, approximately a 1-mm segment was resected from the facial nerve and the free ends were anastomosed. All animals underwent the same surgical procedure and 30 rabbits were grouped randomly in three groups. Control group, the group without any medications; NGF group, the group receiving 250 ng/0.1 ml NGF in the epineurium at the site of anastomosis; GBF group, the group receiving 500 ng/0.1 ml GGF in the epineurium at the site of anastomosis. Medications were given at the time of surgery, and at 24 and 48 h postoperatively. After 2 months, the sites of anastomosis were excised and examined using the electron microscope. It was found that the best regeneration was in the group receiving GGF as compared to the control group in terms of nerve regeneration. Schwann cell and glial cell proliferation were found to be significantly higher in the group receiving GGF as compared to the group receiving NGF. Besides, the number of myelin debris, an indicator of degeneration, was significantly lower in the group with GGF as compared to NGF and control groups (p NGF in order to increase regeneration after nerve anastomosis in experimental traumatic facial nerve paralysis may be a hopeful alternative treatment option in the future. However, further studies on human studies are required to support these results.

  16. Sir Charles Alfred Ballance (1856-1936) and the introduction of facial nerve crossover anastomosis in 1895

    NARCIS (Netherlands)

    Van de Graaf, Robert C.; Ijpma, Frank F. A.; Nicolai, Jean-Philippe A.

    2009-01-01

    Sir Charles Ballance (1856-1936) was the first surgeon in history to perform a facial nerve crossover anastomosis in 1895. Although, recently, several papers on the history of facial nerve surgery have been published, little is known about this historically important operation, the theoretical reaso

  17. Unusual Clinical Presentation of Ethylene Glycol Poisoning: Unilateral Facial Nerve Paralysis

    Directory of Open Access Journals (Sweden)

    Eray Eroglu

    2013-01-01

    Full Text Available Ethylene glycol (EG may be consumed accidentally or intentionally, usually in the form of antifreeze products or as an ethanol substitute. EG is metabolized to toxic metabolites. These metabolites cause metabolic acidosis with increased anion gap, renal failure, oxaluria, damage to the central nervous system and cranial nerves, and cardiovascular instability. Early initiation of treatment can reduce the mortality and morbidity but different clinical presentations can cause delayed diagnosis and poor prognosis. Herein, we report a case with the atypical presentation of facial paralysis, hematuria, and kidney failure due to EG poisoning which progressed to end stage renal failure and permanent right peripheral facial nerve palsy.

  18. Unusual clinical presentation of ethylene glycol poisoning: unilateral facial nerve paralysis.

    Science.gov (United States)

    Eroglu, Eray; Kocyigit, Ismail; Bahcebasi, Sami; Unal, Aydin; Sipahioglu, Murat Hayri; Kocyigit, Merva; Tokgoz, Bulent; Oymak, Oktay

    2013-01-01

    Ethylene glycol (EG) may be consumed accidentally or intentionally, usually in the form of antifreeze products or as an ethanol substitute. EG is metabolized to toxic metabolites. These metabolites cause metabolic acidosis with increased anion gap, renal failure, oxaluria, damage to the central nervous system and cranial nerves, and cardiovascular instability. Early initiation of treatment can reduce the mortality and morbidity but different clinical presentations can cause delayed diagnosis and poor prognosis. Herein, we report a case with the atypical presentation of facial paralysis, hematuria, and kidney failure due to EG poisoning which progressed to end stage renal failure and permanent right peripheral facial nerve palsy.

  19. Post Traumatic Delayed Bilateral Facial Nerve Palsy (FNP): Diagnostic Dilemma of Expressionless Face.

    Science.gov (United States)

    Kumar, Rakesh; Mittal, Radhey Shyam

    2015-04-01

    Bilateral facial nerve palsy [FNP] is a rare condition. Mostly it is idiopathic. Post traumatic bilateral FNP is even more rare and having unique neurosurgical considerations. Post traumatic delayed presentation of bilateral FNP is socially debilitating and also having diagnostic challenge. Due to lack of facial asymmetry as present in unilateral facial paralysis, it is difficult to recognize. We are presenting a case of delayed onset bilateral FNP who developed FNP after 12 days of head injury with a brief discussion of its diagnostic dilemma and management along with literature review.

  20. Removal of vestibular schwannoma and facial nerve preservation using small suboccipital retrosigmoid craniotomy

    Institute of Scientific and Technical Information of China (English)

    CHEN Ling; CHEN Li-hua; LING Feng; LIU Yun-sheng; Madjid Samii; Amir Samii

    2010-01-01

    Background Vestibular schwannoma, the commonest form of intracranial schwannoma, arises from the Schwann cells investing the vestibular nerve. At present, the surgery for vestibular schwannoma remains one of the most complicated operations demanding for surgical skills in neurosurgery. And the trend of minimal invasion should also be the major influence on the management of patients with vestibular schwannomas. We summarized the microsurgical removal experience in a recent series of vestibular schwannomas and presented the operative technique and cranial nerve preservation in order to improve the rates of total tumor removal and facial nerve preservation.Methods A retrospective analysis was performed in 145 patients over a 7-year period who suffered from vestibular schwannomas that had been microsurgicaily removed by suboccipital retrosigmoid transmeatus approach with small craniotomy. CT thinner scans revealed the tumor size in the internal auditory meatus and the relationship of the posterior wall of the internal acoustic meatus to the bone labyrinths preoperatively. Brain stem evoked potential was monitored intraoperatively. The posterior wall of the internal acoustic meatus was designedly drilled off. Patient records and operative reports, including data from the electrophysiological monitoring, follow-up audiometric examinations, and neuroradiological findings were analyzed.Results Total tumor resection was achieved in 140 cases (96.6%) and subtotal resection in 5 cases. The anatomical integrity of the facial nerve was preserved in 91.0% (132/145) of the cases. Intracranial end-to-end anastomosis of the facial nerve was performed in 7 cases. Functional preservation of the facial nerve was achieved in 115 patients (Grade Ⅰ and Grade Ⅱ, 79.3%). No patient died in this series. Preservation of nerves and vessels were as important as tumor removal dudng the operation. CT thinner scan could show the relationship between the posterior wall of the internal

  1. Masseteric nerve for reanimation of the smile in short-term facial paralysis.

    Science.gov (United States)

    Hontanilla, Bernardo; Marre, Diego; Cabello, Alvaro

    2014-02-01

    Our aim was to describe our experience with the masseteric nerve in the reanimation of short term facial paralysis. We present our outcomes using a quantitative measurement system and discuss its advantages and disadvantages. Between 2000 and 2012, 23 patients had their facial paralysis reanimated by masseteric-facial coaptation. All patients are presented with complete unilateral paralysis. Their background, the aetiology of the paralysis, and the surgical details were recorded. A retrospective study of movement analysis was made using an automatic optical system (Facial Clima). Commissural excursion and commissural contraction velocity were also recorded. The mean age at reanimation was 43(8) years. The aetiology of the facial paralysis included acoustic neurinoma, fracture of the skull base, schwannoma of the facial nerve, resection of a cholesteatoma, and varicella zoster infection. The mean time duration of facial paralysis was 16(5) months. Follow-up was more than 2 years in all patients except 1 in whom it was 12 months. The mean duration to recovery of tone (as reported by the patient) was 67(11) days. Postoperative commissural excursion was 8(4)mm for the reanimated side and 8(3)mm for the healthy side (p=0.4). Likewise, commissural contraction velocity was 38(10)mm/s for the reanimated side and 43(12)mm/s for the healthy side (p=0.23). Mean percentage of recovery was 92(5)mm for commissural excursion and 79(15)mm/s for commissural contraction velocity. Masseteric nerve transposition is a reliable and reproducible option for the reanimation of short term facial paralysis with reduced donor site morbidity and good symmetry with the opposite healthy side.

  2. 带蒂筋膜管的耳大神经移植治疗面神经缺失性损伤%Treating defective damage of facial nerve with great auricular nerve grafting covered by pediculated fascial tube

    Institute of Scientific and Technical Information of China (English)

    蒋立新

    2002-01-01

    Objective To study the curative effect of grafting great auricular nerve with pediculated fascial tube in defective damage of facial nerve.Method All the patients in the study were treated by grafting great auricular nerve which was covered by pediculated fascial tube near facial nerve trunk.Result The 3 otogenic fascial paralysis patients had grade III recovery of facial nerve function(30% ~ 38% ) 2.0 to 2.5 years after the nerve grafting operation; 2 post- traumatic facial paralysis patients had grade II recovery of facial nerve function (69% ~ 71% ) 2.5 to 3.5 years after the nerve grafting operation.Conclusion The grafting of pediculated fascial tube surrounded great auricular nerve can provide a biological environment with excellent blood supply for the plerosis and regeneration of nerves and can accelerate the functional recovery of nerves after the nerve grafting.

  3. Evaluation of the efficacy of a novel radical neck dissection preserving the external jugular vein, greater auricular nerve, and deep branches of the cervical nerve

    Directory of Open Access Journals (Sweden)

    Li Y

    2013-04-01

    Full Text Available Yadong Li, Jinsong Zhang, Kai Yang Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China Background: Conventional radical neck dissection often causes a variety of complications. Although the dissection method has been improved by retaining some tissues to reduce complications, the incomplete dissection may cause recurrence of disease. In the present study, we developed a novel radical neck dissection, which preserves the external jugular vein, the greater auricular nerve, and the deep branches of the cervical nerve, to effectively reduce complications and subsequently, to promote the postoperative survival quality. Methods: A total of 100 cases of radical neck dissection were retrospectively analyzed to evaluate the efficacy, rate of complication, and postoperative dysfunction of patients treated with the novel radical neck dissection. Data analysis was performed using the Chi-square test. Results: Compared with conventional radical neck dissection, the novel radical neck dissection could significantly reduce complications and promote postoperative survival quality. Particularly, the preservation of the external jugular vein reduced the surgical risk (ie, intracranial hypertension and complications (eg, facial edema, dizziness, headache. Preservation of the deep branches of the cervical nerve and greater auricular nerve resulted in relatively ideal postoperative functions of the shoulders and ear skin sensory function (P 0.05. Conclusion: Our novel radical neck dissection procedure could effectively reduce the complications of intracranial hypertension, shoulder dysfunction, and ear sensory disturbances. It can be used as a regular surgical approach for oral carcinoma radical neck dissection. Keywords: oral cancer, head and neck cancer, squamous cell carcinoma, survival quality, neck dissection, recurrence

  4. Unilateral high origin of facial artery associated with a variant origin of the glandular branch to the submandibular gland

    Directory of Open Access Journals (Sweden)

    Mohandas Rao KG

    2009-11-01

    Full Text Available The variations in the carotid arteries and their branches are common in the anterior triangle of the neck. However, variations in the origin of facial artery and its branches given in the digastric triangle are not very common. A case of high origin of facial artery and abnormal origin of the glandular branch to submandibular gland encountered during routine dissection of anterior triangle of the neck is reported. The facial artery was arising from the external carotid artery deep in the digastric triangle and the glandular branch to submandibular gland was also arising from the external carotid artery about 1 cm below the origin of facial artery in the digastric triangle. Further, the surgical, importance of the case was discussed.

  5. Functional recovery after facial nerve cable grafting in a rodent model.

    NARCIS (Netherlands)

    Hohman, M.H.; Kleiss, I.J.; Knox, C.J.; Weinberg, J.S.; Heaton, J.T.; Hadlock, T.A.

    2014-01-01

    IMPORTANCE: Cable grafting is widely considered to be the preferred alternative to primary repair of the injured facial nerve; however, quantitative comparison of the 2 techniques has not been previously undertaken in a rodent model. OBJECTIVE: To establish functional recovery parameters after inter

  6. Müllerectomy for upper eyelid retraction and lagophthalmos due to facial nerve palsy.

    Science.gov (United States)

    Hassan, Adam S; Frueh, Bartley R; Elner, Victor M

    2005-09-01

    Facial nerve palsy often results in symptoms of ocular irritation due to inadequate eyelid closure. Weakened protractor function results in relative upper eyelid retraction and contributes to lagophthalmos. To evaluate the role of müllerectomy in the comprehensive surgical treatment of ocular exposure due to facial nerve palsy. Thirty-four patients with chronic facial nerve palsy underwent unilateral transconjunctival removal of Müller muscle and were followed up for an average of 20 months postoperatively. Other procedures were performed to treat lower eyelid retraction, as required. Preoperative and postoperative ocular exposure symptoms, upper eyelid position, lagophthalmos, and keratopathy were compared. Of the 59 preoperative symptoms, 15 (25%) resolved and 39 (66%) improved. Upper eyelid position was lowered by an average of 1.35 mm (PLagophthalmos (P = .002) and corneal exposure (P<.001) were significantly improved. Three patients required levator aponeurosis repair, 2 for preexisting dehiscence and 1 for inadvertent aponeurosis transection. Müllerectomy is a rapid, safe, and reproducible surgical method for lowering the upper eyelid and reducing ocular exposure symptoms and signs due to chronic facial nerve palsy.

  7. Experimental considerations concerning the use of stem cells and tissue engineering for facial nerve regeneration: a systematic review.

    Science.gov (United States)

    Euler de Souza Lucena, Eudes; Guzen, Fausto Pierdoná; Lopes de Paiva Cavalcanti, José Rodolfo; Galvão Barboza, Carlos Augusto; Silva do Nascimento Júnior, Expedito; Cavalcante, Jeferson de Sousa

    2014-05-01

    Peripheral nerve trauma results in functional loss in the innervated organ, and recovery without surgical intervention is rare. Many surgical techniques can be used for repair in experimental models. The authors investigated the source and delivery method of stem cells in experimental outcomes, seeking to clarify whether stem cells must be differentiated in the injured facial nerve and improve the regenerative process. The following key terms were used: nervous regeneration, nerve regeneration, facial nerve regeneration, stem cells, embryonic stem cells, fetal stem cells, adult stem cells, facial nerve, facial nerve trauma, and facial nerve traumatism. The search was restricted to experimental studies that applied stem cell therapy and tissue engineering for nerve repair. Eight studies meeting the inclusion criteria were reviewed. Different sources of stem and precursor cells were explored (bone marrow mesenchymal stem cells, adipose-derived stem cells, dental pulp cells, and neural stem cells) for their potential application in the scenario of facial nerve injuries. Different material conduits (vases, collagen, and polyglycolic acid) were used as bridges. Immunochemistry and electrophysiology are the principal methods for analyzing regenerative effects. Although recent studies have shown that stem cells can act as a promising bridge for nerve repair, considerable optimization of these therapies will be required for their potential to be realized in a clinical setting. Based on these studies, the use of stem cells derived from different sources presents promising results related to facial nerve regeneration and produces effective functional results. The use of tubes also optimizes nerve repair, thus promoting greater myelination and axonal growth of peripheral nerves. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Clinical analysis of 182 cases with facial nerve injury%面神经损伤182例临床资料回顾性分析

    Institute of Scientific and Technical Information of China (English)

    于国霞; 蔡志刚; 卢旭光; 施晓健; 彭歆; 俞光岩

    2008-01-01

    目的 分析颌面部外周性面神经损伤后功能恢复的规律和相关影响因素.方法 回顾分析182例面神经损伤患者的病历资料,分析损伤部位、损伤方式、损伤后治疗时间及治疗方式对于面神经功能恢复结果的影响.结果 口腔颌面部面神经损伤以分支损伤为主.神经损伤方式、部位、患者年龄、修复时间等因素均对面神经功能恢复结果有影响.随访至最终有完整记录的解剖性损伤49例中,45例(92%)在6个月内完全恢复;断裂损伤59例中,53例(90%)于6个月内开始恢复;12个月内,神经吻合35例中33例(94%)面神经功能开始恢复;8例神经移植病例中5例(62%)完全恢复.结论 口腔颌面部手术中应尽量降低对神经的损伤,尽早修复受损神经,这样能够更好地保存面神经功能.%Objective To investigate the recovery patterns and the influencing factors of facial nerve injury in maxillofacial surgery by retrospective analysis of a serial clinical data.Methods A total of 182 patients with facial nerve injury were reviewed.The cause of injury,the initial facial nerve function after trauma,the treatment, the initial recovery time of facial nerve function and the total recovery time were recorded.The factors that influenced the outcome of facial nerve function were analyzed.Results The facial nerve branch injury was common in maxillofacial injury.The injury pattern, location,age and reconstruction time all had effects on the function recovery of the facial nerve.Within 6 months,45 of 49(92%) anatomic injured patients completely recovered in 6 months;53 of 59 patients(90%)began to recoverwhen nerve had been ruptured.In 12 months,33 of 35 patients (94%) after nerve anastomosed and 5 of 8 patients (62%)with nerve transplantation got complete recovery.Conclusions Preserving the facial nerve during surgery is very important.If the facial nerve is injured,reconstructive surgery should be applied as soon as possible.

  9. Neuropathy of motor branch of median or ulnar nerve induced by midpalm ganglion.

    Science.gov (United States)

    Kobayashi, N; Koshino, T; Nakazawa, A; Saito, T

    2001-05-01

    Two cases of neuropathy of a motor branch caused by a midpalmal ganglion are presented. In the first case the ganglion originated from the midcarpal joint, protruded into the thenar muscle, and compressed the motor branch of the median nerve. In the second case the ganglion, distal to the fibrous arch of the hypothenar muscles, originated from the third carpometacarpal joint and compressed the motor branch of the ulnar nerve. In both cases muscle weakness and finger deformity recovered well after resection of the ganglion. This clinical condition is rare compared with carpal tunnel syndrome and Guyon's tunnel syndrome, which are caused by a ganglion in the wrist.

  10. Lyme disease presenting with bilateral facial nerve palsy.

    Science.gov (United States)

    Eng, G D

    1990-09-01

    Facial palsy bilateral, or recurrent, suggests a myriad of diagnostic possibilities. An 11-year-old boy is described whose diagnosis remained elusive for several months. Clinical evolution and subsequent laboratory studies confirmed that he had Lyme disease. Literature review suggests that this disorder is ubiquitous in its manifestations. The diagnosis should be remembered in unexplained neurologic disorders, particularly in cranial and peripheral neuropathies.

  11. Iatrogenic injury to oral branches of the trigeminal nerve: records of 449 cases

    DEFF Research Database (Denmark)

    Hillerup, Søren

    2007-01-01

    The aims of this study were threefold: (1) to describe iatrogenic lesions to oral branches of the trigeminal nerve, signs and symptoms, and functional status, (2) to report on a simple neurosensory examination method, and (3) to discuss means of prevention of iatrogenic injury. The etiology...... and functional status of 449 injuries to oral branches collected over 18 years were retrospectively reviewed. A simple scheme of a clinical neurosensory examination was applied to enable a quantified rating of the perception. Injury to the lingual nerve (n = 261) is not only the most prevalent type of lesion...... was affected more frequently and severely than other oral branches of the trigeminal nerve. The female gender was overrepresented in incidence of injured nerves but no difference was found in the severity of affection between females and males. All grades of loss of neurosensory functions were found...

  12. [Damage of teres minor branch of axillary nerve].

    Science.gov (United States)

    Kallio, Mika; Kovala, Tero; Niemelä, Erkki; Tolonen, Uolevi

    2010-01-01

    Atrophy demarcating to musculus teres minor is seen in magnetic resonance imaging of the shoulder region in 3 to 5.5% of investigations. We describe seven patients with prolonged or recurrent pain of the shoulder region, who were diagnosed in ENMG with damage of the axillary nerve brand to m. teres minor. Probable causes included tear of the rotator cuff, luxation of the shoulder joint, nerve entrapment in the quadrilateral space, neuritis of the brachial plexus and iatrogenic damage associated with shoulder arthroscopy. This nerve damage cannot be proved clinically.

  13. Supramaximal stimulation during intraoperative facial nerve monitoring as a simple parameter to predict early functional outcome after parotidectomy.

    Science.gov (United States)

    Mamelle, Elisabeth; Bernat, Isabelle; Pichon, Soizic; Granger, Benjamin; Sain-Oulhen, Charlotte; Lamas, Georges; Tankéré, Frédéric

    2013-07-01

    A supramaximal stimulation at 2 mA during intraoperative electromyographic (EMG) facial nerve monitoring appears to be a simple and effective parameter to predict immediate postoperative injury. To assess the role of systematic intraoperative facial nerve monitoring in predicting the early functional outcomes obtained after parotidectomy. Data were collected from patients who underwent parotidectomy. Intraoperative EMG monitoring of the facial nerve was performed by registering two parameters, event intensity (>100 μV) and amplitude of response after a supramaximal stimulation at 2 mA, at the beginning and end of gland removal. Early postoperative clinical functional facial nerve disorder was assessed at day 2. Overall, 50 patients were included and an early facial dysfunction was detected in 27 cases (54%). The maximal response amplitude after supramaximal stimulation at the trunk of the facial nerve was higher in patients with normal facial function compared with those with poor outcomes at the end of surgery (p stimulation thresholds, were indicative of a nerve conduction block and were significantly lower in the patient group with a poor outcome compared with the group with a normal facial outcome (p < 0.02).

  14. Facial nerve damage in the treatment of tumours of the parotid gland

    Energy Technology Data Exchange (ETDEWEB)

    Rampling, R.; Catterall, M. (Hammersmith Hospital, London (UK). M.R.C. Cyclotron Unit)

    1984-12-01

    The treatment of malignant parotid gland tumours by either surgery or X-radiotherapy alone results in unacceptably high rates of local recurrence. This has led to a combined management, with radiation given either before or after surgery. In the best series this gives an 85% control rate but with severence of the facial nerve in a high proportion of cases. Fast neutron therapy was given for much more advanced tumours and gave the same control rate. Where the facial nerve had been damaged by the tumour, paralysis was lessened substantially in four of nine cases. However neutrons were the apparent course of damage to the nerve in three cases. Two of these had previously received surgery and X-ray therapy.

  15. T2-signal of ulnar nerve branches at the wrist in guyon's canal syndrome.

    Directory of Open Access Journals (Sweden)

    Jennifer Kollmer

    Full Text Available OBJECTIVE: To evaluate T2-signal of high-resolution MRI in distal ulnar nerve branches at the wrist as diagnostic sign of guyon's-canal-syndrome (GCS. MATERIALS AND METHODS: 11 GCS patients confirmed by clinical/electrophysiological findings, and 20 wrists from 11 asymptomatic volunteers were prospectively included to undergo the following protocol: axial T2-weighted-fat-suppressed and T1-weighted-turbo-spin-echo-sequences (3T-MR-scanner, Magnetom/Verio/Siemens. Patients were examined in prone position with the arm extended and wrist placed in an 8-channel surface-array-coil. Nerve T2-signal was evaluated as contrast-to-noise-ratios (CNR from proximal-to-distal in ulnar nerve trunk, its superficial/sensory and deep/motor branch. Distal motor-nerve-conduction (distal-motor-latency (dml to first dorsal-interosseus (IOD I and abductor digiti minimi muscles was correlated with T2-signal. Approval by the institutional review-board and written informed consent was given by all participants. RESULTS: In GCS, mean nerve T2-signal was strongly increased within the deep/motor branch (11.7±4.8 vs.controls:-5.3±2.4;p = 0.001 but clearly less and not significantly increased in ulnar nerve trunk (6.8±6.4vs.-7.4±2.5;p = 0.07 and superficial/sensory branch (-2.1±4.9vs.-9.7±2.9;p = 0.08. Median nerve T2-signal did not differ between patients and controls (-9.8±2.5vs.-6.7±4.2;p = 0.45. T2-signal of deep/motor branch correlated strongly with motor-conduction-velocity to IOD I in non-linear fashion (R(2 = -0.8;p<0.001. ROC-analysis revealed increased nerve T2-signal of the deep/motor branch to be a sign of excellent diagnostic performance (area-under-the-curve 0.94, 95% CI: 0.85-1.00; specificity 90%, sensitivity 89.5%. CONCLUSIONS: Nerve T2-signal increase of distal ulnar nerve branches and in particular of the deep/motor branch is highly accurate for the diagnostic determination of GCS. Furthermore, for the first time it was found in nerve entrapment

  16. Effectiveness of C5 or C6-Cz assembly in predicting immediate post operative facial nerve deficit.

    Science.gov (United States)

    Verst, Silvia Mazzali; Sucena, Andrea Caivano; Maldaun, Marcos Vinicius Calfat; Aguiar, Paulo Henrique Pires

    2013-10-01

    Intraoperative neurophysiology monitoring (IOM) is a valuable tool in cerebellopontine angle (CPA) surgeries posing risk to the cranial nerves. Transcranial electrical stimulation (TES) for cranial nerves has been performed in the last 7 years, for obtaining the facial nerve motor evoked potential (MEP), using either C3/C4-Cz or C3-C4 (or inverse) stimulating points, which have been correlated with facial nerve functional outcome. Intraoperative surgical and electrophysiological findings were documented prospectively. Patient files were reviewed for clinical data. We studied 23 patients undergoing CPA tumor resection using C5 or C6-Cz montage for TES, and were able to determine the correlation between facial nerve functional outcome and the amplitude drop of facial MEP above 50 %. Patients were evaluated for immediate facial nerve outcome and 6 months after the surgery. Follow-up was performed by structured telephone interviews with local physicians. The sensibility of the studied parameters was 92.8 % for amplitude drop of facial nerve MEP, with positive predictive value of 81.2 %. The absence of changes during IOM has shown a negative predictive value of 100 %. In this series, the used montage was effective in predicting new facial deficit.

  17. Motor evoked potentials enable differentiation between motor and sensory branches of peripheral nerves in animal experiments.

    Science.gov (United States)

    Turkof, Edvin; Jurasch, Nikita; Knolle, Erik; Schwendenwein, Ilse; Habib, Danja; Unger, Ewald; Reichel, Martin; Losert, Udo

    2006-10-01

    Differentiation between motor and sensory fascicles is frequently necessary in reconstructive peripheral nerve surgery. The goal of this experimental study was to verify if centrally motor evoked potentials (MEP) could be implemented to differentiate sensory from motor fascicles, despite the well-known intermingling between nerve fascicles along their course to their distant periphery. This new procedure would enable surgeons to use MEP for placing nerve grafts at corresponding fascicles in the proximal and distal stumps without the need to use time-consuming staining. In ten sheep, both ulnar nerves were exposed at the terminal bifurcation between the last sensory and motor branch. Animals were then relaxed to avoid volume conduction. On central stimulation, the evoked nerve compound action potentials were simultaneously recorded from both terminal branches. In all cases, neurogenic motor nerve action potentials were recorded only from the terminal motor branch. The conclusion was that MEPs can be used for intraoperative differentiation between sensory and motor nerves. Further studies are necessary to develop this method for in situ measurements on intact nerve trunks.

  18. Preservation of facial, cochlear, and other nerve functions in acoustic neuroma treatment.

    Science.gov (United States)

    Sterkers, J M; Morrison, G A; Sterkers, O; El-Dine, M M

    1994-02-01

    Between March 1966 and September 1992, 1400 acoustic neuromas were treated in Paris, France, by surgical excision. The findings over the last 7 years are presented. The translabyrinthine approach has been used in more than 85% of cases. Where hearing preservation is attempted, the middle fossa approach has been adapted for intracanilicular tumors and the retrosigmoid approach for small tumors extending into the cerebellopontine angle, in which the fundus of the internal meatus is free of tumor. The main goal is to achieve a grade I or II result in facial function within 1 month of surgery. Results improved during 1991 after the introduction of continuous facial nerve monitoring and the use of the Beaver mini-blade for dissection of tumor from nerve. With these techniques, facial function of grade I or II at 1 month improved from 20% to 52% for large tumors (larger than 3 cm), from 42% to 81% for medium tumors (2 to 3 cm). and from 70% to 92% for small tumors (up to and including 2 cm extracanalicular). The facial nerve was at greater risk using the retrosigmoid or middle fossa approaches than by the translabyrinthine route. Since 1985, success in hearing preservation has changed little, with useful hearing being preserved in 38.2% of cases operated on by means of the retrosigmoid route and a 36.4% of cases after the middle fossa approach. In older patients with good hearing and small tumors, observation with periodic MRI scanning is recommended. Despite earlier diagnosis, the number of patients suitable for hearing preservation surgery remains very limited and careful selection is required. Trigeminal nerve signs were present in 20% of cases preoperatively, in 10% postoperatively, and recovered spontaneously. Palsies of the other cranial nerves after surgery were much rarer and were as follows: sixth nerve (abducens), 0.5%; ninth nerve (glossopharyngeal), 1.4%; and tenth nerve (vagus), 0.7%. The importance of preservation of function of the nervus intermedius of

  19. Management of Facial Nerve in Surgical Treatment of Previously Untreated Fisch Class C Tympanojugular Paragangliomas: Long-Term Results

    Science.gov (United States)

    Bacciu, Andrea; Ait Mimoune, Hassan; D'Orazio, Flavia; Vitullo, Francesca; Russo, Alessandra; Sanna, Mario

    2013-01-01

    The aim of this study was to evaluate the long-term facial nerve outcome according to management of the facial nerve in patients undergoing surgery for Fisch class C tympanojugular paragangliomas. The study population consisted of 122 patients. The infratemporal type A approach was the most common surgical procedure. The facial nerve was left in place in 2 (1.6%) of the 122 patients, anteriorly rerouted in 97 (79.5%), anteriorly rerouted with segmental resection of the epineurium in 7 (5.7%), and sacrificed and reconstructed in 15 (12.3%). One patient underwent cross-face nerve grafting. At last follow-up, House-Brackmann grade I to II was achieved in 51.5% of patients who underwent anterior rerouting and in 28.5% of those who underwent anterior rerouting with resection of the epineurium. A House-Brackmann grade III was achieved in 73.3% of patients who underwent cable nerve graft interposition. The two patients in whom the facial nerve was left in place experienced grade I and grade III, respectively. The patient who underwent cross-face nerve grafting had grade III. Gross total resection was achieved in 105 cases (86%). Management of the facial nerve in tympanojugular paraganglioma surgery can be expected to ensure satisfactory facial function long-term outcome. PMID:24498582

  20. Hypoglossal-facial nerve anastomosis in the rabbits using laser welding.

    Science.gov (United States)

    Hwang, Kun; Kim, Sun Goo; Kim, Dae Joong

    2008-10-01

    The aim of this study is to compare laser nerve welding of hypoglossal-facial nerve to microsurgical suturing and a result of immediate and delayed repair, and to evaluate the effectiveness of laser nerve welding in reanimation of facial paralysis of the rabbit models. The first group of 5 rabbits underwent immediate hypoglossal-facial anastomosis (HFA) by microsurgical suturing and the second group of 5 rabbits by CO2 laser welding. The third group of 5 rabbits underwent delayed HFA by microsurgical suturing and the fourth group of 5 rabbits by laser nerve welding. The fifth group of 5 rabbits sustained intact hypoglossal and facial nerve as control. In all rabbits of the 4 different groups, cholera toxin subunit B (CTb) was injected in the epineurium distal to the anastomosis site on the postoperative sixth week and in normal hypoglossal nerve in the 5 rabbits of control group. Neurons labeled CTb of hypoglossal nuclei were positive immunohistochemically and the numbers were counted. In the immediate HFA groups, CTb positive neurons were 1416 +/- 118 in the laser welding group (n = 5) and 1429 +/- 90 in the microsurgical suturing group (n = 5). There was no significant difference (P = 0.75). In the delayed HFA groups, CTb positive neurons were 1503 +/- 66 in the laser welding group (n = 5) and 1207 +/- 68 in the microsurgical suturing group (n = 5). Difference was significant (P = 0.009). There was no significant difference between immediate and delayed anastomosis in the laser welding group (P = 0.208), but some significant difference was observed between immediate and delayed anastomosis in the microsurgical suturing group (P = 0.016). Injected CTb in intact hypoglossal neurons (n = 5) were labeled 1970 +/- 165. No dehiscence was seen on the laser welding site of nerve anastomosis in all the rabbits as re-exploration was done for injection of CTb. This study shows that regeneration of the anastomosed hypoglossal-facial nerve was affected similarly by either

  1. Clinical studies of photodynamic therapy for malignant brain tumors: facial nerve palsy after temporal fossa photoillumination

    Science.gov (United States)

    Muller, Paul J.; Wilson, Brian C.; Lilge, Lothar D.; Varma, Abhay; Bogaards, Arjen; Fullagar, Tim; Fenstermaker, Robert; Selker, Robert; Abrams, Judith

    2003-06-01

    In two randomized prospective studies of brain tumor PDT more than 180 patients have been accrued. At the Toronto site we recognized two patients who developed a lower motor neuron (LMN) facial paralysis in the week following the PDT treatment. In both cases a temporal lobectomy was undertaken and the residual tumor cavity was photo-illuminated. The surface illuminated included the temporal fossa floor, thus potentially exposing the facial nerve to the effect of PDT. The number of frontal, temporal, parietal, and occipital tumors in this cohort was 39, 24, 12 and 4, respectively. Of the 24 temporal tumors 18 were randomized to Photofrin-PDT. Of these 18 a temporal lobectomy was carried out exposing the middle fossa floor as part of the tumor resection. In two of the 10 patients where the lobectomy was carried out and the fossa floor was exposed to light there occurred a postoperative facial palsy. Both patients recovered facial nerve function in 6 and 12 weeks, respectively. 46 J/cm2 were used in the former and 130 J/cm2 in the latter. We did not encounter a single post-operative LMN facial plasy in the 101 phase 2 patients treated with Photofrin-PDT. Among 688 supratentorial brain tumor operations in the last decade involving all pathologies and all locations no case of early post-operative LMN facial palsy was identified in the absence of PDT. One further patient who had a with post-PDT facial palsy was identified at the Denver site. Although it is possible that these patients had incidental Bell's palsy, we now recommend shielding the temporal fossa floor during PDT.

  2. Anatomical feasibility of vagus nerve esophageal branch transfer to the phrenic nerve

    Institute of Scientific and Technical Information of China (English)

    Ce Wang; Jun Liu; Wen Yuan; Xuhui Zhou; Xinwei Wang; Peng Xu; Jian Chen; Guoxin Wu; Sheng Shi

    2012-01-01

    This study measured the vagus and phrenic nerves from 12 adult cadavers. We found that the width and thickness of the vagus and phrenic nerves were different in the chest. The distance from the point of the vagus nerve and phrenic nerve on the plane of the inferior border of portal pulmonary arteries (T point) was approximately 7 cm to the diaphragm and was approximately 10 cm to the clavicle level. The number of motor fibers in the vagus nerves was 1 716 ± 362, and the number of nerve fibers was 4 473 ± 653. The number of motor fibers in the phrenic nerves ranged from 3 078 ± 684 to 4 794 ± 638, and the number of nerve fibers ranged from 3 437 ± 642 to 5 071 ± 723. No significant difference was found in the total number of nerve fibers. The results suggest that width, thickness, and total number of nerve fibers are similar between the vagus and phrenic nerves, but the number of motor fibers is different between them.

  3. Study on Clinical Application of Nerve Monitor in Parotid Tumor Surgery

    Institute of Scientific and Technical Information of China (English)

    XU Liang-peng; JIA Bao-jun; AO Jian-hua; QU Dan-yang; SHENG Yan-jiao

    2014-01-01

    Objective The purpose of the study is to explore the application value of the nerve monitor adopted to pinpoint facial nerves before anatomization during a parotid tumor surgery. Methods Facial nerves of 36 patients were pinpointed by N800 nerve monitor produced by Shandong Weigao Group Medical Polymer Co. Ltd before being anatomized and exposed in parotid surgeries in order to protect the corresponding facial nerve branch and complete the related surgery. Results All the facial nerves of the 36 patients were located precisely and 108 related facial nerves were suc-cessfully anatomized and protected without any damage. Conclusion Pinpointing the facial nerve branch with a nerve monitor before anatomization pro-motes not only the efficiency of the surgery but also the safety of it and is proved to be more significant in a secondary surgery.

  4. [Peculiar features of mastoiditis in a brest-fed infant with the "exposed" facial nerve].

    Science.gov (United States)

    Andreeva, I G

    2013-01-01

    This paper reports the clinical case of mastoiditis in a 5-month old child in whom an unusual localization of the totally "naked" facial nerve outside of the bone canal in the mastoid part was discovered intraoperatively. This finding was quite unexpected because nerves are not visible on CT scanograms. The author emphasizes that the clinical course of otitis media in the breast- fed infants and young children is characterized by a number of peculiarities due to specific anatomical, physiological, and immunological features of the child's organism. She also notes that the number of antromastoidotomies for the treatment of mastoiditis has increased in Tatarstan during the recent years.

  5. Thixotropy of levator palpebrae as the cause of lagophthalmos after peripheral facial nerve palsy.

    Science.gov (United States)

    Aramideh, M; Koelman, J H T M; Devriese, P P; Speelman, J D; Ongerboer de Visser, B W

    2002-05-01

    Patients with facial nerve palsy are at risk of developing corneal ulceration because of lagophthalmos (incomplete closure of the affected eyelid). Lagophthalmos could result from thixotropy of the levator palpebrae muscle--that is, the formation of tight crossbridges between the actin and myosin filaments of the muscle fibres causing stiffness of the muscle--rather than from paralysis of the orbicularis occuli muscle as previously supposed. This possibility was investigated in 13 patients with a peripheral facial nerve palsy in a prospective open study. The levator muscle of the affected eyelid was stretched by manipulation and downward movement of the passively closed upper eyelid for approximately 15 seconds. The amount of lagophthalmos was measured before and immediately after this manoeuvre. In all patients except one there was a clear reduction in lagophthalmos (mean reduction 72%; range 60-100%). Thus in this setting the lagophthalmos appears to be caused by thixotropy of the levator palpebrae muscle, which has implications for treatment.

  6. Effect of endoscopic brow lift on contractures and synkinesis of the facial muscles in patients with a regenerated postparalytic facial nerve syndrome.

    Science.gov (United States)

    Bran, Gregor M; Börjesson, Pontus K E; Boahene, Kofi D; Gosepath, Jan; Lohuis, Peter J F M

    2014-01-01

    Delayed recovery after facial palsy results in aberrant nerve regeneration with symptomatic movement disorders, summarized as the postparalytic facial nerve syndrome. The authors present an alternative surgical approach for improvement of periocular movement disorders in patients with postparalytic facial nerve syndrome. The authors proposed that endoscopic brow lift leads to an improvement of periocular movement disorders by reducing pathologically raised levels of afferent input. Eleven patients (seven women and four men) with a mean age of 54 years (range, 33 to 85 years) and with postparalytic facial nerve syndrome underwent endoscopic brow lift under general anesthesia. Patients' preoperative condition was compared with their postoperative condition using a retrospective questionnaire. Subjects were also asked to compare the therapeutic effectiveness of endoscopic brow lift and botulinum toxin type A. Mean follow-up was 52 months (range, 22 to 83 months). No intraoperative or postoperative complications occurred. During follow-up, patients and physicians observed an improvement of periorbital contractures and oculofacial synkinesis. Scores on quality of life improved significantly after endoscopic brow lift. Best results were obtained when botulinum toxin type A was adjoined after the endoscopic brow lift. Patients described a cumulative therapeutic effect. These findings suggest endoscopic brow lift as a promising additional treatment modality for the treatment of periocular postparalytic facial nerve syndrome-related symptoms, leading to an improved quality of life. Even though further prospective investigation is needed, a combination of endoscopic brow lift and postsurgical botulinum toxin type A administration could become a new therapeutic standard.

  7. 44 Cases of Peripheral Facial Paralysis Treated by the SXDZ-100 Nerve and Muscle Stimulator

    Institute of Scientific and Technical Information of China (English)

    YANG Jin-sheng; CUI Cheng-bin; GAO Xin-yan; ZHU Bing; RONG Pei-jing

    2009-01-01

    Objective:To observe the clinical effects of the Hua Tuo Manual Acupuncture Therapeutic Stimulator for peripheral facial paralysis.Methods:87 patients with peripheral facial paralysis were divided randomly into the SXDZ-100 Nerve and Muscle Stimulator treatment group (44 cases) and the G6805 Electric Stimulator control group (43 cases).The acupoints selected for both the two groups were local points as well as distal points as Hegu (LI 4), Waiguan (TE 5), Sanyinjiao (SP 6), Taichong (LR 3).Effectiveness was compared between the two groups.Results:Both groups had a total effective rate of 100%.But the cure rate was 90.9% in the treatment group, and 73.0% in the control group, indicating a significant difference (P<0.05).No side effects were found in either of the two groups.Conclusion:The SXDZ-100 stimulator is more effective than the G6805 electroacupuncture stimulator for treatment of peripheral facial paralysis.

  8. A Case of Wegener’s Granulomatosis Presenting with Unilateral Facial Nerve Palsy

    Directory of Open Access Journals (Sweden)

    Roy Ujjawal

    2016-01-01

    Full Text Available Wegener’s granulomatosis or granulomatosis with polyangiitis is a necrotizing vasculitis affecting both arterioles and venules. The disease is characterized by the classical triad involving acute inflammation of the upper and lower respiratory tracts with renal involvement. However, the disease pathology can affect any organ system. This case presents Wegener’s granulomatosis presenting with facial nerve palsy as the first manifestation of the disease, which is rarely reported in medical literature.

  9. Evaluation of variation in the course of the facial nerve, nerve adhesion to tumors, and postoperative facial palsy in acoustic neuroma.

    Science.gov (United States)

    Sameshima, Tetsuro; Morita, Akio; Tanikawa, Rokuya; Fukushima, Takanori; Friedman, Allan H; Zenga, Francesco; Ducati, Alessandro; Mastronardi, Luciano

    2013-02-01

    Objective To investigate the variation in the course of the facial nerve (FN) in patients undergoing acoustic neuroma (AN) surgery, its adhesion to tumors, and the relationship between such adhesions and postoperative facial palsy. Methods The subjects were 356 patients who underwent AN surgery in whom the course of the FN could be confirmed. Patients were classified into six groups: ventro-central surface of the tumor (VCe), ventro-rostral (VR), ventro-caudal (VCa), rostral (R), caudal (C), and dorsal (D). Results The FN course was VCe in 185 cases, VR in 137, VCa in 19, R in 10, C in 4, and D in one. For tumors  3.0 cm, there was an increasing tendency for the FN to adhere strongly to the tumor capsule, and postoperative facial palsy was more severe in patients with stronger adhesions. Conclusions The VCe pattern was most common for small tumors. Strong or less strong adhesion to the tumor capsule was most strongly associated with postoperative FN palsy.

  10. Hypoglossal Nerve-Facial Nerve Transfer in the Treatment of Peripheral Facial Paralysis%舌下神经-面神经转接术治疗周围性面瘫研究

    Institute of Scientific and Technical Information of China (English)

    蔡小康

    2011-01-01

    目的:探讨舌下神经-面神经转接术治疗周围性面瘫的临床效果.方法:对17例面瘫患者给予舌下神经一面神经转接术,在术后2个月、半年以及一年随访观察其临床效果和并发症.结果:17例患者面部表情肌活动术后逐步恢复,不同程度的显现效果;17例患者均未出现舌肌萎缩及伸舌偏斜等并发症.结论:面神经损伤导致的面瘫,经过神经电生理学检查确定该损伤不可逆后通过舌下神经一面神经转接术治疗确有效果,且未见明显不良反应.%Objective:To evaluate the clinical effects of hypoglossal nerve-facial nerve transfer in the treatment of peripheral facial paralysis. Methods: 17 patients with facial paralysis were treated with hypoglossal nerve-facial nerve transfer surgery,2 months after surgery, six months and one year follow-up observation of clinical effects and complications. Results: 17 patients after facial muscle activity gradually restored,show varying degrees of effectiveness;genioglossus occurred in 17 patients no complications such as atrophy and Shenshe skew. Conclusions:Facial nerve injury caused by facial paralysis, after a neurological examination to determine the electrophysiological adopted after irreversible injury hypoglossal nerve-facial nerve transfer surgery does have effect, and no significant adverse reactions.

  11. Burkitt's non-Hodgkins lymphoma presenting as facial nerve palsy in HIV-positive patients.

    Science.gov (United States)

    Woodcock, H; Nelson, M

    2011-02-01

    An isolated facial nerve palsy is rare as the presentation of a central nervous system lymphoma. In this case series, we present the clinical features of three HIV-positive patients presenting with facial nerve palsies due to HIV-associated Burkitt's lymphoma. These patients had a non-resolving facial paralysis, which occurred during a late stage of HIV. Magnetic resonance imaging (MRI) did not show leptomeningeal enhancement. Cerebrospinal fluid revealed a lymphocytosis with elevated protein and low glucose levels. The diagnosis of Burkitt's lymphoma was made on histology which showed the characteristic 'starry sky' appearance due to scattered tangible body-laden macrophages. The patients were commenced on the intensive chemotherapy regimen of CODOX-M/IVAC. Two patients died of disease progression and the third patient died of chemotherapy toxicity. This case series highlights the need for a high index of suspicion for underlying malignancy when a patient presents with a persistent facial paralysis in the later stages of HIV infection.

  12. Peripheral nerve field stimulation for trigeminal neuralgia, trigeminal neuropathic pain, and persistent idiopathic facial pain.

    Science.gov (United States)

    Klein, Johann; Sandi-Gahun, Sahr; Schackert, Gabriele; Juratli, Tareq A

    2016-04-01

    Peripheral nerve field stimulation (PNFS) is a promising modality for treatment of intractable facial pain. However, evidence is sparse. We are therefore presenting our experience with this technique in a small patient cohort. Records of 10 patients (five men, five women) with intractable facial pain who underwent implantation of one or several subcutaneous electrodes for trigeminal nerve field stimulation were retrospectively analyzed. Patients' data, including pain location, etiology, duration, previous treatments, long-term effects and complications, were evaluated. Four patients suffered from recurrent classical trigeminal neuralgia, one had classical trigeminal neuralgia and was medically unfit for microvascular decompression. Two patients suffered from trigeminal neuropathy attributed to multiple sclerosis, one from post-herpetic neuropathy, one from trigeminal neuropathy following radiation therapy and one from persistent idiopathic facial pain. Average patient age was 74.2 years (range 57-87), and average symptom duration was 10.6 years (range 2-17). Eight patients proceeded to implantation after successful trial. Average follow-up after implantation was 11.3 months (range 5-28). Using the visual analog scale, average pain intensity was 9.3 (range 7-10) preoperatively and 0.75 (range 0-3) postoperatively. Six patients reported absence of pain with stimulation; two had only slight constant pain without attacks. PNFS may be an effective treatment for refractory facial pain and yields high patient satisfaction. © International Headache Society 2015.

  13. Iatrogenic facial nerve injuries during chronic otitis media surgery: a multicentre retrospective study.

    Science.gov (United States)

    Linder, T; Mulazimoglu, S; El Hadi, T; Darrouzet, V; Ayache, D; Somers, T; Schmerber, S; Vincent, C; Mondain, M; Lescanne, E; Bonnard, D

    2017-06-01

    To give an insight into why, when and where iatrogenic facial nerve (FN) injuries may occur and to explain how to deal with them in an emergency setting. Multicentre retrospective study in eight tertiary referral hospitals over 17 years. Twenty patients with partial or total FN injury during surgery for chronic otitis media (COM) were revised. Indication and type of surgery, experience of the surgeon, intra- and postoperative findings, value of CT scanning, patient management and final FN outcome were recorded. In 12 cases, the nerve was completely transected, but the surgeon was unaware in 11 cases. A minority of cases occurred in academic teaching hospitals. Tympanic segment, second genu and proximal mastoid segments were the sites involved during injury. The FN was not deliberately identified in 18 patients at the time of injury, and nerve monitoring was only applied in one patient. Before revision surgery, CT scanning correctly identified the lesion site in 11 of 12 cases and depicted additional lesions such as damage to the lateral semicircular canal. A greater auricular nerve graft was interposed in 10 cases of total transection and in one partially lesioned nerve: seven of them resulted in an HB III functional outcome. In two of the transected nerves, rerouting and direct end-to-end anastomosis was applied. A simple FN decompression was used in four cases of superficially traumatised nerves. We suggest checklists for preoperative, intraoperative and postoperative management to prevent and treat iatrogenic FN injury during COM surgery. © 2016 John Wiley & Sons Ltd.

  14. Facial nerve palsy: incidence of different ethiologies in a tertiary ambulatory

    Directory of Open Access Journals (Sweden)

    Atolini Junior, Nédio

    2009-06-01

    Full Text Available Introduction: The ethiologic diferencial diagnostic for facial nerve paralisis is still a challenge and the literature has shown conflictive results concerning its epidemiology. Objective: To outline the incidence of the different ethiologies and the profile of peripheral facial nerve paralysis patients in the otolaryngology ambulatory of the Faculdade de Ciencias Medicas e Biologicas da PUC-SP - campus Sorocaba. Method: The records of 54 patients with facial nerve paralysis seen during the years of 2007 and 2008 were analysed retrospectively. Results: From the 54 patients analysed, 55,5% were male, median age of 40,6 years and had the right side of the face acomitted in 66,6%. Parestesia of the accomited side in 51,85% and increased tears in 66,6% of the patients were observed as associated symptoms. Bell´s palsy was the most frequent ethiology (53,7%, follwed by: traumatic (24%, Ramsay Hunt syndrome (9,2%, Cholesteatoma (5,5%, malignant otitis media (3,7% and acute otits media (3,7%. Three cases of Bell´s palsy during pregancy was also seen in this series. Conclusion: The data found are similiar of the most of the literature, showing that Bell´s palsy is still the most frequent, followed by traumatic causes and others. There is an equilibrium concerning to the gender, with a slight prevalence for males and for the right side of the face.

  15. The feasibility of sugammadex for general anesthesia and facial nerve monitoring in patients undergoing parotid surgery.

    Science.gov (United States)

    Lu, I-Cheng; Chang, Pi-Ying; Su, Miao-Pei; Chen, Po-Nien; Chen, Hsiu-Ya; Chiang, Feng-Yu; Wu, Che-Wei

    2017-08-01

    The use of neuromuscular blocking agent (NMBA) during anesthesia may interfere with facial nerve monitoring (FNM) during parotid surgery. Sugammadex has been reported to be an effective and safe reversal of rocuronium-induced neuromuscular block (NMB) during surgery. This study investigated the feasibility and clinical effectiveness of sugammadex for NMB reversal during FNM in Parotid surgery. Fifty patients undergoing parotid surgery were randomized allocated into conventional anesthesia group (Group C, n = 25) and sugammadex group (Group S, n = 25). Group C did not receive any NMBA. Group S received rocuronium 0.6 mg/kg at anesthesia induction and sugammadex 2 mg/kg at skin incision. The intubating condition and influence on FNM evoked EMG results were compared between groups. The intubation condition showed significantly better in group S patients than C group patients (excellent in 96% v.s. 24%). In group S, rapid reverse of NMB was found and the twitch (%) recovered from 0 to >90% within 10 min. Positive and high EMG signals were obtained in all patients at the time point of initial facial nerve stimulation in both groups. There was no significant difference as comparing the EMG amplitudes detected at the time point of initial and final facial nerve stimulation in both groups. Implementation of sugammadex in anesthesia protocol is feasible and reliable for successful FNM during parotid surgery. Copyright © 2017. Published by Elsevier Taiwan.

  16. 面神经减压治疗周围性面瘫的临床分析%Facial Nerve Decompression for Peripheral Facial Paralysis

    Institute of Scientific and Technical Information of China (English)

    聂智樱; 毛弈韬; 彭安全; 谢鼎华; 伍伟景

    2014-01-01

    目的:总结各种原因所致周围性面瘫行面神经减压术的经验和疗效。方法回顾分析37例周围性面瘫的临床资料、面神经减压的手术方式及疗效。结果37例中,包括颞骨骨折、中耳乳突手术后、中耳乳突炎、面神经瘤、听神经瘤及中耳癌等不同原因。术后随访3月至4年,其中25例面神经功能恢复至House-BrackmannⅠ、Ⅱ级(68%)。面瘫病程2月者。结论面神经减压术是治疗周围性面瘫的有效手段,对保守治疗恢复不满意、有手术指征的患者,应尽早行面神经减压术。%Objective To report efficacy of facial nerve decompression in treating peripheral facial paralysis of differ-ent causes. Methods The clinical data of 37 cases of peripheral facial paralysis, and surgical approaches as well as efficacy of facial nerve decompression were retrospectively analyzed. Results Causes of facial paralyhsis included temporal bone fracture, post-operative infection, middle ear cholesteatoma, facial neuroma, acoustic neuroma and middle ear carcinoma, etc. Among the 37 cases, 25 demonstrated satisfactory facial nerve recovery of House-Brackmann grade I-II during the fol-low-up period of three months to four years. The facial nerve recovery after decompression in patients with facial paralysis duration of less than two months was obviously better than in patients with facial paralysis duration of greater than two months. Conclusions Facial nerve decompression is an effective method for peripheral facial paralysis. Early decompression in patients with dissatisfied recovery during observation is recommended.

  17. Acute pathological changes of facial nucleus and expressions of postsynaptic density protein-95 following facial nerve injury of varying severity A semi-quantitative analysis

    Institute of Scientific and Technical Information of China (English)

    Jingjing Li; Wenlong Luo

    2008-01-01

    BACKGROUND: Previous studies have demonstrated that postsynaptic density protein-95 (PSD-95) is widely distributed in the central nervous system and is related to the development of the CNS and sensory signal transmission as well as acute or chronic nerve cell death following ischemic brain injury.OBJECTIVE: To semi-quantitatively determine the pathological changes of apoptotic facial neurons and the expression of PSD-95 in the facial nucleus following facial nerve injury of varying extents using immunohistochemical staining methods.DESIGN, TIME AND SETTING: Randomized, controlled animal experiments were performed in the Ultrasonic Institute of the Second Affiliated Hospital of Chongqing University of Medical Sciences from September to December 2007.MATERIALS: Sixty-five healthy, adult, Sprague-Dawley (SD) rats, both male and female, were used for this study. Rabbit anti-rat PSD-95 polyclonal antibody was purchased from Beijing Biosynthesis Biotechnology Co., Ltd.METHODS: SD rats were randomly assigned into a control group with five rats and three injured groups with 20 rats per group. Exposure, clamp and cut for bilateral facial nerve trunks were performed in the rats of the injury groups, and no injury was inflicted on the rats of the control group.MAIN OUTCOME MEASURES: The brainstems of all the rats were excised on days 1, 3, 7, and 14 post injury, and then the facial nuclei were stained with hematoxylin-eosin to observe any pathological changes due to apoptosis in facial neurons. PSD-95 expression in facial nuclei was detected by immunohistochemistry, and the number of PSD-95 positive cells was counted under a light microscope.RESULTS: The expression of PSD-95 in the facial nucleus and morphology of the facial neuron within the exposure group had no obvious changes at various points in time tested (P>0.05). However, the expressions of PSD-95 in the facial nucleus of the clamp group and cut group increased on day 1 post injury (Pclamp group>exposure group

  18. Cross-face nerve grafting for reanimation of incomplete facial paralysis: quantitative outcomes using the FACIAL CLIMA system and patient satisfaction.

    Science.gov (United States)

    Hontanilla, Bernardo; Marre, Diego; Cabello, Alvaro

    2014-01-01

    Although in most cases Bell palsy resolves spontaneously, approximately one-third of patients will present sequela including facial synkinesis and paresis. Currently, the techniques available for reanimation of these patients include hypoglossal nerve transposition, free muscle transfer, and cross-face nerve grafting (CFNG). Between December 2008 and March 2012, eight patients with incomplete unilateral facial paralysis were reanimated with two-stage CFNG. Gender, age at surgery, etiology of paralysis denervation time, donor and recipient nerves, presence of facial synkinesis, and follow-up were registered. Commissural excursion and velocity and patient satisfaction were evaluated with the FACIAL CLIMA and a questionnaire, respectively. Mean age at surgery was 33.8 ± 11.5 years; mean time of denervation was 96.6 ± 109.8 months. No complications requiring surgery were registered. Follow-up period ranged from 7 to 33 months with a mean of 19 ± 9.7 months. FACIAL CLIMA showed improvement of both commissural excursion and velocity greater than 75% in 4 patients, greater than 50% in 2 patients, and less than 50% in the remaining two patients. Qualitative evaluation revealed a high grade of satisfaction in six patients (75%). Two-stage CFNG is a reliable technique for reanimation of incomplete facial paralysis with a high grade of patient satisfaction.

  19. Transient total facial nerve paralysis: an unusual complication of transoral endoscopic-assisted management of subcondylar fracture.

    Science.gov (United States)

    Choi, Hwan Jun; Lee, Young Man

    2012-05-01

    Endoscopic-assisted repair of subcondylar fractures is an additional tool for management; however, there is a steep learning curve. Generally, this technique allows good visualization of the fracture site for reduction through an incision with an acceptable cosmetic result. Recently, the surgical techniques and technology as well as the indications for endoscopic facial fracture repair are in development; there are few available data in the literature regarding detail complications and recovery processes following endoscopic fracture treatment. The purpose of this article was to reveal unusual complication following endoscopic repair of subcondylar fracture in terms of radiographic, photographic, and recovering orders of the facial nerve and facial reanimations. In our case, no damage to the facial nerve was observed intraoperatively, but the patient had total facial paralysis, immediately postoperatively. At long-term follow-up, the facial nerve function was recovered well within 6 months. The authors consider that transoral endoscopic-assisted open reduction constitutes a valid alternative to a transcutaneous approach for the reduction and fixation of subcondylar fractures. It provides the benefits of open reduction and internal fixation without the permanent complications, such as facial nerve injury.

  20. 大鼠面神经损伤后神经元型一氧化氮合酶的表达变化%Expression of Neuronal Nitric Oxide Synthase in the Facial Nucleus after Facial Nerve Injury

    Institute of Scientific and Technical Information of China (English)

    王鹏; 臧晓燕; 张引成

    2014-01-01

    Objective: To observe the variation of neuronal nitric oxide synthase (nNOS) expression in injured facial nerve tissue. Method: 20 adult male SD rats were used in this study, among them , 5 rats were normal controls. In experiment group, a compression injury was applied at one branch of bilateral facial nerve. Every 3 rats in experiment group were sacrified for nNOS immunostaining in a period of 1, 2, 3, 4 and 5 weeks respectively. Results:In normal facial nerve tissue, nNOS expression was not detected. In the injured facial nerve neurons, nNOS immunostaining expression was positive, and lasting up till the fifth weeks. Conclusion: After the nerve injury, the expressing of nNOS was observed in the facial nucleus, which may be related to the death of neuron.%目的:通过观察面神经损伤后神经元型一氧化氮合酶(neuronal NOS, nNOS)在面神经核团中的表达,探讨NO在面神经损伤后的作用。方法:健康成年SD大白鼠20只,其中5只作为正常对照。其余15只为面神经损伤组,在双侧面神经下颊支制作挤压伤。术后1、2、3、4、5周各取3只损伤组大鼠作面神经核团nNOS表达的免疫组化观察。结果:正常情况下面神经元不表达nNOS。面神经损伤后,出现运动神经元变性,其神经元细胞nNOS免疫染色为阳性,并持续至损伤后第5周。结论:面神经损伤后其运动神经元的核团中会出现nNOS的表达。

  1. Facial nucleus up-regulation of brain-derived neurotrophic factor mRNA following electroacupuncture treatment in a rabbit model of facial nerve injury

    Institute of Scientific and Technical Information of China (English)

    Hong Gao; Bangyu Ju; Guohua Jiang

    2008-01-01

    BACKGROUND: The effect of acupuncture treatment on peripheral facial nerve injury is generally accepted. However, the mechanisms of action remain poorly understood. OBJECTIVE: To validate the effect of acupoint electro-stimulation on brain-derived neurotrophic factor (BDNF) mRNA expression in the facial nucleus of rabbits with facial nerve injury, with the hypothesis that acupuncture treatment efficacy is related to BDNE DESIGN, TIME AND SETTING: Peripheral facial nerve injury, in situ hybridization, and randomized, controlled, animal trial. The experiment was performed at the Laboratory of Anatomy, Heilongjiang University of Chinese Medicine from March to September 2005. MATERIALS: A total of 120 healthy, adult, Japanese rabbits, with an equal number of males and females were selected. Models of peripheral facial nerve injury were established using the facial nerve pressing method. METHODS: The rabbits were randomly divided into five groups (n = 24): sham operation, an incision to the left facial skin, followed by suture; model, no treatment following facial nerve model establishment; western medicine, 10 mg vitamin B1, 50 μg vitamin B12, and dexamethasone (2 mg/d, reduced to half every 7 days) intramuscular injection starting with the first day following lesion, once per day; traditional acupuncture, acupuncture at Yifeng, Quanliao, Dicang, Jiache, Sibai, and Yangbai acupoints using a acupuncture needle with needle twirling every 10 minutes, followed by needle retention for 30 minutes, for successive 5 days; electroacupuncture, similar to the traditional acupuncture group, the Yifeng (negative electrode), Jiache (positive electrode), Dicang (negative electrode), and Sibai (positive electrode) points were connected to an universal pulse electro-therapeutic apparatus for 30 minutes per day, with disperse-dense waves for successive 5 days, and resting for 2 days. MAIN OUTCOME MEASURES: Left hemisphere brain stem tissues were harvested on post-operative days 7, 14

  2. The composition of trigeminal nerve branches in normal adult chickens and after debeaking at different ages.

    Science.gov (United States)

    Dubbeldam, J L; De Bakker, M A; Bout, R G

    1995-06-01

    The long term effects of amputation of the tip of the beak were studied in adult hens that were debeaked on the day of hatching, at the age of 8 d and at 6 wk, by EM analysis of fibre spectra of the medial branch of the ophthalmic nerve and of the intramandibular nerve. Three categories of fibre were distinguished for further analysis, i.e. unmyelinated axons, small myelinated fibres and large myelinated fibres. In normal birds the ophthalmic nerve contains relatively more large fibres than the intramandibular nerve. Amputation consistently results in a reduction of the number of large fibres and a substantial increase in the number of small myelinated fibres. The proportion of unmyelinated axons is rather variable, but is not affected by beak trimming. Age at debeaking has no effect. The observations are inconclusive concerning the possibility of heightened nociception.

  3. Early and continued manual stimulation is required for long-term recovery after facial nerve injury.

    Science.gov (United States)

    Grosheva, Maria; Rink, Svenja; Jansen, Ramona; Bendella, Habib; Pavlov, Stoyan P; Sarikcioglu, Levent; Angelov, Doychin N; Dunlop, Sarah A

    2017-02-18

    We previously have shown that manual stimulation (MS) of vibrissal muscles for 2 months after facial nerve injury in rats improves whisking and reduces motor end plate polyinnervation. Here, we seek to determine whether discontinuing or delaying MS after facial-facial anastomosis (FFA) leads to similar results. Rats were subjected to FFA and received MS for (1) 4 months (early and continued), (2) the first but not the last 2 months (discontinued), or (3) the last 2 months (delayed). Intact animals and those not receiving MS (no MS) were also examined. Early and continued MS restored whisking amplitude to 43°, a value significantly higher compared with the discontinued, delayed, and no MS groups (32°, 24°, and 10°, respectively). Motor end plate polyinnervation occurred in all experimental groups but was significantly higher in the delayed group. Early and continued MS results in better recovery than when it is either discontinued or delayed. Muscle Nerve, 2017. © 2017 Wiley Periodicals, Inc.

  4. Management of Synkinesis and Asymmetry in Facial Nerve Palsy: A Review Article

    Directory of Open Access Journals (Sweden)

    Abbasali pourmomeny

    2014-10-01

    Full Text Available Introduction: The important sequelae of facial nerve palsy are synkinesis, asymmetry, hypertension and contracture; all of which have psychosocial effects on patients. Synkinesis due to mal regeneration causes involuntary movements during a voluntary movement. Previous studies have advocated treatment using physiotherapy modalities alone or with exercise therapy, but no consensus exists on the optimal approach. Thus, this review summarizes clinical controlled studies in the management of synkinesis and asymmetry in facial nerve palsy.   Materials and Methods: Case-controlled clinical studies of patients at the acute stage of injury were selected for this review article. Data were obtained from English-language databases from 1980 until mid-2013.   Results: Among 124 articles initially captured, six randomized controlled trials involving 269 patients were identified with appropriate inclusion criteria. The results of all these studies emphasized the benefit of exercise therapy. Four studies considered electromyogram (EMG biofeedback to be effective through neuromuscular re-education.   Conclusion:  Synkinesis and inconsistency of facial muscles could be treated with educational exercise therapy. EMG biofeedback is a suitable tool for this exercise therapy.

  5. Visualization of the Peripheral Branches of the Mandibular Division of the Trigeminal Nerve on 3D Double-Echo Steady-State with Water Excitation Sequence

    National Research Council Canada - National Science Library

    Fujii, H; Fujita, A; Yang, A; Kanazawa, H; Buch, K; Sakai, O; Sugimoto, H

    2015-01-01

    Although visualization of the extracranial branches of the cranial nerves has improved with advances in MR imaging, only limited studies have assessed the detection of extracranial branches of the mandibular nerve (V3...

  6. A Functional Magnetic Resonance Imaging Paradigm to Identify Distinct Cortical Areas of Facial Function : A Reliable Localizer

    NARCIS (Netherlands)

    Romeo, Marco; Vizioli, Luca; Breukink, Myrte; Aganloo, Kiomars; Lao, Junpeng; Cotrufo, Stefano; Caldara, Roberto; Morley, Stephen

    2013-01-01

    Background: Irreversible facial paralysis can be surgically treated by importing both a new neural and a new motor muscle supply. Various donor nerves can be used. If a nerve supply other than the facial nerve is used, the patient has to adapt to generate a smile. If branches of the fifth cranial ne

  7. Hormonal shifts and intensity of free radical oxidation in the blood of patients with facial nerve neuropathies

    Directory of Open Access Journals (Sweden)

    L. V. Govorova

    2010-01-01

    Full Text Available Pathochemical characteristic features of facial nerve neuropathy (FNN have been more accurately defined. Heterogeneous patochemical pattern of facial nerve neuropathy has been shown to be dependent on the severity of the disease, intensity of free radical oxidation processes, and hormonal status of the patient. We have found reliable distinctions in dynamics of free radical oxidation processes, and hormo-nal status in the blood of the patients with moderately severe and severe forms of facial nerve neuropathies. In facial nerve neuropathies we observed regulatory effects of cortisol and somatotropic hormone; in facial nerve neuropathywith moderate severity the hormones of thyroid group were seen to be switching off, falling out the processes regulating metabolism. Follicle stimulating hormone (FSH and luteinizing hormone (LH were found to have regulating effects, especially in the acute phase of the disease. Different dynamics of the hormones in patients with high and low free radical oxidation levels suggests that the oxidative stress intensity could be associated with regulatory effects of the hormones . The results of correlation analysis confirm the reliable distinctions in free radical oxidation characteristics andand cortisole levels, STH, FSH and LH levels.

  8. Ultraestrutura do nervo facial intratemporal em pacientes com paralisia facial idiopática: estudo de evidências de infecção viral Intratemporal facial nerve ultrastructure in patients with idiopathic facial paralysis: viral infection evidence study

    Directory of Open Access Journals (Sweden)

    Rosangela Aló Maluza Florez

    2010-10-01

    Full Text Available A etiologia da paralisia facial periférica idiopática (PFPI ainda é uma incógnita, no entanto, alguns autores aventam a possibilidade de ser uma infecção viral. OBJETIVO: Analisar a ultraestrutura do nervo facial procurando evidências virais que possam nos fornecer dados etiológicos. MATERIAL E MÉTODO: Foram estudados 20 pacientes com PFP, com graus de moderado a severo, de ambos os sexos, entre 18-60 anos, provenientes de Ambulatório de Distúrbios do Nervo Facial. Os pacientes foram divididos em dois grupos: Estudo, onze pacientes com PFPI e Controle, nove pacientes com Paralisia Facial Periférica Traumática ou Tumoral. Foram estudados fragmentos de bainha do nervo facial ou fragmentos de seus cotos, que durante a cirurgia de reparação do nervo facial, seriam desprezados ou encaminhados para estudo anatomopatológico. O tecido foi fixado em glutaraldeído 2% e analisado em Microscopia Eletrônica de Transmissão. RESULTADO: Observamos no grupo estudo atividade celular intensa de reparação com aumento de fibras colágenas, fibroblastos com organelas desenvolvidas, isentos de partículas virais. No grupo controle esta atividade de reparação não foi evidente, mas também não foram observadas partículas virais. CONCLUSÃO: Não foram encontradas partículas virais, no entanto, houve evidências de intensa atividade de reparação ou infecção viral.The etiology of idiopathic peripheral facial palsy (IPFP is still uncertain; however, some authors suggest the possibility of a viral infection. AIM: to analyze the ultrastructure of the facial nerve seeking viral evidences that might provide etiological data. MATERIAL AND METHODS: We studied 20 patients with peripheral facial palsy (PFP, with moderate to severe FP, of both genders, between 18-60 years of age, from the Clinic of Facial Nerve Disorders. The patients were broken down into two groups - Study: eleven patients with IPFP and Control: nine patients with trauma or tumor

  9. Hypoglossal-facial nerve anastomosis and rehabilitation in patients with complete facial palsy: cohort study of 30 patients followed up for three years.

    Science.gov (United States)

    Dalla Toffola, Elena; Pavese, Chiara; Cecini, Miriam; Petrucci, Lucia; Ricotti, Susanna; Bejor, Maurizio; Salimbeni, Grazia; Biglioli, Federico; Klersy, Catherine

    2014-01-01

    Our study evaluates the grade and timing of recovery in 30 patients with complete facial paralysis (House-Brackmann grade VI) treated with hypoglossal-facial nerve (XII-VII) anastomosis and a long-term rehabilitation program, consisting of exercises in facial muscle activation mediated by tongue movement and synkinesis control with mirror feedback. Reinnervation after XII-VII anastomosis occurred in 29 patients, on average 5.4 months after surgery. Three years after the anastomosis, 23.3% of patients had grade II, 53.3% grade III, 20% grade IV and 3.3% grade VI ratings on the House-Brackmann scale. Time to reinnervation was associated with the final House-Brackmann grade. Our study demonstrates that patients undergoing XIIVII anastomosis and a long-term rehabilitation program display a significant recovery of facial symmetry and movement. The recovery continues for at Hypoglossal-facial nerve anastomosis and rehabilitation in patients with complete facial palsy: cohort study of 30 patients followed up for three years least three years after the anastomosis, meaning that prolonged follow-up of these patients is advisable.

  10. Facial Nerve Palsy: An Unusual Presenting Feature of Small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Ozcan Yildiz

    2011-01-01

    Full Text Available Lung cancer is the second most common type of cancer in the world and is the most common cause of cancer-related death in men and women; it is responsible for 1.3 million deaths annually worldwide. It can metastasize to any organ. The most common site of metastasis in the head and neck region is the brain; however, it can also metastasize to the oral cavity, gingiva, tongue, parotid gland and lymph nodes. This article reports a case of small cell lung cancer presenting with metastasis to the facial nerve.

  11. Single session of brief electrical stimulation immediately following crush injury enhances functional recovery of rat facial nerve

    Directory of Open Access Journals (Sweden)

    Eileen M. Foecking, PhD

    2012-04-01

    Full Text Available Peripheral nerve injuries lead to a variety of pathological conditions, including paresis or paralysis when the injury involves motor axons. We have been studying ways to enhance the regeneration of peripheral nerves using daily electrical stimulation (ES following a facial nerve crush injury. In our previous studies, ES was not initiated until 24 h after injury. The current experiment tested whether ES administered immediately following the crush injury would further decrease the time for complete recovery from facial paralysis. Rats received a unilateral facial nerve crush injury and an electrode was positioned on the nerve proximal to the crush site. Animals received daily 30 min sessions of ES for 1 d (day of injury only, 2 d, 4 d, 7 d, or daily until complete functional recovery. Untreated animals received no ES. Animals were observed daily for the return of facial function. Our findings demonstrated that one session of ES was as effective as daily stimulation at enhancing the recovery of most functional parameters. Therefore, the use of a single 30 min session of ES as a possible treatment strategy should be studied in human patients with paralysis as a result of acute nerve injuries.

  12. Measurement of cochlea to facial nerve canal with thin-section computed tomographic image.

    Science.gov (United States)

    Jiang, Ying; Liu, Xiangliang; Yao, Jihang; Tian, Yong; Xia, Changli; Li, Youqiong; Fu, Yan; Luo, Qi

    2013-03-01

    Facial nerve (FN) paralysis is a rare but devastating complication of cochlear implant surgery. This study aimed to measure the cupula of the cochlea to the tympanic segment of the FN canal, cupula of the cochlea to the mastoid segment of the FN canal, and the geniculate ganglion to provide a more secure and accurate orientation of the FN canal and to facilitate operation on the cochlea by avoiding potential damage to FN. Using computed tomography, we scanned skulls of 120 volunteers who suffer no cases of skull base lesions. Multiplane reconstruction images were prepared with high-resolution computed tomography. Preoperative evaluation of the FN anatomy within the temporal bone by high-resolution computed tomography helps in minimizing surgical trauma to the nerve, and these results can help guide clinical surgery on the cochlea.

  13. Malignant peripheral nerve sheath tumor of facial nerve: Presenting as parotid mass

    Directory of Open Access Journals (Sweden)

    Bageshri P Gogate

    2013-01-01

    Full Text Available Malignant peripheral nerve sheath tumor (MPNST is very uncommon tumor of parotid gland and it is an uncommon spindle cell sarcoma accounting for approximately 5% of all soft-tissue sarcoma. There is strong association between MPNSTs and neurofibromatosis (NF-1 and previous irradiation. Structural abnormality of chromosome 17 is associated with NF-1 and so MPNST. We present a case of a 78-year-old male presenting with slowly growing parotid mass who underwent tumor resection.

  14. Bilateral Facial Nerve Palsy in Acute B Cell Lymphoblastic Leukemia: A Case Report and Review of the Literature.

    Science.gov (United States)

    Sen, Shiraj; Gupta, Arjun; Friedman, Paul; Naina, Harris V

    2016-06-01

    Acute lymphoblastic leukemia (ALL) is a haematological malignancy that can involve the central nervous system (CNS). Less than 10 % of patients with ALL have CNS involvement at presentation. The cranial nerve most commonly affected is cranial nerve VII although bilateral involvement is rare. Management and outcomes of these patients are not well understood. Moreover bilateral Bells palsy as a presenting symptom of ALL is extremely uncommon. We report a very unusual presentation of ALL with bilateral facial nerve palsy, and discuss the management strategies and outcomes for patients with ALL that present with cranial nerve palsies.

  15. Scala tympani drill-out technique for oval window atresia with malformed facial nerve:A report of three cases

    Institute of Scientific and Technical Information of China (English)

    Yang Liu a; Feng Yang b

    2015-01-01

    Objective:To report a scala tympani drill-out technique for managing malformed facial nerve covering the entire oval window (OW). Methods:Data from three cases with OW atresia, malformed stapes and abnormal facial nerve courses were reported, in which a scala tympani drill-out technique was employed with a TORP between the tympanic membrane and scala tympani fenestration for hearing reconstruction. Results: Air conduction hearing improved in two of the three cases following surgery. In the third case, there was no improvement in air conduction hearing following a canal wall up mastoidectomy and tympanoplasty. There were no vertigo, tinnitus or sensorineural hearing loss in the three cases. Conclusion:The scala tympani drill-out technique, which is basically fenestration at the initial part of the basal turn, provides a choice in hearing reconstruction when the OW is completely covered by abarrently coursed facial nerve.

  16. [The use of botulinum toxin type a in the acute phase of facial nerve injury after neurosurgical surgery].

    Science.gov (United States)

    Orlova, O R; Akulov, M A; Usachev, D Iu; Taniashin, S V; Zakharov, V O; Saksonova, E V; Mingazova, L R; Surovykh, S V

    2014-01-01

    To evaluate the role of botulinum toxin type A in the acute phase of facial nerve injury after neurosurgical surgery. The study involved 55 patients with acute facial muscle paresis caused by facial nerve injury during surgery on the posterior cranial fossa and cerebello-pontine angle (CPA). The first group consisted of 35 patients (mean age, 48.14±1.26 years) who were administered botulinum toxin type A (xeomin) at a dose of 2-3 U per point in muscles of the intact side of the face. The control group included 20 patients (mean age, 49.85±1.4 years) who underwent standard rehabilitation treatment of this pathology. The treatment efficacy was evaluated using the House-Brackmann Scale, the Yanagihara facial grading system, the Facial Disability Index (FDI), and the Sunnybrook Facial Grading (SFG) Scale. Before treatment, patients of both groups experienced severe dysfunction according to the House-Brackmann Scale. A month after the botulinium toxin type A therapy had been started, a significant improvement in the group of patients who received botulinum toxin was observed at all scales (p<0.05), whereas improvement in the facial nerve function in the second group was observed only by the 3rd month of rehabilitation treatment (p<0.05). The number of synkineses in the patients who did not receive botulinum toxin was 46% higher than that in the first group (p=0.019) one year after the surgery, and it was higher by 91% after 2 years (p<0.001). The use of botulinum toxin type A is reasonable in acute facial nerve injury and should be mandatory in combined therapy of these patients.

  17. [Influence of steroid therapy local injection of steroidal in the region of the stylomastoid foramen and physiotherapy on the recovery of stapedial reflex in patients with facial nerve paralysis].

    Science.gov (United States)

    Krukowska, Jolanta; Czernicki, Jan; Zalewski, Piotr

    2004-01-01

    There are much more publications which informates about positive effects of advisability propose steroid's cure in patients with facial nerve palsy. The aim of the studies was to evaluate the influence of steroidal and physical treatment on the recovery of stapedial reflex and of functions of the damaged nerve. The studies were performed on 37 patients with palsy of facial nerve. Taking into account the stapedial reflex (before the beginning of the treatment) and local injection of steroidal in the region of the stylomastoid foramen, the patients were divided into two groups: I group--21 persons with lacking stapedial reflex, who were not given steroid, II group--16 persons with lacking stapedial reflex who received steroid. Evaluation of results of treatment was performed by means of the Pietruski, House and Brackmann scales, registration of stapedial reflex and accommodation coefficient. The results indicate that local steroid in palsy facial nerve is the treatment of choice in cases of intratemporal branches injury (lack of stapedial reflex) and shortens of duration of stapedial reflex and the nerve function recovery.

  18. Nerve Transfer for Facial Paralysis Under Intravenous Sedation and Local Analgesia for the High Surgical Risk Elderly Patient.

    Science.gov (United States)

    Rubi, Carlos; Cardenas Mejia, Alexander; Cavadas, Pedro Carlos; Thione, Alessandro; Aramburo Garcia, Rigoberto; Rozen, Shai

    2016-07-01

    This case report describes an 86-year-old woman with complete peripheral right-sided facial paralysis resulting from resection of a cervical lipoma 14 months before surgery. Because of the high anesthetic risk, a masseter to facial nerve transfer was performed under combined light sedation and local anesthetic. Good functional and aesthetic outcomes were noted without complications. To our knowledge, nerve transfers under light sedation and local anesthesia have not been described in the literature and may be useful in elderly patients with significant comorbidities. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. The feasibility of sugammadex for general anesthesia and facial nerve monitoring in patients undergoing parotid surgery

    Directory of Open Access Journals (Sweden)

    I-Cheng Lu

    2017-08-01

    Fifty patients undergoing parotid surgery were randomized allocated into conventional anesthesia group (Group C, n = 25 and sugammadex group (Group S, n = 25. Group C did not receive any NMBA. Group S received rocuronium 0.6 mg/kg at anesthesia induction and sugammadex 2 mg/kg at skin incision. The intubating condition and influence on FNM evoked EMG results were compared between groups. The intubation condition showed significantly better in group S patients than C group patients (excellent in 96% v.s. 24%. In group S, rapid reverse of NMB was found and the twitch (% recovered from 0 to >90% within 10 min. Positive and high EMG signals were obtained in all patients at the time point of initial facial nerve stimulation in both groups. There was no significant difference as comparing the EMG amplitudes detected at the time point of initial and final facial nerve stimulation in both groups. Implementation of sugammadex in anesthesia protocol is feasible and reliable for successful FNM during parotid surgery.

  20. A case of optic-nerve hypoplasia and anterior segment abnormality associated with facial cleft

    Directory of Open Access Journals (Sweden)

    Miyake T

    2016-07-01

    Full Text Available Tomoko Miyake,1 Shota Kojima,1 Tetsuya Sugiyama,2 Mari Ueki,1 Jun Sugasawa,1 Hidehiro Oku,1 Kensuke Tajiri,1 Yuka Shigemura,3 Koichi Ueda,3 Atsuko Harada,4 Mami Yamasaki,4 Takumi Yamanaka,4 Hidetsuna Utsunomiya,5 Tsunehiko Ikeda1 1Department of Ophthalmology, Osaka Medical College, Takatsuki City, 2Nakano Eye Clinic of Kyoto Medical Co-operative, Kyoto, 3Department of Plastic and Reconstructive Surgery, Osaka Medical College, Takatsuki City, 4Department of Pediatric Neurosurgery, Takatsuki General Hospital, Takatsuki City, 5Department of Radiological Science, International University of Health and Welfare, Graduate School, Fukuoka, Japan Introduction: The incidence of facial cleft is rare and ranges between 1.43 and 4.85 per 100,000 births. To date, there have been few reports of detailed ophthalmologic examinations performed in cases of facial cleft. Here, we report a case of optic-nerve hypoplasia and anterior segment abnormality associated with facial cleft. Case report: A 9-day-old female infant was delivered by cesarian section at 34 weeks of gestational age (the second baby of twins and weighed 2,276 g upon presentation. She had a facial cleft and ectrodactyly at birth. Right eye-dominant blepharophimosis was obvious. Examination of the right eye revealed inferior corneal opacity with vascularization, downward corectopia, and optic-nerve hypoplasia. The corneal diameter was 8 mm in both eyes, and tonometry by use of a Tono-Pen® XL (Reichert Technologies, Depew, NY, USA handheld applanation tonometer revealed that her intraocular pressure was 11–22 mmHg (Oculus Dexter and 8 mmHg (Oculus Sinister. B-mode echo revealed no differences in axial length between her right and left eyes. When she was 15–16 months old, we attempted to examine her eyes before she underwent plastic surgery under general anesthesia. She had a small optic disc in both eyes and the right-eye disc was tilted. After undergoing canthotomy, gonioscopy and ultrasound

  1. Rehabilitation of long-standing facial nerve paralysis with percutaneous suture-based slings.

    Science.gov (United States)

    Alam, Daniel

    2007-01-01

    Long-standing facial paralysis creates significant functional and aesthetic problems for patients affected by this deficit. Traditional approaches to correct this problem have involved aggressive open procedures such as unilateral face-lifts and sling procedures using fascia and implantable materials. Unfortunately, our results with these techniques over the last 5 years have been suboptimal. The traditional face-lift techniques did not address the nasolabial fold to our satisfaction, and suture-based techniques alone, while offering excellent short-term results, failed to provide a long-term solution. This led to the development of a novel percutaneous technique combining the minimally invasive approach of suture-based lifts with the long-term efficacy of Gore-Tex-based slings. We report our results with this technique for static facial suspension in patients with long-standing facial nerve paralysis and our surgical outcomes in 13 patients. The procedure offers re-creation of the nasolabial crease and suspension of the oral commissure to its normal anatomic relationships. The recovery time is minimal, and the operation is performed as a short outpatient procedure. Long-term 2-year follow-up has shown effective preservation of the surgical results.

  2. Gamma Knife surgery for patients with facial nerve schwannomas: a multiinstitutional retrospective study in Japan.

    Science.gov (United States)

    Hasegawa, Toshinori; Kato, Takenori; Kida, Yoshihisa; Hayashi, Motohiro; Tsugawa, Takahiko; Iwai, Yoshiyasu; Sato, Mitsuya; Okamoto, Hisayo; Kano, Tadashige; Osano, Seiki; Nagano, Osamu; Nakazaki, Kiyoshi

    2016-02-01

    The aim of this study was to explore the efficacy and safety of stereotactic radiosurgery for patients with facial nerve schwannomas (FNSs). This study was a multiinstitutional retrospective analysis of 42 patients with FNSs treated with Gamma Knife surgery (GKS) at 1 of 10 medical centers of the Japan Leksell Gamma Knife Society (JLGK1301). The median age of the patients was 50 years. Twenty-nine patients underwent GKS as the initial treatment, and 13 patients had previously undergone surgery. At the time of the GKS, 33 (79%) patients had some degree of facial palsy, and 21 (50%) did not retain serviceable hearing. Thirty-five (83%) tumors were solid, and 7 (17%) had cystic components. The median tumor volume was 2.5 cm(3), and the median prescription dose to the tumor margin was 12 Gy. The median follow-up period was 48 months. The last follow-up images showed partial remission in 23 patients and stable tumors in 19 patients. Only 1 patient experienced tumor progression at 60 months, but repeat GKS led to tumor shrinkage. The actuarial 3- and 5-year progression-free survival rates were 100% and 92%, respectively. During the follow-up period, 8 patients presented with newly developed or worsened preexisting facial palsy. The condition was transient in 3 of these patients. At the last clinical follow-up, facial nerve function improved in 8 (19%) patients, remained stable in 29 (69%), and worsened in 5 (12%; House-Brackmann Grade III in 4 patients, Grade IV in 1 patient). With respect to hearing function, 18 (90%) of 20 evaluated patients with a pure tone average of ≤ 50 dB before treatment retained serviceable hearing. GKS is a safe and effective treatment option for patients with either primary or residual FNSs. All patients, including 1 patient who required repeat GKS, achieved good tumor control at the last follow-up. The incidence of newly developed or worsened preexisting facial palsy was 12% at the last clinical follow-up. In addition, the risk of hearing

  3. Effect of postoperative brachytherapy and external beam radiotherapy on functional outcomes of immediate facial nerve repair after radical parotidectomy.

    Science.gov (United States)

    Hontanilla, Bernardo; Qiu, Shan-Shan; Marré, Diego

    2014-01-01

    There is much controversy regarding the effect of radiotherapy on facial nerve regeneration. However, the effect of brachytherapy has not been studied. Fifty-three patients underwent total parotidectomy of which 13 were radical with immediate facial nerve repair with sural nerve grafts. Six patients (group 1) did not receive adjuvant treatment whereas 7 patients (group 2) received postoperative brachytherapy plus radiotherapy. Functional outcomes were compared using Facial Clima. Mean percentage of blink recovery was 92.6 ± 4.2 for group 1 and 90.7 ± 5.2 for group 2 (p = .37). Mean percentage of commissural excursion restoration was 78.1 ± 3.5 for group 1 and 74.9 ± 5.9 for group 2 (p = .17). Mean time from surgery to first movement was 5.7 ± 0.9 months for group 1 and 6.3 ± 0.5 months for group 2 (p = .15). Brachytherapy plus radiotherapy does not affect the functional outcomes of immediate facial nerve repair with nerve grafts. Copyright © 2013 Wiley Periodicals, Inc.

  4. Applied anatomy on deep branch of ulnar nerve%尺神经深支的应用解剖

    Institute of Scientific and Technical Information of China (English)

    王斌; 张小雪; 马铁鹏; 李春江; 尹佳丽; 杨焕友; 张文龙; 杨义; 蒋文萍

    2009-01-01

    目的:为尺神经深支卡压和损伤的临床诊治以及高位尺神经损伤直接移植修复尺神经深支提供解剖学依据.方法:选择30侧自肘以上离断新鲜完整无畸形上肢进行解剖,观察尺神经深支的走行和分支.测量小鱼际各肌支的长度、宽度和厚度;尺神经深支相邻肌支间距离;豌豆骨近缘至深支最末分支间长度;尺神经深支逆向可分离长度和分离后的近端宽度和厚度,骨间前神经旋前方肌支远端宽度和厚度.结果:尺神经深支分支复杂,呈树枝状结构,在其走行过程中经Guyon管、豆钩管、对掌肌管、拇收肌腱弓等,解剖关系复杂.相应骨间肌支和蚓状肌支大部在尺神经深支主干同一平面呈不同角度发出.结论:尺神经深支易卡压部位多,可能是高位尺神经损伤后手内在肌功能不易恢复的原因之一;邻近骨折脱位较易损伤尺神经深支;高位尺神经损伤早期行神经移位直接修复尺神经深支,有利于手功能的恢复.%Objective:To provide anatomical basis of neural transplantation to repair deep branch of the ulnar nerve early after injury to the superior position on profundus nervi ulnaris, clinical diagnosis and treatment of injury, and compression of ulnar nerve. Methods:Thirty fresh upper limbs mutilated above elbow without abnormality were dissected. The course and branches of the deep branch of the ulnar nerve were observed. The construction of the wrist ulnar canal, the muscles in-nerved from the deep branch of the ulnar nerve were investigated. The length, width, thickness and the points to enter muscles of branches of the deep branch of the ulnar nerve in muscle of hypothenar and the length of the consecutive branches from the branch of abductor digiti minimi to the branch of the second palmar interossei were measured. The length of the deep branch of the ulnar nerve from proximate of pisiform bone to ending branch and the segregated deep branch of the ulnar

  5. Combined use of diffusion tensor tractography and multifused contrast-enhanced FIESTA for predicting facial and cochlear nerve positions in relation to vestibular schwannoma.

    Science.gov (United States)

    Yoshino, Masanori; Kin, Taichi; Ito, Akihiro; Saito, Toki; Nakagawa, Daichi; Ino, Kenji; Kamada, Kyousuke; Mori, Harushi; Kunimatsu, Akira; Nakatomi, Hirofumi; Oyama, Hiroshi; Saito, Nobuhito

    2015-12-01

    The authors assessed whether the combined use of diffusion tensor tractography (DTT) and contrast-enhanced (CE) fast imaging employing steady-state acquisition (FIESTA) could improve the accuracy of predicting the courses of the facial and cochlear nerves before surgery. The population was composed of 22 patients with vestibular schwannoma in whom both the facial and cochlear nerves could be identified during surgery. According to DTT, depicted fibers running from the internal auditory canal to the brainstem were judged to represent the facial or vestibulocochlear nerve. With regard to imaging, the authors investigated multifused CE-FIESTA scans, in which all 3D vessel models were shown simultaneously, from various angles. The low-intensity areas running along the tumor from brainstem to the internal auditory canal were judged to represent the facial or vestibulocochlear nerve. For all 22 patients, the rate of fibers depicted by DTT coinciding with the facial nerve was 13.6% (3/22), and that of fibers depicted by DTT coinciding with the cochlear nerve was 63.6% (14/22). The rate of candidates for nerves predicted by multifused CE-FIESTA coinciding with the facial nerve was 59.1% (13/22), and that of candidates for nerves predicted by multifused CE-FIESTA coinciding with the cochlear nerve was 4.5% (1/22). The rate of candidates for nerves predicted by combined DTT and multifused CE-FIESTA coinciding with the facial nerve was 63.6% (14/22), and that of candidates for nerves predicted by combined DTT and multifused CE-FIESTA coinciding with the cochlear nerve was 63.6% (14/22). The rate of candidates predicted by DTT coinciding with both facial and cochlear nerves was 0.0% (0/22), that of candidates predicted by multifused CE-FIESTA coinciding with both facial and cochlear nerves was 4.5% (1/22), and that of candidates predicted by combined DTT and multifused CE-FIESTA coinciding with both the facial and cochlear nerves was 45.5% (10/22). By using a combination of

  6. Regeneração pós-traumática do nervo facial em coelhos Posttraumatic facial nerve regeneration in rabbits

    Directory of Open Access Journals (Sweden)

    Heloisa Juliana Zabeu Rossi Costa

    2006-12-01

    Full Text Available A paralisia facial periférica traumática constitui-se em afecção freqüente. OBJETIVO: estudo da regeneração pós-traumática do nervo facial em coelhos, por avaliação funcional histológica dos nervos traumatizados comparados aos normais contralaterais. METODOLOGIA: Vinte coelhos foram submetidos à compressão do tronco do nervo facial esquerdo e sacrificados após duas (grupo AL, quatro (BL e seis (CL semanas da lesão. A comparação entre os grupos foi feita pelas densidades total e parcial de axônios mielinizados. ESTUDO ESTATÍSTICO: método de Tukey (p Posttraumatic facial paralysis is a frequent disease. This work studies posttraumatic regeneration of the facial nerve in rabbits. Functional and histological analysis compared injured and normal nerves on opposite sides. The left facial nerve trunk of twenty rabbits were subjectedto compression lesion, and sacrificed after two (subgroup AL, four (BL and six (CL weeks. Comparison between groups was made by analysing total and partial densities of myelinated axons. STATISTICAL ANALYSIS: Tukey Method (p<0.05. RESULTS:There was partial functional recovery after two weeks, and complete recovery after five weeks. Qualitative analysis demonstrated a degenerative pattern in the AL group, with an increased tissue inflammatory process. Evident regeneration signs were observed in the BL group, and almost complete regeneration was seen in the CL group. Normal nerves (N had an average TD of 15705.59 and average PD of 21800.75. The BL group had an average TD of 10818.55 and an average PD of 15340.56. The CL group had an average TD of 13920.36 and an average PD of 16589.15. The BL group had an average TD of N equal to 68.88%, and the CL group had an average TD of N equal to 88,63% (statistically significant. N showed a significant higher PD than injured nerves. However, this was not statistically different between BL and CL subgroups. Nerve DT was a more reliable method than PD in this study.

  7. 咬肌神经-面神经吻合:跨面神经移植手术的有效补充%Masseter-Facial Nerve Coaptation: An Supplemental Technique for Facial Nerve Reconstruction

    Institute of Scientific and Technical Information of China (English)

    王炜; 杨川

    2011-01-01

    Objective To identify the feasibility of the procedure of Masseter-Facial Nerve coaptation. Methods Two patients suffered from acoustic neuroma resection were performed cross-facial nerve grafting combined with partial Masseter-Facial Nerve coaptation. Results Both of them had an natural smile and eye closure when biting. No mastication disorder and depression on face were found. Conclusion It is an effective procedure to re-innervate the paralytic muscle quickly and is an augmentation for Cross-facial nerve grafting.%目的 初步阐述咬肌神经-面神经吻合手术的方法和疗效.方法 2例听神经瘤术后完全性面瘫患者,进行跨面神经移植术和患侧部分咬肌神经-面神经吻合手术.结果 术后3个月,患者咬牙后可将口角上提和闭合眼睛,咀嚼功能没有影响,面部未出现凹陷畸形.结论 咬肌神经-面神经吻合可以有效、快速地重建面部肌肉的神经支配,是跨面神经移植手术的有效补充.

  8. A Rare Variation of the Axillary Nerve Formed as Direct Branch of the Upper Trunk.

    Science.gov (United States)

    Subasinghe, Sandeepani Kanchana; Goonewardene, Shanti

    2016-08-01

    The brachial plexus has a complex anatomical structure from its origin in the neck and through its course in the axillary region. Knowledge of variations of the brachial plexus has important clinical applications especially in relation to trauma and surgical procedures of upper limb. The present study has reported a rare variation of the brachial plexus where the "axillary nerve" arising as a direct branch from the upper trunk instead from the posterior cord. Once the "axillary nerve" was given off, the remaining superior trunk had joined with the anterior division of middle trunk in the formation of the lateral cord. The posterior cord was formed by the union of posterior divisions of the middle and inferior trunks. The "axillary nerve" has given off braches to subscapularis, latissimus dorsi, deltoid and teres minor muscles while having given a "communicating branch" for the posterior cord. The current report indicates an anatomical variation not documented so far which may help in planning safe surgical procedures in this region and to explain unusual resulting complications.

  9. Outcome of patients presenting with idiopathic facial nerve paralysis (Bell's palsy) in a tertiary centre--a five year experience.

    Science.gov (United States)

    Tang, I P; Lee, S C; Shashinder, S; Raman, R

    2009-06-01

    This is a retrospective study. The objective of this study is to review the factors influencing the outcome of treatment for the patients presented with idiopathic facial nerve paralysis. The demographic data, clinical presentation and management of 84 patients with idiopathic facial nerve paralysis (Bell's palsy) were collected from the medical record office, reviewed and analyzed from 2000 to 2005. Thirty-four (72.3%) out of 47 patients who were treated with oral prednisolone alone, fully recovered from Bell's palsy meanwhile 36 (97%) out of 37 patients who were treated with combination of oral prednisolone and acyclovir fully recovered. The difference was statistically significant. 42 (93.3%) out of 45 patients who presented within three days to our clinic, fully recovered while 28 (71.8%) out of 39 patients presented later then three days had full recovery from Bell's palsy. The difference was statistically significant. The outcome of full recovery is better with the patients treated with combined acyclovir and prednisolone compared with prednisolone alone. The patients who were treated after three days of clinical presentation, who were more than 50 years of age, who had concurrent chronic medical illness and facial nerve paralysis HB Grade IV to VI during initial presentation have reduced chance of full recovery of facial nerve paralysis.

  10. Congenital oval or round window anomaly with or without abnormal facial nerve course: surgical results for 15 ears.

    NARCIS (Netherlands)

    Thomeer, H.G.; Kunst, H.P.; Verbist, B.M.; Cremers, C.W.R.J.

    2012-01-01

    OBJECTIVES: To describe the audiometric results in a consecutive series of patients with congenital ossicular aplasia (Class 4a) or dysplasia of the oval and/or round window (Class 4b), which might include a possible anomalous course of the facial nerve. STUDY DESIGN: Retrospective chart study.

  11. 许旺细胞植入去细胞异体神经修复大鼠面神经缺损%Repair of facial nerve defects by using acellular nerve allografts implanted with Schwann cells in rats

    Institute of Scientific and Technical Information of China (English)

    朱国臣; 肖大江; 黄红宇; 袁渊; 吴四海; 赵新

    2008-01-01

    目的 观察体外分离、培养的许旺细胞对去细胞异体神经修复面神经长距离缺损的促进作用. 方法 30只大鼠随机分成A组、B组和c组(每组10只),制成而神经缺损12 mm模型,分别以去细胞异体神经联合许旺细胞、去细胞异体神经和自体神经移植修复.术后5个月分别行神经电生理、再生神经形态及数量等检测. 结果 A组神经肌肉动作电位的波幅恢复率(术侧/健侧)为(35.8±2.5)%,潜伏期恢复率(健侧/术侧)为(65.8±2.9)%;神经移植段再生轴突数为(1 570±188)个,髓鞘厚度为(0.383±0.031)μm.A组的各项指标优于B组(P0.05). 结论 许旺细胞植入去细胞异体神经可促进面神经长距离缺损的修复.%Objective To observe the effects of in vitro isolated Schwann cells co-cultured with chemically acellular nerve allografts on improving repair of large facial nerve defects. Methods A total of 30 Wistar rats were equally randomized into three groups, ie, experimental group, allograft group and autograft group. Nerve defect of 12 mm in length was made in the left inferior buccal branch of facial nerve and repaired with acellular nerve allograft implanted with Schwann cells, acellular nerve allograft and fresh tibial nerve autograft respectively. At the 5th month postoperatively, the function and morpholo-gy of the regenerated nerves were observed by electrophysiological method, methylene blue staining and transmission electron microscope. Results In experimental group, the recovery rate (operation side/normal side) of amplitude of nerve-muscle action potential was (35.8±2.5)%, the lantency recovery rate (normal side/operation side) (65.8±2.9)%, the number of the regenerated axon 1 570±188 and the myelin thickness (0.383±0.031) μm. The results in the experimental group were significantly supe-rior to those in the acellular nerve allograft group (P 0.05). Conclusion Transplantation of Schwarm cells in acellular nerve allograft can im

  12. Surgical anatomy of the internal branch of the superior laryngeal nerve

    Science.gov (United States)

    Naderi, Sait; Ergur, Ipek; Korman, Esin

    2006-01-01

    The internal branch of the superior laryngeal nerve (ibSLN) may be injured during anterior approaches to the cervical spine, resulting in loss of laryngeal cough reflex, and, in turn, the risk of aspiration pneumonia. Such a risk dictates the knowledge regarding anatomical details of this nerve. In this study, 24 ibSLN of 12 formaldehyde fixed adult male cadavers were used. Linear and angular parameters were measured using a Vernier caliper, with a sensitivity of 0.1 mm, and a 1° goniometer. The diameter and the length of the ibSLN were measured as 2.1±0.2 mm and 57.2±7.7 mm, respectively. The ibSLN originates from the vagus nerve at the C1 level in 5 cases (20.83%), at the C2 level in 14 cases (58.34%), and at the C2–3 intervertebral disc level in 5 cases (20.83%) of the specimens. The distance between the origin of ibSLN and the bifurcation of carotid artery was 35.2±12.9 mm. The distance between the ibSLN and midline was 24.2±3.3 mm, 20.2±3.6 mm, and 15.9±4.3 mm at the level of C2–3, C3–4, and at the C4–5 intervertebral disc level, respectively. The angles of ibSLN were mean 19.6±2.6° medially with sagittal plane, and 23.6±2.6° anteriorly with coronal plane. At the area between the thyroid cartilage and the hyoid bone the ibSLN is the only nerve which traverses lateral to medial. It is accompanied by the superior laryngeal artery, a branch of the superior thyroid artery. The ibSLN is under the risk of injury as a result of cutting or compression of the blades of the retractor at this level. The morphometric data regarding the ibSLN, information regarding the distances between the nerve, and the other consistent structures may help us identify this nerve, and to avoid the nerve injury. PMID:16402208

  13. [Should biopsy be done on the sensory branch of the radial nerve in leprosy patients? Apropos of 112 cases].

    Science.gov (United States)

    Grauwin, M Y; Dieye, M; Mane, I; Cartel, J L

    1997-01-01

    Biopsies of the superficial sensory branch of the radial nerve are contested. Some authors mention it to be simple and without harm, but others are formally against this procedure. At ILAD, 274 biopsies were made between 1986 to 1992. We present a review of 112 leprosy patients for whom biopsy was done. On 112 reexamined patients, we observed 2 benign neuroma, hence 2%. The comparison of nerve function before biopsy and after, of 63 of the 112 patients, reexamination shows no significant modification of the functional score. Given even the occurrence of benign neuroma in only 2% of the cases, the authors do not recommend the biopsy of the superficial sensory branch of the radial nerve. For research purposes on neuritis in leprosy, as well as to assure diagnosis in primary neuritic leprosy, we propose the biopsy of the sensory branch of the musculo cutaneous nerve at elbow level.

  14. [Facial nerve function and hearing preservation experience in middle fossa approach removal of small acoustic tumor surgery].

    Science.gov (United States)

    Yu, Jue-bo; Wu, Hao; Huang, Qi; Yang, Jun; Wang, Zhao-yan; Lü, Jing-rong

    2013-10-01

    The aim of this study was to investigate the hearing and facial nerve preservation in the middle fossa approach surgery for the removal of small acoustic tumor (vestibular schwannomas, VS). A prospective database was established, and data were retrospectively reviewed. Between January 2004 and February 2013, 13 patients with acoustic tumor underwent surgery via middle fossa approach for hearing preservation. The patients consisted of six men and seven women with a mean age of 48 years. Tumor size ranged from 0.8 cm to 1.5 cm. Hearing loss was categorized as American Academy of Otolaryngology Head and Neck Surgery (AAO-HNS) class A, class B, class C and class D. Facial nerve function was evaluated according to House-Brackmann (HB) Grade I-VI. Gross-total resection was accomplished in 12 of 13 patients. Preoperative hearing as class A in ten, class B in two, and class C in one patient respectively. Postoperatively, hearing was graded as class A in eight patients, class B in 3, and class C in 2 patients. Facial nerve function was House-Brackmann (HB) grade I in twelve patients, grade II in one patient preoperatively. Postoperatively, facial nerve function was HB Grade I in twelve patients and Grade III in one patient. The overall hearing preservation rate was at least 80% (8/10) and HB Grade I facial nerve outcome of 100% (12/12) . All cases were followed up for 0.5 to 5 years, no complications were observed. The middle fossa approach for the resection of small VS with hearing preservation is a viable and relatively option. It should be considered among the various options available for the management of small and growing VS.

  15. Analysis of motor fibers in the communicating branch between the cervical nerves and the spinal accessory nerve to innervate trapezius in the rat.

    Science.gov (United States)

    Yan, Jun; Hitomi, Jiro

    2006-11-01

    The communicating branch between the ventral rami of cervical nerves and the spinal accessory nerve (SAN) has been reported to also send motor fibers to supply the trapezius. However, the motor fiber type of the communicating branch and its peripheral distribution are still unclear. To determine the fiber elements within the branch and its peripheral distribution of the motor fibers in the trapezius, the anterograde tracing method was used in this study. The results show that a few a motor end plates from the communicating branch were observed on the extrafusal fibers, while in the muscle spindle the motor elements from the communicating branch were distributed to the polar portions of the intrafusal fibers. These results indicated that the motor fibers passing through the communicating branch to supply the trapezius are mainly y motor fibers, with some a motor fibers. Moreover, the a and y motor fibers from the communicating branch were observed in the clavotrapezius, acromiotrapezius and the rostral part of spinotrapezius. These findings also correlate with the clinical observation indicating that even when the spinal accessory nerve is injured, the trapezius is still capable of slight movement.

  16. Effects of erythropoietin on the expression of tumor necrosis factor-alpha and Bax after facial nerve axotomy in rats

    Institute of Scientific and Technical Information of China (English)

    Wei Zhang; Shengyu Lü; Ziying Yu; Ming Bi; Bin Sun

    2011-01-01

    This study sought to evaluate the effect of high-dose erythropoietin (EPO; 5 000 IU/kg) on the expression of tumor necrosis factor-alpha (TNF-α) and Bax in the facial nucleus after facial nerve transection in rats. A total of 42 Wistar rats of both genders were used in this study, and 40 rats were randomly divided into 2 groups: EPO group and model group. The EPO group was treated with EPO once a day for 5 days at a dose of 5 000 IU/kg body weight. The model group was treated with saline of the same amount. At day 3 after EPO (or saline) treatment, the right facial nerves of the 40 rats were transected at the level of the stylomastoid foramen, with the left sides untreated. The remaining 2 rats that did not undergo axotomy served as the control group. The surviving motor neurons in operated rats were counted in coronal paraffin sections of the facial nucleus. The expression of TNF-α and Bax in the facial nucleus was detected by immunohistochemical staining at days 3, 7, 14, 21, and 28 after axotomy. At days 14, 21, and 28 after facial nerve axotomy, a significantly greater proportion of facial motor neurons survived in the EPO group than in the model group. After axotomy, the expression of TNF-α and Bax increased in motor neurons in both the EPO and the model groups. TNF-α expression reached its peak level at day 14 after axotomy, while Bax expression reached its peak level at day 21. TNF-α expression was much lower in the EPO group than in the model group at all time points. No significant difference in Bax expression was found between the EPO and the model groups. These results indicate that high-dose EPO treatment attenuates the increase in TNF-α expression in the facial nucleus and reduces the loss of motor neurons after facial nerve transection in rats. However, high-dose EPO treatment has little effect on Bax expression.

  17. Èlectroneuromyographiс parameters as prognostic criteria in facial nerve palsy outcome

    Directory of Open Access Journals (Sweden)

    N. G. Savitskaya

    2012-01-01

    Full Text Available In the article we present the results of the retrospective clinico-electrophysiological analysis of 182 patients suffering from the idiopathic neuropathy of the facial nerve (Bell`s palsy. The comparison of the most common electromyographical (ENMG predictors of outcomes was made. It was demonstrated that the most sensitive method in the acutest period (less then 5 days is the level of excitability of the nerve, in the acute period (less then 14 days – estimation of M-answer amplitude loss, and from the 21st day – the presence of denervation in muscles. The most specific electromyographical approach to estimate the therapy efficiency is an analysis of the M-answer amplitude and latency. In conclusion, neurologists have the possibility to predict the outcome and to control the therapy efficiency in any period of the disease. The correlation dynamics ÈNMG sensitivity settings – NLN on different dates can be used to determine the volume of ÈNMG – the NLN study depending on the timing for the treatment of patients.

  18. Diffusion tensor imaging-based fiber tracking for prediction of the position of the facial nerve in relation to large vestibular schwannomas.

    Science.gov (United States)

    Gerganov, Venelin M; Giordano, Mario; Samii, Madjid; Samii, Amir

    2011-12-01

    The reliable preoperative visualization of facial nerve location in relation to vestibular schwannoma (VS) would allow surgeons to plan tumor removal accordingly and may increase the safety of surgery. In this prospective study, the authors attempted to validate the reliability of facial nerve diffusion tensor (DT) imaging-based fiber tracking in a series of patients with large VSs. Furthermore, the authors evaluated the potential of this visualization technique to predict the morphological shape of the facial nerve (tumor compression-related flattening of the nerve). Diffusion tensor imaging and anatomical images (constructive interference in steady state) were acquired in a series of 22 consecutive patients with large VSs and postprocessed with navigational software to obtain facial nerve fiber tracking. The location of the cerebellopontine angle (CPA) part of the nerve in relation to the tumor was recorded during surgery by the surgeon, who was blinded to the results of the fiber tracking. A correlative analysis was performed of the imaging-based location of the nerve compared with its in situ position in relation to the VS. Fibers corresponding to the anatomical location and course of the facial nerve from the brainstem to the internal auditory meatus were identified with the DT imaging-based fiber tracking technique in all 22 cases. The location of the CPA segment of the facial nerve in relation to the VS determined during surgery corresponded to the location of the fibers, predicted by the DT imaging-based fiber tracking, in 20 (90.9%) of the 22 patients. No DT imaging-based fiber tracking correlates were found with the 2 morphological types of the nerve (compact or flat). The current study of patients with large VSs has shown that the position of the facial nerve in relation to the tumor can be predicted reliably (in 91%) using DT imaging-based fiber tracking. These are preliminary results that need further verification in a larger series.

  19. Outcome on hearing and facial nerve function in microsurgical treatment of small vestibular schwannoma via the middle cranial fossa approach.

    Science.gov (United States)

    Ginzkey, Christian; Scheich, Matthias; Harnisch, Wilma; Bonn, Verena; Ehrmann-Müller, Desiree; Shehata-Dieler, Wafaa; Mlynski, Robert; Hagen, Rudolf

    2013-03-01

    Encouraging results regarding hearing preservation and facial nerve function as well as increasing understanding of the natural behaviour of vestibular schwannomas have led to the recommendation of an early treatment in small VS. The aim of the present study was to evaluate current data on functional outcome of patients with small VS treated by middle cranial fossa (MCF) approach. A retrospective chart study of all cases treated by MCF approach between October 2007 and September 2011 was performed. Records were analyzed regarding demographical data, tumor size, hearing status, vestibular function and facial nerve function. Facial nerve function was classified according to the House-Brackmann scale (HB). Hearing status was classified according to the American Association of Otolaryngology-Head and Neck Surgery (AAO-HNS) and a modified classification of Gardner and Robertson (GR). Eighty-nine patients were included in the study; 41 % of VS was classified as intracanalicular (stage 1) and 59 % as stage 2. From 65 patients with a preoperative hearing status according to AAO-HNS A or B, 74 % still presented with A or B after surgery. Using a modified GR classification, from 70 patients categorized as class I or II prior to surgery, 70 % were still class I or II. Looking to the facial nerve function 1 week after surgery, 82 % of patients presented with HB 1 or 2. Three to twelve months later, 96 % demonstrated HB 1 or 2. A persisting facial palsy was recorded in four patients. Preoperative hearing status was evaluated as a prognostic factor for postoperative hearing, whereas no influence was detected in ABR, vestibular function and tumor length. Early diagnosis of small VS due to high-sensitive MRI requires the management of this tumor entity. Natural behaviour of VS in many cases demonstrates an increase of tumor size over time with deterioration of hearing status. The presented data underline the recommendation of an early surgical treatment in small VS as a valuable

  20. Conduction velocity of the rabbit facial nerve: a noninvasive functional evaluation Velocidade de condução no nervo facial do coelho: uma avaliação funcional não invasiva

    Directory of Open Access Journals (Sweden)

    Belmiro Cavalcanti do Egito Vasconcelos

    2003-06-01

    Full Text Available The aim of this study was to evaluate standardized conduction velocity data for uninjured facial nerve and facial nerve repaired with autologous graft nerves and synthetic materials. An evaluation was made measuring the preoperative differences in the facial nerve conduction velocities on either side, and ascertaining the existence of a positive correlation between facial nerve conduction velocity and the number of axons regenerated postoperatively. In 17 rabbits, bilateral facial nerve motor action potentials were recorded pre- and postoperatively. The stimulation surface electrodes were placed on the auricular pavilion (facial nerve trunk and the recording surface electrodes were placed on the quadratus labii inferior muscle. The facial nerves were isolated, transected and separated 10 mm apart. The gap between the two nerve ends was repaired with autologous nerve grafts and PTFE-e (polytetrafluoroethylene or collagen tubes. The mean of maximal conduction velocity of the facial nerve was 41.10 m/s. After 15 days no nerve conduction was evoked in the evaluated group. For the period of 2 and 4 months the mean conduction velocity was approximately 50% of the normal value in the subgroups assessed. A significant correlation was observed between the conduction velocity and the number of regenerated axons. Noninvasive functional evaluation with surface electrodes can be useful for stimulating and recording muscle action potentials and for assessing the functional state of the facial nerve.O objetivo deste estudo foi avaliar os dados padronizados de velocidade de condução para o nervo facial não lesado e o nervo facial reparado com enxerto autógeno e com materiais sintéticos. Na avaliação foram medidas as diferenças pré-operatórias de velocidade de condução do nervo facial em cada lado e verificada a existência de uma correlação positiva entre a velocidade de condução do nervo facial e o número de axônios regenerados no p

  1. Report of a Case: Blade-vent implant application taking into acount the lateral branch of the inferior alveoar nerve

    OpenAIRE

    大滝, 祐吉; 植田, 章夫; 宮坂, 伸; 小松, 史; 岩井, 健治; 後藤, 一輔; 千野, 武廣

    1997-01-01

    Dental implants are now widely used for dental rehabilitation, but in some cases insufficient planning and complications result in poor prognoses. Paresthesia, which can be caused by nerve injury, is one of the postoperative complications. We report a case in which we applied a blade-vent implant into the mandibular molar region taking into account the lateral branch of the inferior alveolar nerve. The postoperative course was uneventful without paresthesia. In the preoperative examinations, ...

  2. Seizure and unilateral facial nerve paralysis in a newborn with Dandy-Walker malformation – A case report

    Directory of Open Access Journals (Sweden)

    Subhajit Bhakta

    2014-01-01

    Full Text Available The Dandy-Walker syndrome (DWS is a rare posterior fossa malformation. It can have a varied presentation depending on the age. A newborn presenting with neonatal seizure along with unilateral facial nerve palsy is rather a rare presentation of DWS and very few such cases were reported in the past. We are reporting a case of a newborn male baby presenting with neonatal seizure within 48 hrs of birth along with right sided LMN type facial nerve palsy which on due course of investigation revealed as a case of Dandy–Walker malformation. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 48-51 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9673

  3. Facial nerve paralysis and partial brachial plexopathy after epidural blood patch: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Radi Shahien

    2011-02-01

    Full Text Available Radi Shahien, Abdalla BowirratDepartment of Neurology, Ziv Medical Center, Zfat, IsraelAbstract: We report a complication related to epidural analgesia for delivery in a 24-year-old woman who was admitted with mild pre-eclampsia and for induction of labor. At the first postpartum day she developed a postdural puncture headache, which was unresponsive to conservative measures. On the fifth day an epidural blood patch was done, and her headache subsided. Sixteen hours later she developed paralysis of the right facial nerve, which was treated with prednisone. Seven days later she complained of pain in the left arm and the posterior region of the shoulder. She was later admitted and diagnosed with partial brachial plexopathy.Keywords: facial nerve paralysis, partial brachial plexopathy, epidural blood patch

  4. The Relationship of the Facial Nerve to the Condylar Process: A Cadaveric Study with Implications for Open Reduction Internal Fixation

    OpenAIRE

    Barham, H. P.; Collister, P.; V. D. Eusterman; Terella, A. M.

    2015-01-01

    Introduction. The mandibular condyle is the most common site of mandibular fracture. Surgical treatment of condylar fractures by open reduction and internal fixation (ORIF) demands direct visualization of the fracture. This project aimed to investigate the anatomic relationship of the tragus to the facial nerve and condylar process. Materials and Methods. Twelve fresh hemicadavers heads were used. An extended retromandibular/preauricular approach was utilized, with the incision being based pa...

  5. Epineurial repair of an iatrogenic facial nerve neurotmesis after total ear canal ablation and lateral bulla osteotomy in a dog with concurrent cranio-mandibular osteopathy

    Directory of Open Access Journals (Sweden)

    Ignacio Calvo

    2014-02-01

    Full Text Available A 7-year-old male entire West Highland white terrier was referred to the Small Animal Hospital at the University of Glasgow for bilateral, chronic, medically unresponsive otitis media and externa. A history of cranio-mandibular osteopathy was also reported. Bilateral total ear canal ablation and lateral bulla osteotomy was performed with the aid of a pneumatic burr. Extensive bone proliferation was present bilaterally originating from the caudal mandibular ramus and tympanic bulla which incorporated the horizontal canal on each side. The right facial nerve was identified leaving the stylomastoid foramen and running in a cranial direction through a 1.5 cm diameter cuff of bone surrounding the horizontal canal and external acoustic meatus. Despite careful dissection, a facial nerve neurotmesis ensued which required microsurgical epineurial repair. Neurologic examination performed 12 h post-operatively revealed abnormalities consistent with right facial nerve paralysis. At 3 months, the facial nerve function was found to have improved significantly and was assessed to be normal four months after surgery. To the authors’ knowledge, this clinical communication described the first reported clinical case where unilateral facial nerve paralysis resulting from iatrogenic facial nerve neurotmesis was successfully treated by microsurgical epineurial repair.

  6. Transient facial nerve paralysis (Bell's palsy following intranasal delivery of a genetically detoxified mutant of Escherichia coli heat labile toxin.

    Directory of Open Access Journals (Sweden)

    David J M Lewis

    Full Text Available BACKGROUND: An association was previously established between facial nerve paralysis (Bell's palsy and intranasal administration of an inactivated influenza virosome vaccine containing an enzymatically active Escherichia coli Heat Labile Toxin (LT adjuvant. The individual component(s responsible for paralysis were not identified, and the vaccine was withdrawn. METHODOLOGY/PRINCIPAL FINDINGS: Subjects participating in two contemporaneous non-randomized Phase 1 clinical trials of nasal subunit vaccines against Human Immunodeficiency Virus and tuberculosis, both of which employed an enzymatically inactive non-toxic mutant LT adjuvant (LTK63, underwent active follow-up for adverse events using diary-cards and clinical examination. Two healthy subjects experienced transient peripheral facial nerve palsies 44 and 60 days after passive nasal instillation of LTK63, possibly a result of retrograde axonal transport after neuronal ganglioside binding or an inflammatory immune response, but without exaggerated immune responses to LTK63. CONCLUSIONS/SIGNIFICANCE: While the unique anatomical predisposition of the facial nerve to compression suggests nasal delivery of neuronal-binding LT-derived adjuvants is inadvisable, their continued investigation as topical or mucosal adjuvants and antigens appears warranted on the basis of longstanding safety via oral, percutaneous, and other mucosal routes.

  7. Hiccup reflex is mediated by pharyngeal branch of glossopharyngeal nerve in cats.

    Science.gov (United States)

    Kondo, Tukasa; Toyooka, Hidenori; Arita, Hideho

    2003-11-01

    Hiccup reflex is a coordinated motor activity that causes a brief strong inspiratory movement accompanied by glottic adduction. Our previous study has demonstrated that mechanical stimulation of the dorsal epipharynx elicits hiccup-like response. To identify the afferent pathway of the hiccup-like response, the pharyngeal branch of the glossopharyngeal nerve (PB-GPN) which distributed to the dorsal epipharyngeal area was electrically stimulated in anesthetized, spontaneously breathing cats. To access the epipharynx and to directly observe a glottic movement, we made a submental opening at the region rostral to the epiglottis. An activity from the lateral cricoarytenoid (LCA) muscle of the larynx was recorded as an index of glottic adduction, and intrapleural pressure (Ppl) as an index of an inspiratory movement. Electrical stimulation of PB-GPN evoked a fixed motor pattern of hiccup-like response representing a spiky strong negative change in Ppl accompanied by an initial brief burst of LCA electromyogram (EMG). LCA excitation occurred prior to the spiky inspiratory movement. An initial and transient glottic adduction during the response was confirmed by direct observation. Electrical stimulation of the main trunk of the glossopharyngeal nerve evoked expiratory reflex, but not inspiratory (hiccup-like) response. These results indicated that PB-GPN is responsible for hiccup reflex.

  8. Occurrence and severity of upper eyelid skin contracture in facial nerve palsy.

    Science.gov (United States)

    Ziahosseini, K; Venables, V; Neville, C; Nduka, C; Patel, B; Malhotra, R

    2016-05-01

    PurposeTo describe the occurrence and severity of upper eyelid skin contracture in facial nerve palsy (FNP).MethodsWe enroled consecutive patients with unilateral FNP into this study. Patients with previous upper eyelid surgery for either side were excluded. We developed a standardised technique to measure the distance between the upper eyelid margin and the lower border of brow (LMBD). FNP was graded using the Sunnybrook grading scale. Its aetiology, duration, and treatment were noted. Upper and lower marginal reflex distance and lagophthalmos were also noted.ResultsSixty-six patients (mean age 51 years) were included. FNP was owing to a variety of aetiologies. LMBD on the paralytic side was shorter than the normal contralateral side in 47 (71%), equal in 15 (23%), and larger in four (6%) patients. The mean contracture was 3.4 mm (median: 3, range: 1-12) with 11 (17%) patients showing 5 mm or more of skin contracture. The mean LMBD on the paralytic side in all patients was significantly smaller than the contralateral side; 30±3.7 (median: 30; 95% CI 29-31) compared with 32±3.7 (median: 32; 95% CI 32-33), respectively, Pcontracture and to caution surgeons against unnecessary upper eyelid skin excision.

  9. Bupivacaine Injection for Management of Lagophthalmos Due to Long-Standing Idiopathic Facial Nerve Palsy.

    Science.gov (United States)

    Rajabi, Mohammad Taher; Shadravan, Mahla; Mazloumi, Mehdi; Tabatabaie, Syed Ziaeddin; Hosseini, Seyedeh Simindokht; Rajabi, Mohammad Bagher

    2015-01-01

    To report the results of bupivacaine injection into the orbicularis oculi muscle to treat lagophthalmos in patients with long-standing Bell palsy. In this prospective interventional case series, bupivacaine, 5 ml of a 0.750% solution, was injected into the preseptal and pretarsal area of the orbicularis oculi in each of 10 patients with idiopathic peripheral facial nerve palsy. The measures of vertical eyelid apertures during open and closed eyes were made before the procedure and 1, 3, and 6 months after injection. A total of 10 eyes including 2 men and 8 women with an average age of 43 years (26-64 years) were studied. The mean amount of lagophthalmos before injection and after 6 months of follow up were 3.9 mm and 2.3 mm, respectively (p = 0.01)). The mean amount of corneal exposure before injection and after 6 months of follow up was 1.05 mm and 0.25 mm, respectively (p lagophthalmos and epiphora.

  10. 面神经血管瘤诊断及治疗%Diagnosis and treatment of facial nerve hemangioma

    Institute of Scientific and Technical Information of China (English)

    郭良蓉; 李健东

    2015-01-01

    目的研究面神经血管瘤的临床特点及影像学表现。方法收集2006年1月~2011年12月在北京世纪坛医院面神经研究室诊治的5例面神经血管瘤患者临床资料。男2例,女3例,年龄29~44岁;5例面神经血管瘤患者,4例均行颞骨高分辨率CT(high resolution CT,HRCT)及面神经增强MRI检查,1例仅行面神经增强MRI。结果5例患者均以突发单侧面瘫起病;左侧4例,右侧1例;5例患者均有面神经膝节段受累;面神经血管瘤在HRCT上主要表现为膝状神经节及邻近迷路段、水平段面神经骨管扩大,周围骨质边缘不连续、欠规则。较典型者呈点状或针状高密度类似蜂窝状结构;MRI上主要表现为以膝状神经节为中心的软组织结节影,伴邻近节段面神经增粗。平扫呈混杂T1、不均匀稍长T2异常信号,边界欠清,增强扫描后异常强化。结论详细病史、结合颞骨HRCT及多平面重建、面神经增强MRI等辅助检查,有助于面神经血管瘤术前诊断;根据患者听力情况、肿瘤范围、累及部位选择适宜的手术径路,在尽可能保留面神经完整性的基础上切除肿瘤。%[ABSTRACT]OBJECTIVETo study clinical features and imaging manifestations of facial nerve hemangioma. METHODSClinical data of 5 cases with facial nerve hemangioma, who were diagnosed and treated in facial lab of Beijing Shijitan hospital between January 2006 and December 2011, were collected. There were 2 male and 3 female. The age ranged from 29-44 years. Among the 5 cases with facial nerve hemangioma, both HRCT of temporal bone and facial nerve enhancement MRI were performed on 4 cases, and one case underwent facial nerve enhancement MRI examination only.RESULTSAll the 5 cases firstly presented with sudden unilateral facial palsy. Facial palsy affected the left and right side in 4 cases and 1 case, respectively. Geniculate ganglion was affected in all cases. Local bony canal

  11. 颞骨骨折导致的双侧周围性面瘫%Facial Nerve Decompression for Bilateral Facial Paralysis in Temporal Bone Fracture

    Institute of Scientific and Technical Information of China (English)

    李晓红; 刘菲; 王若雅; 韩维举

    2014-01-01

    Objective The purpose of this rieview is to study management of bilateral facial nerve paralysis in temporal bone fracture. Methods This is a retrospective review of 8 cases of bilateral facial paralysis after bilateral temporal bone frac-ture that were treated with facial nerve decompression on at least one side. High-resolution computed tomography, audiomet-rictests and electromyogram (EMG) were obtained. Evaluation of the facial nerve function according to the House-Brackmann (H-B) grading scale. The decision for surgery was based mainly on the results of afore mentioned evaluations. Timing and the efficacy of surgical intervention were evaluated by pre-vs. post-operative facial nerve function assessments, as well as com-parison between the operation side and the opposite side. Results All the 8 patients were male, aged between 19 and 49 years. Traffic accident was the most commom cause (5/8). Fracture was longitudinal in all 16 temporal bones, with immediate onset of facial paralysis. Preoperative facial nerve function is between gradesⅤ and Ⅵ, in H-B scale, and with l patient showing bilateral conductive hearing loss, 4 Ratients showing bilateral lugh-frequency sensorineural deafness and 3 Ratients showing normal hearing. Among 8 patients, Facial nerve decompression was performed in 11 ears. H-B gradeⅠ-Ⅱfacial nerve function were aclueved in all cases at follow up (more than l year in some). The only patient with bilateral conductive hearing loss also received bilateral ossicular reconstruction, followed by recovery to normal hearing. Conclusions Traffic crash continues to be themain cause of temporal bone fracture and hilaterd faial paralysis and hilaterd faial paralysis. Facial paralysis caused by tempo-ral bone trauma can be satisfactorily treated with decompression.%目的:探讨外伤后双侧颞骨纵形骨折致双侧周围性面瘫行面神经减压手术的适应症、手术时机及疗效。方法回顾性收集外伤后双侧颞骨骨折

  12. Study of recurrent branch of median nerve (Thenar's muscular branch in relation to the flexor retinaculum and median in 64 hands (32 Men

    Directory of Open Access Journals (Sweden)

    Amirsadri R

    1998-07-01

    Full Text Available Variation of recurred branch of median nerve in relation to the median and flexor retinaculum are significant for both hand surgeons and specialists always. In this study, 64 cadaver hands (32 men have been dissected. The median nerve was identified at the proximal edge of the flexor retinaculum, and in order to expose carpal tunnel the ligament was divided, and the above subjects were studied. The results are: 1 The relation of recurrent nerve to the flexor retinaculum was classified into 4 types: A In (53.1% of subjects, this branch arises from the median after the flexor retinaculum. B In (31.3% of subjects, it arises from the median in the carpal tunnel and the moves around the lower edge of flexor retinaculum and enters the thenar region. C In (14.1% of subjects, it arises from the median in the carpal tunnel and pierces the flexor retinaculum. D In (1.56% of subjects it arises, in the carpal tunnel and it divides into two subbranches here. One follows pattern A and the other pattern C. 2 In this step, the relation of the recurrent branch to the median nerve was studied. The results show that inspite of this image even though most often the recurrent branch arises from the lateral side of median, in (68.75% of subjects it arises from it's anterior surface. The MC Nemar test reveals that there is no relation between manifestation of mentioned patterns with right or left hands.

  13. 面神经功能评定方法%Approaches of Facial Nerve Function Evaluation (review)

    Institute of Scientific and Technical Information of China (English)

    舒湘宁; 马跃文

    2015-01-01

    面神经功能评定在特发性面神经麻痹诊疗过程中有至关重要的作用,是评估预后的主要工具。基于易掌握、易推广、成本低等因素,主观评估系统是目前使用最广泛的方法。客观评估系统在指标量化、可重复性、评价者间一致性等方面具有明显的优势,即使受限于技术、成本等因素,也会成为未来应用的主流,具有广阔的开发前景。本文回顾不同时期和类型的面神经功能评估系统在面神经功能评定中的临床应用,对现有各种面神经功能评价方法进行总结,为科学、合理地在特发性面神经麻痹疾病中制定、筛选和应用面神经功能评价系统提供参考与借鉴。%Facial nerve grading system (FNG) plays a crucial role in the diagnosis and treatment of idiopathic facial paralysis, and also serves as a primary tool for prognosis. Subjective grading systems are currently the most widely used methods due to their easy accessibility, popularization and low costs. Objective grading systems, which have obvious advantages in terms of index quantization, repeatability and consistency between evaluators, will become the mainstream in future application and possess development prospect despite their limitation of technology and cost. This article reviewd the clinical application of different types of FNGs in facial nerve grading among different peri-ods, and made a summarization of currently-existing facial nerve grading methods. It may provide a scientific and reasonable reference to the constitution, filter and application of facial nerve grading systems in treating idiopathic facial paralysis.

  14. Sleeve bridging of the rhesus monkey ulnar nerve with muscular branches of the pronator teres:multiple ampliifcation of axonal regeneration

    Institute of Scientific and Technical Information of China (English)

    Yu-hui Kou; Pei-xun Zhang; Yan-hua Wang; Bo Chen; Na Han; Feng Xue; Hong-bo Zhang; Xiao-feng Yin; Bao-guo Jiang

    2015-01-01

    Multiple-bud regeneration,i.e., multiple amplification, has been shown to exist in peripheral nerve regeneration. Multiple buds grow towards the distal nerve stump during proximal nerve ifber regeneration. Our previous studies have veriifed the limit and validity of multiple ampli-ifcation of peripheral nerve regeneration using small gap sleeve bridging of small donor nerves to repair large receptor nerves in rodents. The present study sought to observe multiple ampli-ifcation of myelinated nerve ifber regeneration in the primate peripheral nerve. Rhesus monkey models of distal ulnar nerve defects were established and repaired using muscular branches of the right forearm pronator teres. Proximal muscular branches of the pronator teres were su-tured into the distal ulnar nerve using the small gap sleeve bridging method. At 6 months after suture, two-ifnger lfexion and mild wrist lfexion were restored in the ulnar-sided injured limbs of rhesus monkey. Neurophysiological examination showed that motor nerve conduction veloc-ity reached 22.63 ± 6.34 m/s on the affected side of rhesus monkey. Osmium tetroxide staining demonstrated that the number of myelinated nerve fibers was 1,657 ± 652 in the branches of pronator teres of donor, and 2,661 ± 843 in the repaired ulnar nerve. The rate of multiple ampliifcation of regenerating myelinated nerve ifbers was 1.61. These data showed that when muscular branches of the pronator teres were used to repair ulnar nerve in primates, effective regeneration was observed in regenerating nerve ifbers, and functions of the injured ulnar nerve were restored to a certain extent. Moreover, multiple ampliifcation was subsequently detected in ulnar nerve axons.

  15. Anatomical study of the internal nasal branch of the infraorbital nerve: Application to Minimizing Nerve Damage With Surgery In and Around the Nose.

    Science.gov (United States)

    Iwanaga, Joe; Watanabe, Koichi; Henry, Brandon; Tomaszewski, Krzysztof A; Walocha, Jerzy A; Oskouian, Rod J; Shane Tubbs, R

    2017-09-01

    The internal nasal branch of the infraorbital nerve (ION) runs down the nose and around the ala to be distributed to the nasal septum and vestibule. The aim of this study was to measure the internal nasal branch around the ala of the nose and discuss its possible relevance in clinical/surgical practice. Twelve sides from seven specimens derived from fresh frozen and embalmed Caucasian cadaveric heads were dissected. The specimens included three males and four females. The ages of the cadavers at death ranged from 65 to 84 years. The diameter of the internal nasal branch, horizontal distance from the lateral contour of the ala (Point A) to the branch (distance H) and vertical distance from the bottom part of the ala (Point B) to the branch (distance V) were recorded. Distance H ranged from -1.6 to 1.5 mm on right sides and -1.0 to 1.5 mm on left sides. The diameter of the nerves at Point A ranged from 1.3 to 1.8 mm on right sides and 1.3 to 1.6 mm on left sides. Distance V ranged from -1.5 to 1.0 mm on right sides and -2.3 to 1.1 mm on left sides. The diameter of the nerves at Point B ranged from 0.7 to 1.3 mm on right sides and 0.8 to 1.2 mm on left sides. The results of this study are the first to detail the topography of the internal nasal branch of the ION. Clin. Anat. 30:817-820, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  16. Anastomose do nervo facial de coelhos com cola de fibrina: estudo da velocidade de condução nervosa Rabbit facial nerve anastomosis with fibrin glue: nerve conduction velocity evaluation

    Directory of Open Access Journals (Sweden)

    Francisco Aurelio Lucchesi Sandrini

    2007-04-01

    Full Text Available OBJETIVO: Este estudo tem o objetivo de avaliar através da velocidade de condução nervosa com eletrodos de superfície a utilização da cola de fibrina na anastomose nervosa. MÉTODOS: Neste experimento, foram avaliadas as diferenças entre as velocidades de condução nervosa pré e pós-operatória do nervo facial esquerdo de 12 coelhos. Foi verificada a existência de correlação entre a velocidade de condução nervosa e o número de axônios regenerados no pós-operatório. Os nervos transeccionados foram unidos com cola de fibrina. O potencial de ação motora foi obtido com o uso de eletrodos de superfície. O eletrodo de estimulação foi colocado imediatamente à frente do pavilhão auditivo (tronco do nervo facial e o eletrodo de gravação foi colocado no músculo quadrado do lábio inferior. RESULTADOS: A média normal da velocidade de condução nervosa foi de 36,53 m/seg. Ao final do período, a velocidade de condução nervosa atingiu um valor de aproximadamente 81% do valor normal. Não foi observada correlação significativa entre a velocidade de condução nervosa pós-operatória e o número de axônios regenerados (p=0,146. CONCLUSÃO: A anastomose com cola de fibrina pode ser utilizada para anastomose nervosa no modelo animal e nervo estudados.AIM: The aim of this study was to evaluate the use of fibrin glue on nerve anastomosis, and study conduction velocity obtained by surface electrodes. METHODS: In this experimental model we evaluated nerve conduction velocity differences in the preoperative and postoperative periods, for the left facial nerve of 12 rabbits. Then, we evaluated whether there were correlations between conduction velocity and the number of postoperative regenerated axons. The sectioned nerves were anastomosed with fibrin glue. The muscle action potentials were obtained from surface electrodes. The stimulation electrode was placed immediately before the ear pinna (facial nerve trunk and the recording

  17. Occurrence and severity of upper eyelid skin contracture in facial nerve palsy

    Science.gov (United States)

    Ziahosseini, K; Venables, V; Neville, C; Nduka, C; Patel, B; Malhotra, R

    2016-01-01

    Purpose To describe the occurrence and severity of upper eyelid skin contracture in facial nerve palsy (FNP). Methods We enroled consecutive patients with unilateral FNP into this study. Patients with previous upper eyelid surgery for either side were excluded. We developed a standardised technique to measure the distance between the upper eyelid margin and the lower border of brow (LMBD). FNP was graded using the Sunnybrook grading scale. Its aetiology, duration, and treatment were noted. Upper and lower marginal reflex distance and lagophthalmos were also noted. Results Sixty-six patients (mean age 51 years) were included. FNP was owing to a variety of aetiologies. LMBD on the paralytic side was shorter than the normal contralateral side in 47 (71%), equal in 15 (23%), and larger in four (6%) patients. The mean contracture was 3.4 mm (median: 3, range: 1–12) with 11 (17%) patients showing 5 mm or more of skin contracture. The mean LMBD on the paralytic side in all patients was significantly smaller than the contralateral side; 30±3.7 (median: 30; 95% CI 29–31) compared with 32±3.7 (median: 32; 95% CI 32–33), respectively, P<0.0001, two-tailed paired t-test. Conclusion To our knowledge, this is the first study that quantitatively demonstrates contraction of the upper eyelid skin in FNP. This finding is valuable in directing optimal early management to minimise skin contracture and to caution surgeons against unnecessary upper eyelid skin excision. PMID:26939561

  18. Upregulation of Nav1.8 in demyelinated facial nerves might be relevant to the generation of hemifacial spasm.

    Science.gov (United States)

    Xia, Lei; Dou, Ning-Ning; Zhong, Jun; Zhu, Jin; Wang, Yong-Nan; Liu, Ming-Xing; Visocchi, Massimiliano; Li, Shi-Ting

    2014-07-01

    Our previous studies demonstrated that the abnormal muscle response could vanish when the ipsilateral superior cervical ganglion was removed and reappear when norepinephrine was dripped at the neurovascular conflict site. Evidentially, we believed that the mechanism of hemifacial spasm should involve emersion of ectopical action potential in the compressed facial nerve fibers. As the action potential is ignited by ion channel opening, we focused on Nav1.8 that has been found overexpressed in peripheral nerve while damaged. In this study, Moller model was adopted, 20 Sprague-Dawley rats underwent drip of norepinephrine, and the abnormal muscle response wave was monitored in 14 rats. Antibodies against unique epitopes of the α subunit of sodium channel isoforms were used to detect the Nav1.8 neuronal isoforms, and the immunohistochemistry showed strong staining in 13 rats, which were all in the abnormal muscle response positive group (P spasm is an ectopic action potential that emerged on the damaged facial nerve, which might be coupled by Nav1.8.

  19. Importance of anatomically locating the infrapatellar branch of the saphenous nerve in reconstructing the anterior cruciate ligament using flexor tendons,

    Directory of Open Access Journals (Sweden)

    Julio Cesar Gali

    2014-12-01

    Full Text Available Objective:To describe the path of the infrapatellar branch of the saphenous nerve (IBSN using the medial joint line, anterior tibial tuberosity (ATT, tibial collateral ligament and a horizontal line parallel to the medial joint line that passes over the ATT, as reference points, in order to help surgeons to diminish the likelihood of injuring this nerve branch during reconstruction of the anterior cruciate ligament (ACL using flexor tendons.Methods:Ten frozen knees that originated from amputations were examined. Through anatomical dissection performed with the specimens flexed, we sought to find the IBSN, from its most medial and proximal portion to its most lateral and distal portion. Following this, the anatomical specimens were photographed and, using the ImageJ software, we determined the distance from the IBSN to the medial joint line and to a lower horizontal line going through the ATT and parallel to the first line. We also measured the angle of the direction of the path of the nerve branch in relation to this lower line.Results:The mean angle of the path of the nerve branch in relation to the lower horizontal line was 17.50 ±6.17°. The mean distance from the IBSN to the medial joint line was 2.61 ± 0.59 cm and from the IBSN to the lower horizontal line, 1.44 ±0.51 cm.Conclusion:The IBSN was found in all the knees studied. In three knees, we found a second branch proximal to the first one. The direction of its path was always from proximal and medial to distal and lateral. The IBSN was always proximal and medial to the ATT and distal to the medial joint line. The medial angle between its direction and a horizontal line going through the ATT was 17.50 ± 6.17°.

  20. Autologous platelet rich plasma repair facial nerve injury%自体富血小板血浆修复面神经损伤★

    Institute of Scientific and Technical Information of China (English)

    张兴安; 吴蜀江; 卢海彬; 石修全; 王洪玲; 曹云亮; 李元秀

    2013-01-01

      背景:周围性面神经损伤治疗包括手术、理疗及药物等方法,但有些情况下治疗效果并不十分理想。目的:研究自体富血小板血浆在面神经损伤修复中的作用。方法:将健康大耳白兔10只双侧面神经上颊支横断后置入硅胶神经再生导管,一侧注入富血小板血浆为实验侧,另一侧注入生理盐水为对照侧。术后8周进行面神经大体观察、神经电生理检测、组织学观察、图像分析、评价面神经再生恢复情况。结果与结论:实验侧口轮匝肌动作电位潜伏期明显低于对照侧,复合神经肌肉动作电位振幅(M 波)明显高于对照侧(P <0.01)。实验侧再生神经更显成熟,再生轴突较多,髓鞘分化较好,髓鞘厚度较均匀,再生轴突的直径接近正常,神经轴突较密集,排列较规则,神经纤维外膜较较对照组增厚,胶原纤维、弹力纤维层较对照组增多;对照侧再生轴突数目较少,分布不均匀,轴突发育较差,并见大量纤维结缔组织,空泡变性较实验侧为多。实验侧再生神经在有髓轴突直径、面积、髓鞘厚度及轴突计数等方面均明显优于对照侧,两组差异有显著性(P <0.01)。提示富血小板血浆在面神经损伤修复再生中具有促进作用。%BACKGROUND: Therapeutic methods for of peripheral facial nerve injury include surgery, physical therapy and drug treatment, but the treatment effect is not ideal in some certain cases. OBJECTIVE: To study the effect of autologous platelet rich plasma on repair of facial nerve injury. METHODS: The bilateral destroyed buccal nerve branches of the 10 white rabbits were put in silica gel nerve regeneration chamber, one side injected with platelet rich plasma as experimental group, the other side injected with normal saline as control group. The general observation, neuroelectrophysiology detection, histological observation, image analysis and

  1. Comprehensive approach in surgical reconstruction of facial nerve paralysis: a 10-year perspective.

    Science.gov (United States)

    Gur, Eyal; Stahl, Shy; Barnea, Yoav; Leshem, David; Zaretski, Arik; Amir, Aharon; Meilik, Beni; Miller, Ehud; Shapira, Eyal; Abu Jabel, Amin; Weiss, Jerry; Arad, Ehud

    2010-04-01

    Facial paralysis presents diverse functional and aesthetic abnormalities. Reconstruction may be achieved by several methods. We reviewed the management and outcome of facial paralysis patients to establish principles on which a comprehensive reconstructive approach may be based. Records were reviewed of all patients operated for facial paralysis at our institution between 1998 and 2007. Ninety-five patients were included, of which 15 patients had static reconstruction alone, and 80 patients had dynamic reconstruction. Presented is our experience in reconstruction of facial paralysis over the past decade, delineating a comprehensive approach to this condition. Various surgical techniques are described.

  2. Electrical response grading versus House-Brackmann scale for evaluation of facial nerve injury after Bell’s palsy:a comparative study

    Institute of Scientific and Technical Information of China (English)

    Bin Huang; Zhang-ling Zhou; Li-li Wang; Cong Zuo; Yan Lu; Yong Chen

    2014-01-01

    OBJECTIVE: There are no convenient techniques to evaluate the degree of facial nerve injury during a course of acupuncture treatment for Bell’s palsy. Our previous studies found that observing the electrical response of specific facial muscles provided reasonable correlation with the prognosis of electroacupuncture treatment. Hence, we used the new method to evaluate the degree of facial nerve injury in patients with Bell’s palsy in comparison with the House-Brackmann scale. The relationship between therapeutic effects and prognosis was analyzed to explore an objective method for evaluating Bell’s palsy. METHODS: The facial nerve function of 68 patients with Bell’s palsy was assessed with both electrical response grading and the House-Brackmann scale before treatment. Then differences in evaluation results of the two methods were compared. All enrolled patients received electroacupuncture treatment with disperse-dense wave at 1/100 Hz for 4 weeks. After treatment, correlation analysis was conducted to ifnd the relationship between electrical response and therapeutic effects or prognosis. RESULTS: Checking consistency between electrical response grading and House-Brackmann scale: Kappa value 0.028 (P = 0.578). Correlation analysis: the two methods were correlated with the prognosis, and electrical response grading (rER= 0.789) was better than the House-Brackmann scale (rHB= 0.423). CONCLUSION: Electrical response grading is superior to the House-Brackmann scale in efficacy and reliability, and can conveniently assess the degree of facial nerve injury. The House-Brackmann scale is suitable for the patients with mild facial nerve injury, but its evaluation quality for severe facial nerve injury is poor.

  3. Anatomic research of suboccipito-retrosigmoidal approach for minimally invasive exposure of facial-acoustic nerve complex utilizing virtual reality skill

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    Ke TANG

    2014-06-01

    Full Text Available Objective To discuss microanatomy features of facial-acoustic nerve complex in suboccipito-retrosigmoidal minimally invasive approach based on virtual reality image model. Methods CT and MRI scans were performed to 5 adult cadaver heads, and then, image data was inputted into Vitrea virtual reality system to establish three-dimensional anatomy model of facial-acoustic nerve complex. Suboccipito-retrosigmoidal approach was simulated by selecting osseous landmark points on the calvaria and skull base. Anatomic exposures in surgical trajectory were observed and measured following minimally invasive design. Statistical comparison was launched by paired t test. Results Routes simulating suboccipito-retrosigmoidal approach for exposure of facial-acoustic nerve complex passed under the inferior edge of transverse sinus. Spacial sequence of nerves and vessels in the route was displayed clearly. Vertebral artery and posterior inferior cerebellar artery did not show in the route. Cerebella, lower cranial nerves, anterior inferior cerebellar artery, facial-acoustic nerve complex were exposed successively in route before minimally invasive design. Then, lower cranial nerves pierced the jugular foramen at the site between the jugular bulb and inferior petrosal sinus. Minimally invasive route was higher than that before minimally invasive design and involved cerebella, anterior inferior cerebellar artery and facial-acoustic nerve complex successively. Lower cranial nerves and jugular bulb were not shown in minimally invasive route. Measure and comparative analysis showed that volumes of route (t = 36.331, P = 0.000 and cerebella (t = 16.775, P = 0.000 involved before minimally invasive design were more than that after minimally invasive design with statistically significant difference. Comparison did not show significant differences for the volumes of facial-acoustic nerve complex (t = 1.680, P = 0.127 and anterior inferior cerebellar artery (t = 1.278, P = 0

  4. Modelo experimental comportamental e histológico da regeneração do nervo facial em ratos Behavioral and histologic experimental model of facial nerve regeneration in rats

    Directory of Open Access Journals (Sweden)

    Andrei Borin

    2006-12-01

    Full Text Available O estabelecimento de modelos experimentais é o passo inicial para estudos de regeneração neural. OBJETIVO: Estabelecer modelo experimental de regeneração do nervo facial. MATERIAIS E MÉTODOS: Ratos Wistar com secção completa e sutura do tronco do nervo facial extratemporal, com análise comportamental e histológica até 9 semanas. FORMA DE ESTUDO: Estudo prospectivo experimental. RESULTADOS: Progressiva recuperação clínica e histológica dos animais. CONCLUSÃO: Estabelecemos um método aceitável para o estudo de regeneração do nervo facial em ratos.To setup an experimental model is the first step to study neural regeneration. AIM: Setting up an experimental model on facial nerve regeneration. MATERIAL AND METHODS Wistar rats with complete sectioning and suturing of the extratemporal facial nerve trunk; with a behavioral and histological analysis for 9 weeks. STUD DESIGN: Experimental prospective study. RESULTS: Progressive clinical and histological recovery of the animals. CONCLUSION: Our method is acceptable to study facial nerve regeneration in rats.

  5. 面神经减压术治疗外伤性周围性面瘫62例%Treatment of traumatic peripheral facial paralysis with facial nerve decompression ( 62 cases report)

    Institute of Scientific and Technical Information of China (English)

    蒋刈; 刘云亮; 刘昉; 陈娟

    2012-01-01

    Objective To evaluate the curative effect of facial nerve decompression in the treatment of traumatic peripheral facial paralysis. Methods 62 patients with traumatic peripheral facial paralysis, admitted into Fujian Provincial Hospital from 2000 to 2010, were reviewed. The therapeutic management and prognosis were summarized. Results Within a 3 months to 2 years' follow-up, the facial nerve function were improved to a varying degree in 57 patients, but not in the other 5 patients. Conclusion The facial nerve decompression is an effective management for traumatic facial paralysis.%目的 探讨面神经减压术治疗外伤性周围性面瘫疗效,总结面神经减压术治疗经验.方法 回顾性分析62例外伤性周围性面瘫患者的病历资料,总结治疗及预后情况.结果 随访3个月~2年,除5例无明显效果外,其他57例患者均有不同程度的恢复.结论 面神经减压术是治疗外伤性面瘫的有效手段.

  6. 神经组织工程支架或异种神经移植在面神经缺损中的应用%Nerve tissue engineering scaffolds or heterologous nerve grafts in facial nerve defects

    Institute of Scientific and Technical Information of China (English)

    宁丽娜; 熊杰

    2011-01-01

    背景:了解面神经损伤的修复方法,以及各种组织支架的特性与优势,对于修复方法与材料的合理选择是十分必要的.目的:总结神经组织工程支架或异种神经移植在面神经缺损中的应用进展.方法:应用计算机检索PubMed数据库及CNKI数据库,在标题和摘要中以"组织工程支架,神经移植,面神经,修复"或"tissue engineering scaffolds,nerve transplantation,facial,repair"为检索词进行检索.根据纳入标准选择21篇文献进行综述.结果与结论:面神经缺损后立即直接缝合神经的断端是最好的修复方法.自体神经移植受神经移植体来源之限,常造成供区失神经支配;以及产生束外有髓和无髓轴突无规则生长会导致神经纤维错向再生,造成严重的联带运动的不足.异体或异种神经移植法虽然取得了一定的效果,但仍处于动物实验的研究阶段,尚难以应用于临床.%BACKGROUND: It is necessary for proper selection of repair methods and scaffold materials to understand repair methods of facial nerve injury and features and benefits of various scaffolds.OBJECTIVE: To summarize the progress in nerve tissue engineering scaffolds or heterologous nerve grafts for repair of facial nerve defects.METHODS: A computer search of PubMed and CNKI databases were performed using keyword of “tissue engineering scaffold, nerve transplantation, facial, repair” in Chinese and English. Totally 21 articles were reviewed.RESULTS AND CONCLUSION: It is the best method to directly suture nerve stump immediately after facial nerve defects. Autologous nerve grafting is limited by implant sources, which often result in denervation of the donor site. Irregular growth of extrapyramidal myelinated and non-myelinated axons can lead to the fault regeneration of nerve fibers, causing serious shortcomings associated with the movement. Allogeneic or xenogeneic neural transplantation has yielded some results, but it is still used in

  7. Reversal of moderate and intense neuromuscular block induced by rocuronium with low doses of sugammadex for intraoperative facial nerve monitoring.

    Science.gov (United States)

    Fabregat López, J; Porta Vila, G; Martin-Flores, M

    2013-10-01

    We report two cases in which moderate and intense rocuronium-induced neuromuscular block was reversed intraoperatively with low sugammadex doses in order to facilitate electromyographic evaluation of facial nerve function during surgery of the parotid gland and the middle ear. Acceleromyography was used to assess reversal of neuromuscular block before starting electromyography monitoring. Rocuronium-induced neuromuscular block was reversed with sugammadex 0.22mgkg(-1) when the TOF ratio was 0.14 in the first patient, and with sugammadex 2mgkg(-1) during intense block (PTC 0) in the second patient. In each case, appropriate neuromuscular function (TOF ratio≥0.9) was established soon after sugammadex administration, and electromyographic evaluation of facial nerve was successfully conducted. The use of rocuronium and sugammadex, coupled with objective neuromuscular monitoring with acceleromyography, assured complete restoration of neuromuscular function and created the optimal conditions for the surgical team. Copyright © 2012 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  8. A new idea of electro-acupuncture treatment for peripheral facial paralysis and the nerve-endocrine hypothesis

    Institute of Scientific and Technical Information of China (English)

    Chao-Yong Wu; Guang-Fu Wu; Xin-Yu Wang

    2016-01-01

    Based on the traditional Chinese medicine treatment of peripheral facial paralysis (PFP), this paper presents a new method of PFP. According to facial nerve distribution and innervation of the muscle, 10 points were selected and the intermittent wave of electro-acupuncture was performed for treatment of peripheral facial paralysis. It is speculated that the possible mechanism of action is mainly dependent on the regulation of neuroendocrine system.%#摘要在传统中医治疗周围性面瘫的基础上,本文提出了一种针灸治疗周围性面瘫的新方法,根据面神经分布及其支配的肌肉进行选穴定位,共设计了10个穴,并以断续波行电针刺激治疗周围性面瘫;推测其可能的作用机制主要是依赖于神经-内分泌系统的调节作用。

  9. A rare case of human immunodeficiency virus associated bilateral facial nerve palsy in North India

    Directory of Open Access Journals (Sweden)

    Sanjay Gupta

    2014-10-01

    Full Text Available Human immunodeficiency virus (HIV cases are on the increase in India and worldwide, so are its various complications. Neurological complications are important causes of morbidity and mortality in patients with HIV infection. They can occur at any stage of the disease and can affect any level of the central or peripheral nervous systems. In the literature, several cases of HIV-associated facial paralysis have been reported; however, bilateral facial palsy is rarely reported

  10. A rare case of human immunodeficiency virus associated bilateral facial nerve palsy in North India

    OpenAIRE

    Sanjay Gupta; Jitendra Kumar

    2014-01-01

    Human immunodeficiency virus (HIV) cases are on the increase in India and worldwide, so are its various complications. Neurological complications are important causes of morbidity and mortality in patients with HIV infection. They can occur at any stage of the disease and can affect any level of the central or peripheral nervous systems. In the literature, several cases of HIV-associated facial paralysis have been reported; however, bilateral facial palsy is rarely reported

  11. Constancy and characteristics of the anterior cutaneous branch of the first intercostal nerve: correcting the descriptions in human anatomy texts.

    Science.gov (United States)

    Miyawaki, Makoto

    2006-12-01

    Human anatomy texts state that the anterior cutaneous branch of the first intercostal nerve (Rca-Th1) does not exist or that, even if it does, it is poorly developed. However, an anterior cutaneous branch in the first intercostal space (Rca-1) was observed in 74.8% of cases examined (104/139 sides) and was not poorly developed at all. Some of the observed Rca-I were even larger than the anterior cutaneous branches in the second intercostal space (Rca-ll). The segment of origin of the Rca-I was analyzed in 37 sides and 66.2% (49/74 branches) were confirmed to be from Th1. As a result, in contrast with traditional beliefs, it was shown that Rca-Th1 exists. The Rca-I was classified into two types according to the course and distribution: (i) an anterior cutaneous branch that appeared at the anterior end of the first intercostal space (ICS), ran through the pectoralis major muscle and extended in the first ICS (Rca-1); and (ii) another branch that appeared at the same place but ran downward along the anterior surface of the second costal cartilage, deep to the pectoralis major muscle, to reach the inferior edge of the second costal cartilage or the second ICS, passed through the pectoralis major muscle and extended to the second rib or the second ICS (pseudo Rca-2). It was found that 77.8% (35/45 branches) of Rca-1 and 48.3% (14/29 branches) of pseudo Rca-2 were derived from Th1. Accordingly, the author suggests that the description in human anatomy texts should be revised to read, '... the Rca-Th1 exists quite constantly and some of appear at a position resembling Rca-Th2'.

  12. MRI-based diagnostic imaging of the intratemporal facial nerve; Die kernspintomographische Darstellung des intratemporalen N. facialis

    Energy Technology Data Exchange (ETDEWEB)

    Kress, B.; Baehren, W. [Bundeswehrkrankenhaus Ulm (Germany). Abt. fuer Radiologie

    2001-07-01

    Detailed imaging of the five sections of the full intratemporal course of the facial nerve can be achieved by MRI and using thin tomographic section techniques and surface coils. Contrast media are required for tomographic imaging of pathological processes. Established methods are available for diagnostic evaluation of cerebellopontine angle tumors and chronic Bell's palsy, as well as hemifacial spasms. A method still under discussion is MRI for diagnostic evaluation of Bell's palsy in the presence of fractures of the petrous bone, when blood volumes in the petrous bone make evaluation even more difficult. MRI-based diagnostic evaluation of the idiopatic facial paralysis currently is subject to change. Its usual application cannot be recommended for routine evaluation at present. However, a quantitative analysis of contrast medium uptake of the nerve may be an approach to improve the prognostic value of MRI in acute phases of Bell's palsy. (orig./CB) [German] Die detaillierte kernspintomographische Darstellung des aus 5 Abschnitten bestehenden intratemporalen Verlaufes des N. facialis gelingt mit der MRI unter Einsatz von Duennschichttechniken und Oberflaechenspulen. Zur Darstellung von pathologischen Vorgaengen ist die Gabe von Kontrastmittel notwendig. Die Untersuchung in der Diagnostik von Kleinhirnbrueckenwinkeltumoren und der chronischen Facialisparese ist etabliert, ebenso wie die Diagnostik des Hemispasmus facialis. In der Diskussion ist die MRI zur Dokumentation der Facialisparese bei Felsenbeinfrakturen, wobei die Einblutungen im Felsenbein die Beurteilung erschweren. Die kernspintomographische Diagnostik der idiopathischen Facialisparese befindet sich im Wandel. In der herkoemmlichen Form wird sie nicht zur Routinediagnostik empfohlen. Die quantitative Analyse der Kontrastmittelaufnahme im Nerv koennte jedoch die prognostische Bedeutung der MRI in der Akutphase der Bell's palsy erhoehen. (orig.)

  13. Chemically extracted acellular allogenic nerve and accompanying peripheral vein for repair of facial nerve defects%以化学去细胞法处理同种异体神经与周围静脉伴行修复面神经缺损*★

    Institute of Scientific and Technical Information of China (English)

    马洪斌; 张荣明

    2013-01-01

    BACKGROUND:Studies have showed that repair of facial nerve defect in rabbit with chemical y extracted acel ular al ogenic nerve can achieve good effect. OBJECTIVE:To explore a more effective operation means to repair facial nerve defects on the basis of chemical y extracted acel ular al ogenic nerve. METHODS:New Zealand rabbits were randomly divided into the experimental group and the control group. The experimental group received chemical y extracted acel ular al ogenic sural nerve transplantation and then received adventitial suture with accompanying peripheral vein to prepare the animal models of defects of buccal branches of facial nerve;the control group received the autologous facial nerve in situ anastomosis. The rabbits in the control group were treated with facial nerve cutting on the proximal and distal part of the same position that did not damage the normal anatomy relations between the cut nerve and the surrounding tissues, then the adventitia suture bridge was performed at the cutting site. RESULTS AND CONCLUSION:At 3 months after operation, the animals of both groups survived wel with basical y symmetrical facial expression and normal moustache swinging, no formation of obvious scars and neuroma could be seen at the neural transplantation site. The microscope observation results showed that there were no significant differences in the conduction velocity of right facial nerve buccal branch, number of myelinated nerve fibers in the 5.0 mm segment of graft distal anastomosis and the count of target muscle motor endplate between two groups (P>0.05). Repairing of rabbit facial nerve defects with chemical y extracted acel ular al ogenic nerve and accompanying peripheral vein shows a postoperative result similar to that of autologous facial nerve in situ anastomosis.%  背景:有研究表明化学去细胞法处理的同种异体神经修复面神经缺损可以取得较好的修复效果。  目的:在化学去细胞法处理同种异体神

  14. Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve and Release of the Plantar Aponeurosis for Chronic Heel Pain

    OpenAIRE

    Lui, Tun Hing

    2016-01-01

    Entrapment of the first branch of the lateral plantar nerve is a commonly missed cause of recalcitrant plantar heel pain. The diagnosis is made on a clinical ground with maximal tenderness at the site of nerve entrapment. Treatment of the nerve entrapment is similar to that for plantar fasciitis, with rest, activity modification, nonsteroidal anti-inflammatory drugs, stretching exercise, and local steroid injection. Surgical release of the deep abductor hallucis fascia is indicated when conse...

  15. Use of an infrared camera to improve the outcome of facial nerve monitoring.

    Science.gov (United States)

    Murphy, Emily K

    2008-03-01

    Intraoperative cranial nerve neuromonitoring (IONM) has significantly reduced morbidity historically associated with skull-base procedures. It provides the surgeon with immediate feedback to preserve both anatomic and physiologic function of monitored nerves. However, when the surgeon cauterizes tissue near the nerve, the monitoring equipment is saturated by the cautery signal, eliminating IONM information at a critical time. The use of an infrared camera under the drapes to observe the face for movement due to nerve stimulation is an invaluable adjunct to traditional IONM. Monitoring may also be improved by contralateral electrode placement to help identify artifact from nerve stimulation, using the microscope's video output to compare the surgeon's hand movements to recorded activity, and learning basic anatomy of the inner ear and skull base in order to know when heightened attention is important.

  16. Compressive neuropathy of the first branch of the lateral plantar nerve: a study by magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Rogéria Nobre Rodrigues

    2015-12-01

    Full Text Available Abstract Objective: To assess the prevalence of isolated findings of abnormalities leading to entrapment of the lateral plantar nerve and respective branches in patients complaining of chronic heel pain, whose magnetic resonance imaging exams have showed complete selective fatty atrophy of the abductor digiti quinti muscle. Materials and Methods: Retrospective, analytical, and cross-sectional study. The authors selected magnetic resonance imaging of hindfoot of 90 patients with grade IV abductor digiti quinti muscle atrophy according to Goutallier and Bernageau classification. Patients presenting with minor degrees of fatty muscle degeneration (below grade IV and those who had been operated on for nerve decompression were excluded. Results: A female prevalence (78.8% was observed, and a strong correlation was found between fatty muscle atrophy and plantar fasciitis in 21.2%, and ankle varices, in 16.8% of the patients. Conclusion: Fatty atrophy of the abductor digiti quinti muscle is strongly associated with neuropathic alterations of the first branch of the lateral plantar nerve. The present study showed a significant association between plantar fasciitis and ankle varices with grade IV atrophy of the abductor digiti quinti muscle.

  17. Preoperative identiifcation of facial nerve and cochlear nerve in patients with acoustic neuroma%听神经瘤患者术前面神经及耳蜗神经显影技术

    Institute of Scientific and Technical Information of China (English)

    蔡林彬; 杨军

    2016-01-01

    Acoustic neuroma is the most common benign tumor in cerebellopontine angle region. Surgical treatment of acoustic neuroma carries a risk of facial nerve dysfunction and hearing loss, which can be reduced by preoperative identification of facial nerve and cochlear nerve.This article reviews recent advances in imaging of intracranial nerve and mainly fouces on facial nerve and cochlear nerve in patients with acoustic neuroma.%听神经瘤是最常见的桥小脑角良性肿瘤,手术可引起面瘫、听力下降等并发症,术前定位面神经、耳蜗神经可降低其发生率。本文对近年来发展的颅内神经显影技术做一综述,主要集中于听神经瘤患者的面神经、耳蜗神经定位手段。

  18. Facial Nerve Neuromas:Diagnosis and management%面神经肿瘤的诊断及治疗进展

    Institute of Scientific and Technical Information of China (English)

    王萌萌; 韩维举; 王若雅; 吴军

    2014-01-01

    Objective To discuss on clinical features, radiological characteristics, differential diagnosis and surgical approaches in treating facial nerve tumors and repairing the nerve, as well as treatment outcomes. Methods Cases of facial nerve tumor cases reported after 2002 in Pubmed, Medline, LWW, Elsevier, Springer, CKNI and CQVIP were reviewed in comparison to cases treated by the authors. Results A total of 23 reports were identified covering a total of 354 cases. The average onset age 43.90 years and sex ratio was 1:1.1. Facial palsy, hearing loss and tinnitus were the most common present-ing symptoms. In 271 of the 354 cases, facial nerve function before operation were reported (normal=113, House-Brackman grade II=30, H-B grade III=38, H-B grade IV=29, H-B grade V=29, H-B grade VI=32. The horizontal segment and geniculate ganglion were the most location of involvement. Surgical approach selection depended on tumor location and hear-ing level before operation. Mastoid and labyrinthine approach were commonly used. Facial nerve repairing method was dictat-ed by the length of facial nerve defect and the availability of facial nerve stump . Greater auricular nerve grafts were the most common material used to repair facial nerve in our cases. Of the 208 cases with followed-up data, facial function reached H-B grade I in 34 cases, H-B grade II in 27 cases, H-B grade III in 76 cases, H-B grade IV in 48 case s, H-B grade V in 6 cases and H-B grade VI in 17 cases. Conclusion Facial palsy, hearing loss and tinnitus are the most common symptoms in facial nerve tumors. The seemingly impossible facial nerve tumors must be considered in patients with facial palsy. The hori-zontal segment and geniculate ganglion are most often involved in facial nerve tumors. Selection of operation approach is de-termined by the location and site of the tumor and if residual hearing is to be preserved. Facial nerve repair should be consid-ered unless examination indicates complete loss of facial

  19. Facial nerve paralysis due to intra-aural Hyalomma tick infestation.

    Science.gov (United States)

    Doğan, Müzeyyen; Devge, Cem; Tanrıöver, Ozlem; Pata, Yavuz Selim; Sönmezoğlu, Meral

    2012-01-01

    We present the case of a 33 year-old man from a village of the north-eastern part of central Anatolia admitted to the otolaryngology department of Yeditepe University Hospital with right facial asymmetry and pain on the right ear. A tick of the genus Hyalomma was observed in the external auditory canal of the right ear and it was removed with fine cup forceps under otomicroscopy. We are of the opinion that in patients presenting with sudden acute ear pain and facial palsy, the ear canal should be examined to exclude an infestation by ticks.

  20. Bell palsy in lyme disease-endemic regions of canada: a cautionary case of occult bilateral peripheral facial nerve palsy due to Lyme disease.

    Science.gov (United States)

    Ho, Karen; Melanson, Michel; Desai, Jamsheed A

    2012-09-01

    Lyme disease caused by the spirochete Borrelia burgdorferi is a multisystem disorder characterized by three clinical stages: dermatologic, neurologic, and rheumatologic. The number of known Lyme disease-endemic areas in Canada is increasing as the range of the vector Ixodes scapularis expands into the eastern and central provinces. Southern Ontario, Nova Scotia, southern Manitoba, New Brunswick, and southern Quebec are now considered Lyme disease-endemic regions in Canada. The use of field surveillance to map risk and endemic regions suggests that these geographic areas are growing, in part due to the effects of climate warming. Peripheral facial nerve palsy is the most common neurologic abnormality in the second stage of Lyme borreliosis, with up to 25% of Bell palsy (idiopathic peripheral facial nerve palsy) occurring due to Lyme disease. Here we present a case of occult bilateral facial nerve palsy due to Lyme disease initially diagnosed as Bell palsy. In Lyme disease-endemic regions of Canada, patients presenting with unilateral or bilateral peripheral facial nerve palsy should be evaluated for Lyme disease with serologic testing to avoid misdiagnosis. Serologic testing should not delay initiation of appropriate treatment for presumed Bell palsy.

  1. The image variations in mastoid segment of facial nerve and sinus tympani in congenital aural atresia by HRCT and 3D VR CT.

    Science.gov (United States)

    Wang, Zhen; Hou, Qian; Wang, Pu; Sun, Zhaoyong; Fan, Yue; Wang, Yun; Xue, Huadan; Jin, Zhengyu; Chen, Xiaowei

    2015-09-01

    To find the variations of middle ear structures including the spatial pattern of mastoid segment of facial nerve and the shapes of the sinus tympani in patients with congenital aural atresia (CAA) by using the high-resolution (HR) CT and 3D volume rendered (VR) CT images. HRCT was performed in 25 patients with congenital aural atresia including six bilateral atresia patients (n=25, 21 males, 4 females, mean age 13.8 years, range 6-19). Along the long axis of the posterior semicircular canal ampulla, the oblique axial multiplanar reconstruction (MPR) was set to view the depiction of the round window and the mastoid segment of facial nerve. Volumetric rending technique was used to demonstrate the morphologic features. HRCT and 3D VR findings in atresia ears were compared with those in 19 normal ears of the unilateral ears of atresia patients. On the basic plane, the horizontal line distances between the mastoid segment of the facial nerve and the round window (h-RF) in atresia ears significantly decreased compared to the control ears (PVR CT images. HRCT and 3D VR CT could help a better understanding of different kinds of variations in mastoid segment of facial nerve and sinus tympani in CAA ears. And it may further help surgeons to make the correct decision for hearing rehabilitation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. 3-Dimensional visualization study of angle nerve of facial nerve%面神经的角神经三维可视化研究

    Institute of Scientific and Technical Information of China (English)

    杨柠泽; 苏晓玮; 王志军; 王滨; 吕宁

    2012-01-01

    Objective To validate the previous anatomic study result about angle nerve of facial nerve through 3-dimensional(3-D) visualization technique,so as to provide theory basis for clinic treatment of nerve loss.Method The full-thickness soft tissue at internal side of inner canthus was harvested from adult cadaveric head.The skin was 3cm in length and l cm in width,with 2 prarelled cut lines as location markers.The specimen was sliced continuously into 120 slices,with 10μm in thickness for every slice,0.25 mm apart. The slices underwent HE staining and 2-D digital image was gained by high resolution scanner.Then 3-D reconstruction was performed.Results ① It showed the 3-D structures and routes of angle nerve,as well as the relationship between angle nerve and angle arteriovenous.All the reconstructed structures can be displayed together or separately,also from any angles.② It confirmed the accuracy of microscopic anatomy study about angle nerve. ③ The 3-D reconstruction of angle nerve,as well as the surrounding structure could be very useful for clinical application.Conclusion Based on the histologic study and computer technology,the 3-D reconstruction of angle nerve could provide accurate basis for the feasibility of clinic treatment of angle nerve loss.%目的 通过三维可视化技术,验证前期解剖学研究结果,并为失神经支配手术提供一定的理论依据.方法 取自愿捐献的甲醛固定的成人尸头,切取内眦角内侧全层软组织长3 cm、宽1 cm,以皮肤表面2平行刀痕为定位线,连续横断石蜡切片,片厚10 μm,切片间距0.25 mm,共切取120张切片.采用HE组织化学染色,高分辨率扫描仪获取二维数码图像后进行三维重建.结果 ①真实再现了角神经的三维立体结构及角神经与内眦动静脉的三维立体行径,且重建结构不但能单独或搭配显示,并可从任意角度显示.②证实了角神经显微解剖学研究的正确性.③角神经毗邻关系的三维重

  3. 咬肌神经-面神经转位术对听神经瘤术后面瘫的治疗效果观察%Therapeutic Effect of the Masseter Nerve and Facial Nerve Transposition of Acoustic Neuroma Postoperative Facial Paralysis

    Institute of Scientific and Technical Information of China (English)

    李斌

    2016-01-01

    ObjectiveTo investigate the curative effect of masseter nerve and facial nerve transposition of facial paralysis after acoustic neuroma surgery.Methods Selected in our hospital to acoustic neuroma surgery patients with facial paralysis after 79 cases,al patients were to be masseter nerve and facial nerve transposition in the treatment of,for the observation of the therapeutic effect of patients.ResultsPatients after treatment,folow-up 1 year facial lip functions were significantly better than those before treatment,another 61 cases good action smile,10 subjects with mild to moderate recovery,8 cases of poor recovery,the 3 patients appeared parotid masseteric region of subsidence,but chewing function has not lost.Conclusion Masseter nerve and facial nerve transposition of auditory neuroma after operation,the effect of treatment of facial paralysis is good.%目的:探讨咬肌神经-面神经转位术对听神经瘤术后面瘫的治疗效果。方法选取听神经瘤术后面瘫患者79例,均予以咬肌神经-面神经转位术治疗,观察患者的治疗效果。结果患者治疗后、随访1年内面肌上唇上提功能均优于治疗前;61例微笑动作良好,10例中等程度恢复,8例恢复较差;其中3例患者出现腮腺咬肌区下陷,但是咀嚼功能并未丧失。结论咬肌神经-面神经转位术对听神经瘤术后面瘫的治疗效果好。

  4. Ultrasound study is useful to discriminate between axonotmesis and neurotmesis also in very small nerves: a case of sensory digital ulnar branch study.

    Science.gov (United States)

    Renna, Rosaria; Rosaria, Renna; Coraci, Daniele; Daniele, Coraci; De Franco, Paola; Erra, Carmen; Ceruso, Massimo; Padua, Luca

    2012-12-01

    Discrimination between axonotmesis and neurotmesis is crucial in traumatic nerve injury. We present the case of a 43-year-old woman which presented hypoesthesia in the fourth and fifth right fingers, started after surgery for Dupuytren syndrome. At ultrasound study, the ulnar digital sensory branch was identified. Before the division into the two terminal branches, a neuroma was observed, while neurotmesis was excluded. This case shows the utility of ultrasonography in peripheral nervous system examination and the possibility of visualization of very small nerves and their terminal branches.

  5. Results of Facial Nerve Microsurgery for Peripheral Facial Palsy in 15 Patients%面神经减压术治疗周围性面瘫15例临床分析

    Institute of Scientific and Technical Information of China (English)

    方瑾; 李海同; 潘军燕; 陈晓红; 周水洪; 柴亮; 杨雪明; 王媚; 鲍洋洋; 钱林荣

    2014-01-01

    Objcetive To report results of facial nerve decompression for peripheral facial palsy caused by different facial never diseases.Methods Etiologies in this group included trauma (n=9), Bell’s palsy (n=3) and cholesteatoma in middle ear (n=3).All patients were treated with facial nerve decompression via transmastoid, subtemporal or supralabyrinthine approach-es.The House-Brackmann facial nerve grade was assessed during the 0.5 to 2 years follow up.Results Among the 9 traumat-ic facial palsy patients caused by temporal bone fracture, 5 received surgery within 2 to 4 weeks and achieved grade I (n=4) or II (n=1) facial function;3 received surgery within 5 to 8 weeks and achieved gradeⅡ(n=2) orⅢ(n=1) facial function;and 1 received the operation within 9 to 12 weeks after the injury and achieved only gradeⅣfacial function.Two patients with Bell ’s palsy were operated on within 9 to12 weeks and achieved grade I or II facial function. One Bell’s palsy patient achieved gradeⅢfacial function after receiving surgery 12 weeks after disease onset. The 3 cases of middle ear cholesteatoma were oper-ated upon in 1 to 2 weeks and all achieved grade I facial function. Conclusions Appropriate timing and facial nerve decom-pression operations based on the etiologies can lead to good facial function results.%目的:探讨不同面神经疾病致周围性面瘫行面神经减压手术的疗效。方法对9例外伤性面瘫、3例贝尔氏面瘫及3例中耳胆脂瘤所致的周围性面瘫,经乳突-颞下迷路上隐窝进路面神经显微减压手术,术后随访0.5~2年,按面瘫H-B分级法评估面神经功能恢复程度。结果9例颞骨骨折面瘫(Ⅳ级2例,V级6例,Ⅵ级1例),伤后2~4周手术5例,术后面神经功能恢复I级4例,Ⅱ级1例;伤后5~8周手术3例,面神经功能恢复Ⅱ级2例,Ⅲ级1例;伤后9~12周手术1例,恢复Ⅳ级。3例贝尔面瘫(Ⅳ级1例,V级2例),9~12周手术2

  6. Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve and Release of the Plantar Aponeurosis for Chronic Heel Pain.

    Science.gov (United States)

    Lui, Tun Hing

    2016-06-01

    Entrapment of the first branch of the lateral plantar nerve is a commonly missed cause of recalcitrant plantar heel pain. The diagnosis is made on a clinical ground with maximal tenderness at the site of nerve entrapment. Treatment of the nerve entrapment is similar to that for plantar fasciitis, with rest, activity modification, nonsteroidal anti-inflammatory drugs, stretching exercise, and local steroid injection. Surgical release of the deep abductor hallucis fascia is indicated when conservative treatment failed. Endoscopic release of the nerve through the dorsal and plantar portals, as well as endoscopic plantar aponeurosis release, is a feasible approach.

  7. [Facial palsy].

    Science.gov (United States)

    Cavoy, R

    2013-09-01

    Facial palsy is a daily challenge for the clinicians. Determining whether facial nerve palsy is peripheral or central is a key step in the diagnosis. Central nervous lesions can give facial palsy which may be easily differentiated from peripheral palsy. The next question is the peripheral facial paralysis idiopathic or symptomatic. A good knowledge of anatomy of facial nerve is helpful. A structure approach is given to identify additional features that distinguish symptomatic facial palsy from idiopathic one. The main cause of peripheral facial palsies is idiopathic one, or Bell's palsy, which remains a diagnosis of exclusion. The most common cause of symptomatic peripheral facial palsy is Ramsay-Hunt syndrome. Early identification of symptomatic facial palsy is important because of often worst outcome and different management. The prognosis of Bell's palsy is on the whole favorable and is improved with a prompt tapering course of prednisone. In Ramsay-Hunt syndrome, an antiviral therapy is added along with prednisone. We also discussed of current treatment recommendations. We will review short and long term complications of peripheral facial palsy.

  8. Initial assessment of facial nerve paralysis based on motion analysis using an optical flow method.

    Science.gov (United States)

    Samsudin, Wan Syahirah W; Sundaraj, Kenneth; Ahmad, Amirozi; Salleh, Hasriah

    2016-01-01

    An initial assessment method that can classify as well as categorize the severity of paralysis into one of six levels according to the House-Brackmann (HB) system based on facial landmarks motion using an Optical Flow (OF) algorithm is proposed. The desired landmarks were obtained from the video recordings of 5 normal and 3 Bell's Palsy subjects and tracked using the Kanade-Lucas-Tomasi (KLT) method. A new scoring system based on the motion analysis using area measurement is proposed. This scoring system uses the individual scores from the facial exercises and grades the paralysis based on the HB system. The proposed method has obtained promising results and may play a pivotal role towards improved rehabilitation programs for patients.

  9. Anatomia dos ramos do nervo lingual em suíno Anatomy of branches of nerve lingual in pigs

    Directory of Open Access Journals (Sweden)

    Jussara Rocha Ferreira

    2008-12-01

    Full Text Available Neste trabalho, foram estudadas as ramificações e a distribuição do nervo lingual em 18 línguas de suínos adultos de ambos os sexos, sem especificação de raça. O material, colhido a fresco em rotina de abate, foi resfriado (4°C para transporte, fixado em solução aquosa de formaldeído (7%, 72 horas, imerso em solução aquosa de ácido nítrico (15%, 72 horas, e dissecado sob lupa (RANSOR - II-20. Cada antímero dissecado possibilitou o registro dos ramos nervosos linguais primários, secundários e terciários presentes no interior das estruturas miofasciais do órgão, exibindo diferentes arranjos: o antímero esquerdo apresentou quatro a 10 ramos primários, quatro a 12 ramos secundários e zero a 11 ramos terciários. Já o antímero direito apresentou três a 8 ramos primários, zero a 11 ramos secundários e zero a 10 ramos terciários. Em 27,6% das análises, os ramos linguais estabelecem associações com as fibras do nervo hipoglosso no antímero correspondente.The distribution and ramifications of the lingual nerve of 18 tongues of adult pigs from both genders with no strain specification were studied. The material freshly collected in slaughter routine was cooled (4°C for transportation, fixed in formaldehyde aqueous solution (7%, 72h, immerse in nitric acid aqueous solution (15%, 72h and dissected with magnifying glass (RASOR, II-20. Each dissected antimere enabled the recording of primary, secondary and tertiary lingual nervous branches present inside the myofascial structure of the organ, exhibiting different arrangements: left antimere: 4 to 10 primary branches, 4 to 12 secondary antimeres and 0 to 11 tertiary branches; right antimere: 3 to 8 primary branches, 0 to 11 secondary antimeres and 0 to 10 tertiary branches. In 27.6% of analyses, the lingual branches established associations with the fibers of the hypoglossal nerve in the corresponding antimere.

  10. Large Posterior Communicating Artery Aneurysm: Initial Presentation with Reproducible Facial Pain Without Cranial Nerve Deficit

    Directory of Open Access Journals (Sweden)

    Stacie Zelman

    2016-11-01

    Full Text Available Unruptured posterior communicating artery (PCOM aneurysms can be difficult to diagnose and, when large (≥ 7mm, represent a substantial risk to the patient. While most unruptured PCOM aneurysms are asymptomatic, when symptoms do occur, clinical manifestations typically include severe headache (HA, visual acuity loss, and cranial nerve deficit. This case report describes an atypical initial presentation of a large unruptured PCOM aneurysm with symptoms mimicking trigeminal neuralgia, without other associated cranial nerve palsies or neurologic deficits. The patient returned to the emergency department four days later with a HA, trigeminal neuralgia, and a new cranial nerve III palsy. After appropriate imaging, she was found to have a large PCOM aneurysm, which was treated with surgical clipping with significant improvement in patient’s symptoms.

  11. PlexinA3 restricts spinal exit points and branching of trunk motor nerves in embryonic zebrafish.

    Science.gov (United States)

    Feldner, Julia; Reimer, Michell M; Schweitzer, Jörn; Wendik, Björn; Meyer, Dirk; Becker, Thomas; Becker, Catherina G

    2007-05-02

    The pioneering primary motor axons in the zebrafish trunk are guided by multiple cues along their pathways. Plexins are receptor components for semaphorins that influence motor axon growth and path finding. We cloned plexinA3 in zebrafish and localized plexinA3 mRNA in primary motor neurons during axon outgrowth. Antisense morpholino knock-down led to substantial errors in motor axon growth. Errors comprised aberrant branching of primary motor nerves as well as additional exit points of axons from the spinal cord. Excessively branched and supernumerary nerves were found in both ventral and dorsal pathways of motor axons. The trunk environment and several other types of axons, including trigeminal axons, were not detectably affected by plexinA3 knock-down. RNA overexpression rescued all morpholino effects. Synergistic effects of combined morpholino injections indicate interactions of plexinA3 with semaphorin3A homologs. Thus, plexinA3 is a crucial receptor for axon guidance cues in primary motor neurons.

  12. Surgical treatment of facial paralysis.

    Science.gov (United States)

    Mehta, Ritvik P

    2009-03-01

    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (facial paralysis (3 weeks to 2 yr) and chronic facial paralysis (>2 yr). For acute facial paralysis, the main surgical therapies are facial nerve decompression and facial nerve repair. For facial paralysis of intermediate duration, nerve transfer procedures are appropriate. For chronic facial paralysis, treatment typically requires regional or free muscle transfer. Static techniques of facial reanimation can be used for acute, intermediate, or chronic facial paralysis as these techniques are often important adjuncts to the overall management strategy.

  13. Targeted fascicular biopsy of the sciatic nerve and its major branches: rationale and operative technique.

    Science.gov (United States)

    Capek, Stepan; Amrami, Kimberly K; Dyck, P James B; Spinner, Robert J

    2015-09-01

    OBJECT Nerve biopsy is typically performed in distal, noncritical sensory nerves without using imaging to target the more involved regions. The yield of these procedures rarely achieves more than 50%. In selected cases where preoperative evaluation points toward a more localized (usually a more proximal) process, targeted biopsy would likely capture the disease. Synthesis of data obtained from clinical examination, electrophysiological testing, and MRI allows biopsy of a portion of the major mixed nerves safely and efficiently. Herein, experiences with the sciatic nerve are reported and a description of the operative technique is provided. METHODS All cases of sciatic nerve biopsy performed between 2000 and 2014 were reviewed. Only cases of fascicular nerve biopsy approached from the buttock or the posterior aspect of the thigh were included. Demographic data, clinical presentation, and the presence of percussion tenderness for each patient were recorded. Reviewed studies included electrodiagnostic tests and imaging. Previous nerve and muscle biopsies were noted. All details of the procedure, final pathology, and its treatment implications were recorded. The complication rate was carefully assessed for temporary as well as permanent complications. RESULTS One hundred twelve cases (63 men and 49 women) of sciatic nerve biopsy were performed. Mean patient age was 46.4 years. Seventy-seven (68.8%) patients presented with single lower-extremity symptoms, 16 (14.3%) with bilateral lower-extremity symptoms, and 19 (17%) with generalized symptoms. No patient had normal findings on physical examination. All patients underwent electrodiagnostic studies, the findings of which were abnormal in 110 (98.2%) patients. MRI was available for all patients and was read as pathological in 111 (99.1%). The overall diagnostic yield of biopsy was 84.8% (n = 95). The pathological diagnoses included inflammatory demyelination, perineurioma, nonspecific inflammatory changes

  14. Safety profile of bone marrow mononuclear stem cells in the rehabilitation of patients with posttraumatic facial nerve paralysis-a novel modality (phase one trial).

    Science.gov (United States)

    Aggarwal, Sushil Kumar; Gupta, Ashok Kumar; Modi, Manish; Gupta, Rijuneeta; Marwaha, Neelam

    2012-08-01

    Objectives The objectives of this study were to study the safety profile and role of mononuclear stem cells in the rehabilitation of posttraumatic facial nerve paralysis not improving with conventional treatment. Study Design This is a prospective nonrandomized controlled trial. Study Setting This study is conducted at Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh between July, 2007 and December, 2008. Patients We included eight patients of either sex aged between 18 and 60 years of posttraumatic facial nerve paralysis not improving with conventional treatment presented to PGIMER, Chandigarh between July 2007 and December 2008. Methods All patients underwent preoperative electroneuronography (ENoG), clinical photography, and high-resolution computed tomography (HRCT) temporal bone. All patients then underwent facial nerve decompression and stem cell implantation. Stem cells processing was done in well-equipped bone marrow laboratory. Postoperatively, all patients underwent repeat ENoG and clinical photography at 3 and 6 months to assess for objective and clinical improvement. Clinical improvement was graded according to modified House-Brackmann grading system. Intervention Done All patients of posttraumatic facial nerve paralysis who were not improving with conventional surgical treatment were subjected to facial nerve decompression and stem cell implantation. Main Outcome Measures All patients who were subjected to stem cell implantation were followed up for 6 months to assess for any adverse effects of stem cell therapy on human beings; no adverse effects were seen in any of our patients after more than 6 months of follow-up. Results Majority of the patients were male, with motor vehicle accidents as the most common cause of injury in our series. Majority had longitudinal fractures on HRCT temporal bone. The significant improvement in ENoG amplitude was seen between preoperative and postoperative amplitudes on

  15. [Gold weight implants for lagophthalmos correction in chronic facial nerve paralysis (late results)].

    Science.gov (United States)

    Grusha, Y O; Fedorov, A A; Iskusnykh, N S; Bogacheva, N V; Kobzova, M V; Novikov, I A; Fettser, E I; Shchegoleva, T A

    2016-01-01

    Upper eyelid weigh gold implant is the widely accepted standard for the treatment of paralytic lagophthalmos (PL). To evaluate late outcomes of PL correction with chain gold implants. Chain gold implants were inserted in the upper eyelids of 70 patients with lagophthalmos due to chronic facial paralysis. A comprehensive ophthalmic examination was performed prior to surgery and then at months 1, 3, 6, 12, 24, and 36. The results obtained prove the method highly effective. None of the patients developed any severe complications. Cases of implant removal were few. Some of the studied biometric parameters decreased significantly after surgery, while the upper eyelid excursion increased. The implant had no effect on the inner surface of the cornea and its peripheral thickness. Efficacy of the proposed eyelid implant has been convincingly demonstrated; late complications have been analyzed.

  16. Effect of copper sulphate on the rate of afferent discharge in the gastric branch of the vagus nerve in the rat

    Science.gov (United States)

    Niijima, Akira; Jiang, Zheng-Yao; Daunton, Nancy G.; Fox, Robert A.

    1991-01-01

    The afferent nerve activity was recorded from a nerve filament isolated from the peripheral cut end of the gastric branch of the vagus nerve. The gastric perfusion of 4 ml of two different concentrations (0.04 percent and 0.08 percent) of CuSO4 solution provoked an increase in afferent activity. The stimulating effect of the 0.08 percent solution was stronger than that of the 0.04 percent solution, and lasted for a longer period of time. The observations suggest a possible mechanism by which CuSO4 elicits emesis.

  17. FGF-2 is required to prevent astrogliosis in the facial nucleus after facial nerve injury and mechanical stimulation of denervated vibrissal muscles.

    Science.gov (United States)

    Hizay, Arzu; Seitz, Mark; Grosheva, Maria; Sinis, Nektarios; Kaya, Yasemin; Bendella, Habib; Sarikcioglu, Levent; Dunlop, Sarah A; Angelov, Doychin N

    2016-03-01

    Recently, we have shown that manual stimulation of paralyzed vibrissal muscles after facial-facial anastomosis reduced the poly-innervation of neuromuscular junctions and restored vibrissal whisking. Using gene knock outs, we found a differential dependence of manual stimulation effects on growth factors. Thus, insulin-like growth factor-1 and brain-derived neurotrophic factor are required to underpin manual stimulation-mediated improvements, whereas FGF-2 is not. The lack of dependence on FGF-2 in mediating these peripheral effects prompted us to look centrally, i.e. within the facial nucleus where increased astrogliosis after facial-facial anastomosis follows "synaptic stripping". We measured the intensity of Cy3-fluorescence after immunostaining for glial fibrillary acidic protein (GFAP) as an indirect indicator of synaptic coverage of axotomized neurons in the facial nucleus of mice lacking FGF-2 (FGF-2(-/-) mice). There was no difference in GFAP-Cy3-fluorescence (pixel number, gray value range 17-103) between intact wildtype mice (2.12±0.37×10(7)) and their intact FGF-2(-/-) counterparts (2.12±0.27×10(7)) nor after facial-facial anastomosis +handling (wildtype: 4.06±0.32×10(7); FGF-2(-/-): 4.39±0.17×10(7)). However, after facial-facial anastomosis, GFAP-Cy3-fluorescence remained elevated in FGF-2(-/-)-animals (4.54±0.12×10(7)), whereas manual stimulation reduced the intensity of GFAP-immunofluorescence in wild type mice to values that were not significantly different from intact mice (2.63±0.39×10). We conclude that FGF-2 is not required to underpin the beneficial effects of manual stimulation at the neuro-muscular junction, but it is required to minimize astrogliosis in the brainstem and, by implication, restore synaptic coverage of recovering facial motoneurons.

  18. 听神经瘤显微手术面神经损伤的预防%Prevention of facial nerve injury in acoustic neuroma microsurgery

    Institute of Scientific and Technical Information of China (English)

    雷霆; 李龄

    2008-01-01

    目的 总结与分析听神经瘤显微手术中预防面神经损伤的方法.方法 经MRI和(或)CT检查确诊的大型听神经瘤(≥4.0 cm)180例(72%)及中型听神经瘤(2.4~4.0 cm)70例(28%).均采用经患侧枕下乙状窦后入路保留面神经的显微手术.注意三大解剖关系:骨性解剖、蛛网膜解剖、神经与血管的解剖.肿瘤囊内减压后,确认面神经的起始位置、面神经与肿瘤的关系、面神经变形与扭曲、面神经分离的方法、面神经的断裂端-端吻合.随访6个月~1年.结果 肿瘤全切除240例(96.0%);次全切除10例(4.0%),其中死亡1例(0.4%).面神经功能评定:Ⅰ级214例(85.6%);Ⅱ级25例(10.0%);Ⅲ级5例(2.1%);Ⅳ级5例(2.1%).结论 术中注意典型的解剖位置,正确的手术入路和显微手术技术可达到较高的肿瘤全切除率,提高面神经的功能保全率.%Objective To summarize and analyse the techniques of avoiding facial nerve iniury during acoustic neuroma microsurgery.Methods One hundred and eighty patients with large acoustic neuroma(≥4 cm)and 70 patients with medium acoustic neuroma(2.4-4.0 cm)Were diagnosed by MRI/CT scan before operation and confirmed by postoperational pathologic examination.All of patients were treated by sub-occipital retrosigmoid approach for tumor removal and facial nerve reservation during operation.The relationships among the bone,arachnoid,nerve and vascular anatomy were panicularly observed during the operation. After decompression of the tumor,the origination and location of the facial nerve as well as the relationship between the tumor and the facial nerve should be identified.The patients were followed-up from 6 months to 1 year postoperatively and assessed by House-Brackmann facial nerve function grading system.Results Total tumor resection was achieved in 240 of 250 cases (96%)and subtotal in 10 cases including 1 case died because of cerebellar encephalomalacia after operation. According to the House

  19. [Surgical facial reanimation after persisting facial paralysis].

    Science.gov (United States)

    Pasche, Philippe

    2011-10-01

    Facial reanimation following persistent facial paralysis can be managed with surgical procedures of varying complexity. The choice of the technique is mainly determined by the cause of facial paralysis, the age and desires of the patient. The techniques most commonly used are the nerve grafts (VII-VII, XII-VII, cross facial graft), dynamic muscle transfers (temporal myoplasty, free muscle transfert) and static suspensions. An intensive rehabilitation through specific exercises after all procedures is essential to archieve good results.

  20. A Rare Variation of the Axillary Nerve Formed as Direct Branch of the Upper Trunk

    OpenAIRE

    Subasinghe, Sandeepani Kanchana; Goonewardene, Shanti

    2016-01-01

    The brachial plexus has a complex anatomical structure from its origin in the neck and through its course in the axillary region. Knowledge of variations of the brachial plexus has important clinical applications especially in relation to trauma and surgical procedures of upper limb. The present study has reported a rare variation of the brachial plexus where the “axillary nerve” arising as a direct branch from the upper trunk instead from the posterior cord. Once the “axillary nerve” was giv...

  1. Padronização das técnicas de secção do nervo facial e de avaliação da mímica facial em ratos Standardization of techniques used in facial nerve section and facial movement evaluation in rats

    Directory of Open Access Journals (Sweden)

    Simone Damasceno de Faria

    2006-06-01

    paralisia facial a partir da observação clínica desses animais.AIM: standardization of the technique to section the extratemporal facial nerve in rats and creation of a scale to evaluate facial movements in these animals before and after surgery. STUDY DESIGN: Experimental. METHOD: twenty Wistar rats were anesthetized with ketamine xylazine and submitted to sectioning of the facial nerve near its emergence through the mastoid foramen. Eye closure and blinking reflex, vibrissae movement and positioning were observed in all animals and a scale to evaluate these parameters was then created. RESULTS: The facial nerve trunk was found between the tendinous margin of the clavotrapezius muscle and the auricular cartilage. The trunk was proximally sectioned as it exits the mastoid foramen and the stumps were sutured with a 9-0-nylon thread. An evaluation and graduation scale of facial movements, independent for eye and vibrissae, was elaborated, together with a sum of the parameters, as a means to evaluate facial palsy. Absence of eye blinking and closure scored 1; the presence of orbicular muscle contraction, without blinking reflex, scored 2; 50% of eye closure through blinking reflex, scored 3, 75% of closure scored 4. The presence of complete eye closure and blinking reflex scored 5. The absence of movement and posterior position of the vibrissae scored 1; slight shivering and posterior position scored 2; greater shivering and posterior position, scored 3 and normal movement with posterior position, scored 4; symmetrical movement of he vibrissae, with anterior position, scored 5. CONCLUSION: The rat anatomy allows easy access to the extratemporal facial nerve, allowing its sectioning and standardized suture. It was also possible to establish an evaluation and graduation scale of the rat facial movements with facial palsy based on the clinical observation of these animals.

  2. Comparison of 2-D turbo spin echo and 3-D gradient echo sequences for the detection of the trigeminal nerve and branches anatomy

    Energy Technology Data Exchange (ETDEWEB)

    Held, P.; Fruend, R.; Seitz, J.; Nitz, W.; Haffke, T.; Hees, H

    2001-01-01

    The aim of this study was to assess the detectability of the trigeminal nerve and its branches using T1 weighted (w.) 3-D magnetization prepared rapid gradient echo (MP-RAGE), T2* w. 3D CISS and T2 w. 2-D turbo spin echo MR sequences. Thirty healthy volunteers were examined for this purpose using a 1.5 Tesla MR unit. The detectability of the trigeminal nerve and Gasser's Ganglion, i.e. structures that are surrounded by liquor was best using 3-D CISS. In the case of the ophthalmic, maxillary and mandibular nerves, the T1 w. 3-D MPRAGE was significantly better than T2* w. CISS and T2 w. 2-D turbo spin echo. The latter yielded the poorest results. We conclude that both high resolution T2* w. and T1 w. 3-D sequences are necessary in order to detect the liquor-surrounded trigeminal nerve and its soft tissue-surrounded branches. We would therefore recommend the inclusion of constructive interference in steady state (CISS) and MP-RAGE in a MR imaging protocol of the trigeminal nerve and its branches.

  3. Repair of brachial plexus lower trunk injury by transferring brachialis muscle branch of musculocutaneous nerve:anatomic feasibility and clinical trials

    Institute of Scientific and Technical Information of China (English)

    ZHENG Xian-you; HOU Chun-lin; GU Yu-dong; SHI Qi-lin; GUAN Shi-bing

    2008-01-01

    Background There are few effective methods for treating injuries to the lower trunk of brachial plexus,and the curative effect is usually poor.The purpose of this study was to provide anatomic references for transferring the brachialis muscle branch of musculocutaneous nerve(BMBMCN)for selective neurotization of finger flexion in brachiaI plexus lower trunk injury,and to evaluate its clinical curative effects.Methods Microanatomy and measurement were done on 50 limbs from 25 adult human cadavers to obserye the origin,branch,type of the BMBMCN and median nerve,as well as their adjacent structures.Internal topographic features of the fascicular groups of the median nerve at the level of the BMBMCN were observed.In addition,the technique of BMBMCN transfer for selective neurotization of finger flexion of the median nerve was designed and tested in 6 fresh adult human cadavers.Acetylcholinesterase(AchE)staining of the BMBMCN and median nerve was done to observe the features of the nerve fibers.This technique was clinically tried to restore digital flexion in 6 cases of adult brachial plexus lower trunk injury.These cases were followed up for 3,6,9 and 12 months postoperatively.Recovery of function,grip strength,nerve electrophysiology and muscle power of the affected limbs were observed and measured.Results The brachialis muscle was totally innervated by the musculocutaneous nerve(MCN).Based on the Hunter's line,the Ievel of the origin of the BMBMCN was(13.18±2.77)cm.AchE histochemical staining indicated that the BMBMCN were totally made up of medullated nerve fibers.At the level of the BMBMCN,the median nerve consistently collected into three fascicular groups as shown by microanatomy in combination with AchE stain.The posterior fascicular group was mainly composed of anterior Interosseous nerves and branches to the palmaris longus.The technique was tested in six fresh cadavers successfully,except that stoma split occurred in one case.Five of the six cases recovered

  4. Intraoperative facial nerve reservation in patients with acoustic neuromas%听神经瘤显微手术与面神经保护

    Institute of Scientific and Technical Information of China (English)

    王伟; 田道锋; 陈治标; 王军民; 蔡强; 徐海涛; 张申起; 陈谦学

    2013-01-01

    目的 探讨大中型听神经瘤的显微手术治疗及面神经保护技巧.方法 自2007年9月至2011年9月在面神经电生理监测下采用枕下乙状窦后入路显微手术切除大中型听神经瘤142例.结果 肿瘤全切除136例(95.7%),次全切除6例(4.3%).术中面神经解剖保留132例(93.0%),面神经与肿瘤粘连紧密无法保留10例(7.0%).本组无长期昏迷及死亡病例.术后出现颅内感染3例、后组颅神经受损7例、眼睑闭合不能90例,无脑脊液漏病例.所有病人术后均随访3个月到2年,无术后复发病例;按House-Brackmann分级评估面神经功能,Ⅰ~Ⅱ级78例(54.9%),Ⅲ~Ⅳ级53例(37.3%),Ⅴ~Ⅵ级11例(7.8%).结论 充分了解桥脑小脑角区显微解剖知识,特别是了解听神经瘤与面神经的解剖关系,有助于提高手术效果.娴熟的操作技巧是手术成功的关键,术中监测及面神经的保留有助于面神经功能的保护.%Objective To summarize the experience in intraoperatively reservating facial nerves in patients with acoustic neuromas.Methods The clinical data of 142 patients with acoustic neuromas,who were treated in our hospital from September,2007 to September,2011,were analyzed retrospectively.All the patients were treated by microsurgery through suboccipital retrosigmoid approach under neurophysiological monitoring of the facial nerves.Results The total resection of the tumors was achieved in 136 (95.7%)patients and subtotal in 6(4.3%).The facial nerves were anatomically reservated in 132(93.0%).All the patients were followed up from 3 months to 2 years and the outcomes showed that the facial nerves function of 78(54.9%),53(37.3%)and 11(7.8%)patients belonged in House-Brackmann grades Ⅰ~Ⅱ,Ⅲ~Ⅳ and Ⅴ-Ⅵ respectively.Conclusions Fully understood the anatomy of cerebellopontin angle,especially the positional relationship between the acoustic neuroma and facial nerve,and skilled microsurgical

  5. The Role of Intraoperative Facial Nerve Monitoring in Acoustic Neuroma Resection%术中神经监测在听神经瘤切除术中对面神经的保护作用

    Institute of Scientific and Technical Information of China (English)

    沈上杭; 王占祥; 陈玉英; 刘希尧; 谭国伟; 郭剑锋

    2009-01-01

    BACKGROUND & OBJECTIVE: To maintain the anatomic and functional intactness of facial nerve is one of the goal of acoustic neuroma resection. In this article, we investigated the role of intraoperative facial nerve monitoring in acoustic neuroma resection. METHODS: Clinical data of 57 patients with acoustic neuroma treated in our hospital were retrospectively analyzed. Among 57 patients, tumors were removed under microscope without intranperative facial nerve monitoring in 35 cases and with intraoperative monitoring in 22 cases. Post operative facial nerve function was followed up in all patients. RESULTS: House-Brackmann system was used for evaluating the function of facial nerve 3 months after operation. Among 22 cases with intraoperative facial nerve monitoring, facial nerve intactness was observed in 18 cases, Grade Ⅰ facial paralysis in 2 cases and Grade Ⅱ facial paralysis in 2 cases, repectively. The monitoring group had 2 cases Among 35 cases without intracperative facial nerve monitoring, intact faical function was observed in 14 cases, Grade Ⅰfacial paralysis in 12 cases, Grade Ⅱ facial paralysis in 6 cases, grade Ⅲ facial paralysis in 2 cases, and Grade Ⅴ facial paralysis in 1 case, respectively.Patients with intraoperative facial nervemonitoring had better performance in facial nerve function than those without monitoring (P< 0.05). CONCLUSION: Intraoperative nerve monitoring techniques facilitates the localization and preservation of the facial nerve in acoustic neuroma resection.%背景与目的:面神经瘫痪是听神经瘤切除术中最常见的并发症,近年来随着术中神经监测技术的应用,术后面神经功能已得到较好的保护.本研究旨在探讨术中神经监测在听神经瘤手术中对面神经功能的保护作用.方法:分析本院收治手术的57例听神经瘤患者,其中直接显微镜下切除肿瘤(非监测组)35例,显微镜下切除肿瘤过程中使用术中神经监测仪对

  6. 面神经损伤吻合术手术时机研究%Optimal Timing for Repair of Facial Nerve Trauma

    Institute of Scientific and Technical Information of China (English)

    胡炯炯; 周梁; 马兆鑫

    2011-01-01

    目的:探讨面神经损伤后最佳的修复时机.方法:以行面神经即时吻合术和延迟吻合术后豚鼠的辣根过氧化物酶(HRP)标记神经元数、有髓纤维数/HRP标记神经元等为观察指标,评价面神经即时吻合和延迟不同时期吻合术后面神经再生的情况.结果:各组指标比较,延迟7d缝合组和即时缝合组的治疗效果最佳,此2组间差异无统计学意义;延迟60 d缝合组和延迟90 d缝合组治疗效果最差.结论:在无法即时行面神经吻合术的情况下,可在神经断伤后7d吻合面神经.尽量争取在神经离断伤后60 d内修补损伤的面神经.%Objective:To evaluate the curative effect of immediate nerve suture and delayed nerve suture more comprehensively and more impersonally with longer time course. Methods: All the guinea pigs were randomly assigned to one of eight groups, normal group, group of immediate FFA, group of delayed FFA for 7 days, group of delayed FFA for 14 days, group of delayed FFA for 21 days, group of delayed FFA for 30 days, group of delayed FFA for 60 days, and group of delayed FFA for 90 days by turns. Two months after nerve suture, from observing of HRβ-labeled neurons and axons per motoneuron ratio, we evaluate the curative effect of immediate facial-facial anastomosis (FFA) and FFA delayed for 7-90 days objectively. Results-. Delayed FFA for 7 days showed equal or even better curative effect than the group of immediate FFA did,the group of delayed FFA for 60days and 90 days showed apparenT1y poorer curative effect than the immediately sutured and other delayed sutured ones did. Conclusions: Repairing facial nerve 7 days after trauma could get as good curative effect as immediate suturing of the nerve. Facial nerve regenerates poorly if it is repaired 60-90 days after trauma. The result is of some value to clinical works, that is, if immediate repair of facial nerve is impossible, repairing it 7 days after trauma is also ideal. Meanwhile, we

  7. 面神经电生理监测在大型听神经瘤术中的应用%Intraoperative electrophysiologic monitoring of the facial nerve in operation of large acoustic neuromas

    Institute of Scientific and Technical Information of China (English)

    赵学明; 药天乐; 万大海; 王永红; 范益民; 郝解贺

    2011-01-01

    Objective To explore intraoperative protection of facial nerve and evaluate its function after operation in large acoustic neuromas surgery by electrophysiologic monitoring. Method A total of 42 patients'clinical data with large acoustic neuromas between Jun, 2007 and Mar, 2010 were analyzed retrospectively,who were treated microsurgically with intraoperative electrophysiological monitoring in our department. Results The facial nerve was preserved anatomically in 37 patients (88%). The function of facial nerve was kept well in 30 cases (71%). Stimulative intensity of 1 ~ 3 V at the end of operation is related to the good function of facial nerve. The proximal - to - distal amplitude ratio of facial nerve after surgery less than 0. 3 presented with a bad facial function. ConclusionsIntraoperative monitoring has significantly decreased facial nerve morbidity in large acoustic neuromas surgery. Stimulative intensity at the exit of facial nerve from brainstem is related to the facial nerve function negatively. The proximal - to - distal amplitude ratio can predict the facial nerve function positively following acoustic neuromas resection.%目的 探讨大型听神经瘤术中面神经监测对面神经保护及评估术后面神经功能的临床意义。方法回顾性分析我科2007年6月至2010年3月术中行面神经监测的42例大型听神经瘤的临床资料。结果 面神经解剖保留37例(88%),面神经功能保留30例(71%)。术末刺激强度1~3V即引起肌电反应者预后良好;而术末面神经近端与远端波幅之比<0.3者预后差。结论 大型听神经瘤术中面神经监测可显著降低术后面神经瘫痪的发生率,术末面神经脑干端的刺激强度与面神经功能呈负相关,而面神经近端与远端波幅之比与面神经功能呈正相关。

  8. Intraoperative neuromonitoring of the external branch of the superior laryngeal nerve during robotic thyroid surgery: a preliminary prospective study

    Science.gov (United States)

    Kim, Su-jin; Oh, Byung-Mo; Oh, Eun Mee; Bae, Dong Sik; Choi, June Young; Myong, Jun Pyo; Youn, Yeo-Kyu

    2015-01-01

    Purpose The aim of this study was to evaluate the feasibility of monitoring external branch of the superior laryngeal nerve (EBSLN) during robotic thyroid surgery. Methods A total of 10 patients undergoing bilateral axillo-breast approach (BABA) robotic thyroid surgery were enrolled. The nerve integrity monitor (NIM Response 2.0 System) was used for EBSLN monitoring. We performed voice assessments preoperatively and at 1 and 3 months postoperatively using Voice Handicap Index-10 (VHI-10), maximal phonation time (MPT), phonation efficient index (PEI), and laryngeal electromyography (EMG). Results A total of 19 EBSLNs were at risk and 14 EBSLNs (73.7%) were identified using neuromonitoring. VHI-10 showed a change of voice over time (0.1 vs. 3.6 vs. 1.3); however, this was not statistically significant. VHI-10 scores normalized at 3 months postoperatively compared to the preoperative scores. MPT (a) (16.0 vs. 15.6 vs. 15.4), and MPT (e) (20.1 vs. 15.4 vs. 18.5) showed no significant differences preoperatively compared to the values obtained 1 and 3 months postoperatively. There was a significant change of PEI over time (4.8 vs. 1.1 vs. 4.6) (P = 0.036); however, the values normalized at 3 months postoperatively. Laryngeal EMG results showed 4 cases (21.2%) of neuropathy of EBSLNs at 1 month postoperatively, and electrodiagnostic studies revealed nearly complete recovery of the function of EBSLNs in 4 patients at 3 months postoperatively Conclusion It is suggested that neuromonitoring of EBSLNs during BABA robotic thyroid surgery is feasible and might be helpful to preserve voice quality. PMID:26576402

  9. Versatility of lateral cutaneous branches of intercostal vessels and nerves: anatomical study and clinical application.

    Science.gov (United States)

    Iida, Takuya; Narushima, Mitsunaga; Yoshimatsu, Hidehiko; Mihara, Makoto; Kikuchi, Kazuki; Hara, Hisako; Yamamoto, Takumi; Araki, Jun; Koshima, Isao

    2013-11-01

    The use of the intercostal artery perforator (ICAP) flap has recently become popular in reconstructions of the breast, upper arm and trunk. Lateral cutaneous branches (LCBs) are a group of the ICAPs that penetrate the fascia near the middle axillary line. However, reports on its precise anatomy and clinical applications are quite limited. We performed an anatomical study of LCBs using cadavers. Based on the findings, we developed novel clinical application methods as follows: (1) sensate superficial circumflex iliac perforator (SCIP) flap, (2) supercharged SCIP flap, (3) ICAP-based propeller flap (IBPF) and (4) free ICAP flap based on LCB. LCBs have the following advantages: (1) Long pedicles can be obtained in the supine position without risk of pneumothorax. (2) The neurovascular bundle is consistently available, allowing elevation of sensate flaps. (3) Donor-site morbidity is low. Therefore, we believe that LCBs offer a versatile option in reconstructive surgery. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. Paralisia facial periférica bilateral na leucemia linfóide aguda: relato de caso Bilateral peripheric facial nerve palsy in acute linfoid leukemia: a case report

    Directory of Open Access Journals (Sweden)

    Marcos L. Antunes

    2004-04-01

    Full Text Available A mímica facial é fundamental para a expressão e comunicação humana, que são possíveis apenas através da integridade do nervo facial. Sendo assim, a paralisia facial periférica (PFP pode deixar seqüelas estéticas, funcionais e psicológicas. A causa mais comum é a paralisia de Bell (50 a 80%, onde a maioria dos pacientes apresenta manifestação unilateral. O acometimento bilateral simultâneo é raro, sendo a leucemia a neoplasia que com maior freqüência pode resultar nesse tipo de manifestação. A seguir, relatamos o caso de um paciente de dezoito anos de idade apresentando leucemia linfóide aguda (LLA e PFP simultânea, ambas refratárias ao tratamento quimioterápico, culminando com o óbito cinco meses após o início da PFP. Realizou-se considerações importantes sobre a fisiopatologia da PFP na LLA, além de uma revisão da literatura.The facial mimic is very important to the human expression and communication, which depend on the integrity of the facial nerve. So, the peripheric facial palsy (PFP can leave esthetics, functional and psychological sequelae. The more common etiology is Bell's palsy (50 to 80% and most of the patients show a unilateral manifestation. The simultaneous bilateral PFP is rare, and the leukemia is the neoplasia that can often that kind of manifestation. We present a clinical case of an 18-year-old patient with acute lymphoid leukemia and simultaneous bilateral facial palsy, who did not recover after the chemotherapy treatment, and died five months after the initial manifestation of the facial palsy. Important considerations were accomplished about the physiopathology of PFP in acute lymphoid leukemia, besides literature review.

  11. Role of Kabat rehabilitation in facial nerve palsy: a randomised study on severe cases of Bell's palsy.

    Science.gov (United States)

    Monini, S; Iacolucci, C M; Di Traglia, M; Lazzarino, A I; Barbara, M

    2016-08-01

    The treatment of Bell's palsy (BP), based on steroids and/or antiviral drugs, may still leave a certain percentage of affected subjects with disfiguring sequelae due to incomplete recovery. The different procedures of physical rehabilitation have not been demonstrated to play a favourable role in this disorder. The aim of the present study was to compare functional outcomes in severe cases of Bell's palsy when treated by steroids alone or by steroids accompanied by Kabat physical rehabilitation. This prospective study included 94 subjects who showed sudden facial nerve (FN) palsy with House-Brackmann grade IV or V and who were divided into two groups on the basis of the therapeutic approach: one group (a) was treated by steroids, and the other (b) received steroids in combination with physical rehabilitation. Medical treatment consisted in administration of steroids at a dosage of 60 mg per day for 15 days; physical rehabilitative treatment consisted in proprioceptive neuromuscular facilitation according to Kabat, and was administered to one of the two groups of subjects. Recovery rate, degree of recovery and time for recovery were compared between the two groups using the Mann-Whitney and univariate logistic regression statistical tests (Ward test). Kabat patients (group b) had about 20 times the odds of improving by three HB grades or more (OR = 17.73, 95% CI = 5.72 to 54.98, p Kabat subjects). No difference was observed in the incidence of synkineses between the two groups. Steroid treatment appears to provide better and faster recovery in severe cases (HB IV and V) of BP when complemented with Kabat physical rehabilitation. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  12. [Different stimulation intensities of acupuncture at Hegu (LI 4) for central facial nerve paralysis after ischemic stroke: a randomized controlled trial].

    Science.gov (United States)

    Li, Ling-Xin; Tian, Guang; Meng, Zhi-Hong; Fan, Xiao-Nong; Zhang, Chun-Hong; Shi, Xue-Min

    2014-07-01

    To observe the clinical efficacy of acupuncture at Hegu (LI 4) on central facial nerve paralysis after ischemic stroke, and explore dose-effect relationship among different stimulation intensities of acupuncture at Hegu (LI 4) as well as its optimal treatment plan. According to different acupuncture stimulation intensities which were based on treatment time and needle insertion direction, fifty patients were randomly divided into a Hegu 1 group, a Hegu 2 group, a Hegu 3 group, a Hegu 4 group and a control group, ten cases in each one. Different stimulation intensities of acupuncture at Hegu (LI 4) combined with facial paralysis acupoints, including Yingxiang (LI 20), Dicang (ST 4), Jiache (ST 6) and Quanliao (SI 18), were applied in Hegu 1 to 4 groups; meanwhile acupuncture at stroke acupoints, including Neiguan (PC 6), Shuigou (GV 26) and Sanyinjiao (SP 6), and medication treatment were adopted. Except acupuncture at Hegu (LI 4), the treatment of the control group was identical as Hegu groups. The treatment duration lasted for 14 days. The House-Brackmann facial never grading systems (H-B), Toronto facial grading system (TFGS), degrees of facial never paralysis (DFNP), facial disability index (FDI) and clinical efficacy were compared among groups. (1) Compared before the treatment, H-B, TFGS, DFNP and physical function score in FDI were all improved significantly in the Hegu 1 to 4 groups (all P 0.05); all the scores in the control group were not evidently changed (all P > 0.05). (2) Compared with the control group, differences of H-B before and after treatment in the Hegu 1 to 4 groups, differences of TFGS in the Hegu 2 group and differences of DFNP in the Hegu 1 and Hegu 2 group were significantly improved (all P 0.05), in which the most evident change was found in Hegu 2 group. (3) The total effective rate was 90.0% (9/10), 100.0% (10/10), 90.0% (9/10) and 80.0% (8/10) in Hegu 1 to 4 groups, which were significantly higher than 60.0% (6/10) in the control group

  13. The anatomical research of grafting ring finger radial digital branch of median nerve for repairing injuried deep branch of ulnar nerve defects%正中神经环指桡侧指神经支移植修复尺神经深支缺损的应用解剖

    Institute of Scientific and Technical Information of China (English)

    王斌; 尹佳丽; 董秀芝; 陈超; 韩海生; 李浩

    2011-01-01

    目的 为研究环指桡侧指神经支移植修复尺神经深支缺损提供解剖学基础. 方法 对16例32侧新鲜成人上肢进行观测.在10倍手术显微镜下对腕部尺神经深支、正中神经旋前方肌支和环指桡侧指神经支进行显微解剖及测量. 结果 正中神经旋前方肌支直径为(1.13±0.02)mm,正中神经环指桡侧指神经支直径为(1.17±0.05)mm,对掌肌管出口处尺神经深支直径为(1.75±0.07)mm.显微镜下分离环指桡侧指神经支,对掌肌管出口处尺神经深支至旋前方肌支入肌长度即移植段神经长度为(104.59±20.25)mm. 结论 环指桡侧指神经支移植为带血运的神经移植,属肌支对肌支的吻合,是修复尺神经深支缺损的有效方法.%Objective To provide anatomical basis of neural transplantation to repair deep branch of ulnar nerve defect with the ring finger radial digital branch. Methods Thirty-two sides of 16 cases fresh forearms were dissected and observed.Microdissect and measure the deep branch of ulnar nerve,quadrate pronator of median nerve and it's ring finger radial digital branch under 10-times operating microscope. Results The diameter of quadrate pronator of median nerve was (1.13 ± 0.02)mm,ring finger radial digital branch of median nerve was (1.17 ± 0.05)mm,mid-palmar section of deep branch of ulnar nerve was(1.75± 0.07)mm.Dissect ring finger radial digital branch of median nerve to muscular branch of quadrate pronator under operating microscope,retaining it's blood supply.The length between the deep branch of ulnar nerve and ring finger radial digital branch was( 104.59 ± 20.25)mm.Conclusion ①Solving the problem of nerve grafting without blood supply before,benefit to the survival of the grafting segment and the regeneration of the neuro fiber,and function restoring.②This kind of grafting is the bridging of muscular branch to muscular branch,abide by the principle of neurophysiology.③Neural transplantation to repair deep

  14. A variant extensor indicis muscle and the branching pattern of the deep radial nerve could explain hand functionality and clinical symptoms in the living patient.

    Science.gov (United States)

    Kumka, Myroslava

    2015-03-01

    The purpose of this study is to document the topographic anatomy of an extensor indicis (EI) muscle with a double tendon and the associated distribution of the deep branch of the radial nerve (DBRN). Both EI tendons were positioned deep to the tendons of the extensor digitorum as they traversed the dorsal osseofibrous tunnel. They then joined the medial slips of the extensor expansion of the second and third digits. In all other dissected forearms, a tendon of the EI muscle joined the medial slip of the extensor expansion to the index finger. The DBRN provided short branches to the superficial extensor muscles, long branches to the abductor pollicis longus and extensor pollicis brevis muscles, and terminated as the posterior interosseous nerve. Descending deep to the extensor pollicis longus muscle, the posterior interosseous nerve sent branches to the extensor pollicis brevis and EI muscles. Understanding of the topographic anatomy of an EI with a double tendon, and the associated distribution of the DBRN, may contribute to accurate diagnosis and treatment of hand lesions.

  15. 耳源性面神经麻痹的手术治疗%Surgical treatment in otogenic facial nerve palsy

    Institute of Scientific and Technical Information of China (English)

    冯国栋; 高志强; 翟梦瑶; 吕威; 亓放; 姜鸿; 查洋; 沈鹏

    2008-01-01

    objective To study the character of facial nerve palsy due to four difierent auris diseases including chronic otitis media,Hunt syndrome,tumor and physical or chemical factors,and to discuss the principles of the surgical management of otogenic facial nerve palsy.Methods The clinical charaeters of 24 patients with otogenic facial nerve palsy because of the four different auris diseases were retrospectively analyzed,all the cases were performed surgical management from October 1991 to March 2007.Facial nerve function Was evaluated with House-Brackmann(HB) grading system.Results The 24 patients including 10 males and 14 females were analysised,of whom 12 cases due to cholesteatoma,3 cases due to chronic otitis media,3 cases due to Hunt syndrome,2 cases resulted from acute otitis media,2 cases due to Dhysical or chemical factors and 2 cases due to tumor.All cases were treated with operations included facial nerve decompression,lesion resection with facial nerve decompression and lesion resection without facial nerve decompression,I patient'S facial nerve was resected because of the tumor.According to HB grade system,I degree recovery was attained in 4 cases,while Ⅱ degree in 10 cases,Ⅲ degree in 6 cases,Ⅳ degree in 2 cases,V degree in 2 cases and Ⅵ degree in 1 case.Conclusions Removing the lesions completely Was the basic factor to the surgery of otogenie facial palsy,moreover,it was important to have facial nerve decompression soon after lesion removal.%目的 总结由于中耳炎、Hunt综合征、肿瘤及理化损伤4种常见耳源性疾病导致的面神经麻痹手术治疗的经验,增加对手术治疗耳源性面神经麻痹的认识.方法 回顾性分析1991年10月至2007年3月间由于上述4种耳部疾病导致面神经麻痹的24例患者的临床资料.面神经功能评估采用House-Brackman分级.结果 24例患者中男10例,女14例;年龄14~82岁,平均44.5岁.耳部病变包括:胆脂瘤中耳炎12例(其中合并Hunt综合征1

  16. 肌皮神经的交通支及临床意义%Communicating Branches and Clinical Significance of the Musculocutaneous Nerve

    Institute of Scientific and Technical Information of China (English)

    曹园园; 黄素群

    2013-01-01

      目的:观测肌皮神经的走行及分支,为临床预防及修复肌皮神经损伤提供解剖学基础.方法:对12具成人防腐尸体双上肢进行解剖,观察并测量肌皮神经的起点、长度、分支及交通支.结果:肌皮神经主干长51.15±42.74mm,起始点左右径3.19±1.35mm,前后径1.93±1.21mm,喙突距肌皮神经起点距离为40.82±12.72mm,肌皮神经穿喙肱肌者占91.67%(22侧).观察发现有4侧上肢存在肌皮神经至正中神经的交通支.结论:肌皮神经走行、起点和分支的变异均较大,同时存在交通支,临床应注意这些变异,以在外科手术中预防肌皮神经损伤及在修复过程中选择最佳术式.%Objective:To provide anatomy knowledge for injury of musculocutaneous nerve prevention and transportation by observation of its location and its branches. Methods: The bilateral forearms of 12 adult cadavers were dissected. We determined the origins of musculocutaneous nerve,measured its length and studied its branches and communicating branches as wel1. Results: The musculocutaneous nerve trunk was (51.15±42.74)mm long.The left-right diameter of the nerve origin was(3.19±1.35)mm,and its front-back diameter was(1.93 ± 1.21)mm. It starts at(40.82 ± 12.72)mm from coracoids process. There were 91.67% (22 case) museuloeutaneous nerve though coracobrachialis. 4 case of communicating branches between musculocutaneous nerve and median nerve were observed. Conclusion: There are great variation in musculocutaneous nerve’s origin.It is very important to know these variations,in case of extra damage to musculocutaneous nerve when trying to repair it.

  17. Parotidectomía y vena facial Parotidectomy and facial vein

    Directory of Open Access Journals (Sweden)

    F. Hernández Altemir

    2009-10-01

    Full Text Available La cirugía de los tumores benignos de la parótida, es una cirugía de relaciones con estructuras fundamentalmente nerviosas cuyo daño, representa un gravísimo problema psicosomático por definirlo de una manera genérica. Para ayudar al manejo quirúrgico del nervio facial periférico, es por lo que en el presente artículo tratamos de enfatizar la importancia de la vena facial en la disección y conservación del nervio, precisamente donde su disección suele ser más comprometida, esto es en las ramas más caudales. El trabajo que vamos a desarrollar hay que verlo pues, como un ensalzamiento de las estructuras venosas en el seguimiento y control del nervio facial periférico y de porqué no, el nervio auricular mayor no siempre suficientemente valorado en la cirugía de la parótida al perder protagonismo con el facial.Benign parotid tumor surgery is related to fundamental nervous structures, defined simply: that when damaged cause great psychosomatic problems. In order to make peripheral facial nerve surgery easy to handle for the surgeon this article emphasizes the importance of the facial vein in the dissection and conservation of the nerve. Its dissection can be compromised if the caudal branches are damaged. The study that we develop should be seen as praise for the vein structures in the follow up and control of the peripheral facial nerve, and the main auricular nerve that is often undervalued when it is no longer the protagonist in the face.

  18. [Guiding values of facial nerve 3D-TOF-MRA and 3D-FIESTA scan for primary hemifacial spasm operation].

    Science.gov (United States)

    Wu, Guo-qing; Wang, Lei; Yin, Wei-ning; Liu, Xian-ming; Li, Chuan-feng; Wu, Guo-hong

    2013-12-03

    To explore the operative guiding values of facial nerve three-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) and three-dimensional fast imaging employing steady state acquisition three-dimensional fast imaging employing steady state acquisition (3D-FIESTA) scan. A total of 125 cases of primary hemifacial spasm was treated at our hospital from 2004 to 2012. Among them, 80 cases received preoperative facial nerve MRA scan. The imaging and intraoperative findings were compared to determine the responsible blood vessels. Responsible blood vessels were found in all 80 cases. Sixty patients (75%) had the involvement of single vessel of anterior inferior cerebellar artery (AICA, n = 57), posterior inferior cerebellar artery (PICA, n = 1), superior cerebellar artery (SCA, n = 1) and vertebral artery (VA, n = 1). Two or more vessels were implicated in 9 patients (11.25%). The culprits were AICA+ internal auditory artery (n = 8) and PICA+ internal auditory artery (n = 1). The source of responsible vessels of 11 cases could not be determined before surgery. Through intraoperative anatomy, 59 patients had single vessel lesions, including AICA (n = 53), PICA (n = 4), SCA (n = 1) and VA (n = 1). Among 14 cases of multiple vessels, there were AICA + internal auditory artery (n = 7), internal auditory artery + PICA (n = 2), AICA + brain stem perforating artery (n = 3) and AICA + vein (n = 2). Seven cases were uncertain. No significant statistical difference existed between two groups. Facial nerve 3D-TOF-MRA and 3D-FIESTA scan can identify the status of responsible blood vessels to guide operations.

  19. Anatomy and Clinical Application of Transfer of Pronator Quadratus Muscle Branch of Anterior Interosseous Nerve in Repairing Thrhenar Muscle Branch of Median Nerve and Deep Branch of Ulnar Nerve%骨间前神经旋前方肌支转位修复鱼际肌支和尺神经深支的解剖学观察和临床应用

    Institute of Scientific and Technical Information of China (English)

    李长青; 费起礼

    2001-01-01

    目的:了解有关应用骨间前神经旋前方肌支转位修复正中神经鱼际肌支和尺神经深支的解剖,总结应用此方法的临床效果。方法:观察6具成人上肢标本,测量其旋前方肌支、正中神经鱼际肌支和尺神经深支的横径,以及正中神经鱼际肌支起始处、尺神经深支起始处至旋前方肌上缘的距离。1996年4月~1997年3月,临床应用5例。旋前方肌支转位修复陈旧性尺神经损伤3例,陈旧性正中神经损伤1例,急性正中神经损伤1例,其中3例需游离神经移植。结果:骨间前神经旋前方肌支在旋前方肌上缘处、正中神经鱼际肌支起始处、尺神经深支起始处,神经干横径分别为1.3~1.9、1.5~2.3、1.8~2.3mm。正中神经鱼际肌支起始处、尺神经深支起始处至旋前方肌上缘的距离分别是75.2~84.8 mm、53.5~74.0 mm。临床应用经12~23个月随访,4例手内在肌功能恢复M3~M4级,1例未见恢复。结论:骨间前神经旋前方肌支转位修复正中神经鱼际肌支和尺神经深支可达到肌支-肌支修复的设想,缩短再生距离和时间,有利于手内在肌的功能恢复。%Objective:To introduce the anatoamy and clinical application of transfer of the pronator quadratus muscle(PQ)branch of anterior interosseous nerve(AIN)in repairing thenar muscle branch of median nerve (MN) and deep branch of ulnar nerve (UN). Methods: The nerve stem diameter of PQ branch of AIN, thenar muscle branch of MN, and deep branch of the UN,as well as distance between the upper margin of PQ and the origin of thenar muscle branch and deep branch of UN were measured in 6 adult forearm specimens respectively. The surgical procedures were performed in 5 cases from April 1996 to March 1997, which included 3 cases of old injury of ulnar nerve,and 1 case of old and 1 case of fresh injury of median nerve.Nerve graft was used in 3 cases. Results:The nerve stem diameter of PQ

  20. Neurovascular free-muscle transfer for the treatment of established facial paralysis following ablative surgery in the parotid region.

    Science.gov (United States)

    Takushima, Akihiko; Harii, Kiyonori; Asato, Hirotaka; Ueda, Kazuki; Yamada, Atsushi

    2004-05-01

    to the primary recipient branches. A soft-tissue flap was transferred simultaneously with the latissimus muscle segment in three patients. Contraction of grafted muscle was not observed in two patients with gracilis transfer and in three patients with latissimus dorsi transfer. In one patient with gracilis transfer and one patient with latissimus dorsi transfer, acquired muscle contraction was excessive, resulting in unnatural smile animation. The recipient nerves for both of these patients were the ipsilateral facial nerve stumps, which were dissected by opening the facial nerve canal in the mastoid process. From the standpoint of operative technique, the one-stage transfer for latissimus dorsi muscle appears superior. Namely, a combined soft-tissue flap can provide sufficient augmentation for depression of the parotid region following wide resection. A long vascular stalk of thoracodorsal vessels is also useful for anastomosis, with recipient vessels available after extensive ablation and neck dissection.

  1. Clinical investigation on 22 cases of acoustic neuromas with intraoperative facial nerve function monitoring%听神经瘤术中面神经功能监测22例临床研究

    Institute of Scientific and Technical Information of China (English)

    贺宇波; 吉宏明; 赵建伟; 陈胜利; 张刚利; 李荔荣

    2011-01-01

    目的 探讨术中面神经监测对术后面神经功能保留的影响.方法 使用英国牛津公司Medelec神经生理术中监测仪,对22例听神经瘤术中进行面神经自发面肌电图及电刺激诱发面肌电图监测.结果 通过术中监测自发肌电图结合电刺激诱发肌电图可以精确判断面神经的位置;本组22例大中型听神经瘤,术后6月面神经H-B分级Ⅰ-Ⅱ级13例,Ⅲ级2例,Ⅳ级1例,Ⅴ级1例,Ⅵ级5例.结论 术中肌电图监测可以提示面神经的位置和走行,为手术时避免损伤神经提供依据;肿瘤切除后可帮助确认面神经结构是否完整;全切肿瘤后引出肌电图的最小电刺激强度与面神经预后密切相关.%Objective To explore the influence of intraoperative monitoring on postoperative facial nerve function in acoustic neuroma patients. Methods The facial nerve spontaneous and stimulated electromyography( EMG ) of 22 cases of acoustic neuromas were monitored by Oxford company Medelec intraoperative neurophysiologic monitor. Results The position of facial nerve was correctly located via intraoperative monitoring spontaneous EMG combined with stimulated EMG. According to House-Brackmann facial nerve grading system,the facial nerve was grade I - II in 13 of 22 cases after operation for 6 months,grade Ⅲ in 2 cases,grade Ⅳ in one case,grade Vin one case,and grade VI in 5 cases. Conclusion Intraoprative electromyography( EMG ) could reveal the position of facial nerve and avoid the nerve injury. EMG could help confirm the integrity of the postoperative facial nerve. The minimal stimulated intensity which can derive EMG is related with the prognosis of facial nerve function after total resection of the tumor.

  2. Outcomes of facial nerve reservation during acoustic neuroma surgery under neural electrophysiological monitoring%神经电生理监测在听神经瘤切除术中保留面神经的效果

    Institute of Scientific and Technical Information of China (English)

    张旸; 徐海涛; 许媛; 陆小明; 刘宁; 鲁艾林

    2015-01-01

    Objective To summarize the outcomes of facial nerve reservation during acoustic neuroma surgery under neural electrophysiological monitoring .Methods Acoustic neuroma resection under microscope was performed via suboccipital retrosigmoid approach in 161 patients .Intraoperative continuous monitoring of evoked potential of the facial nerve was carried out during operation .The facial nerve function was valuated during and after surgery .Results The results of facial nerve function after surgery in 101 cases were consistent with those monitored during operation with an accordance rate of 62.7% .Conclusion The anatomy and facial nerve reservation during acoustic neuroma resection can be improved by intraoperative continuous monitoring of evoked potential of the facial nerve .Some interference factors need to be eliminated in order to improve the accuracy of intraoperative neurophysiological monitoring .%目的:总结电生理监测对听神经瘤术中保留面神经的效果。方法听神经瘤患者161例,采用经枕下乙状窦后入路,显微镜下实施听神经瘤切除术。术中采用神经电生理技术监测面神经诱发电位;术中和术后评估面神经功能。结果术后面神经功能评估结果与术中神经电生理监测结果一致率为62.7%(101/161)。结论神经电生理监测技术应用于听神经瘤显微外科手术可提高面神经解剖和神经功能保留效果;但同时应排除干扰因素,提高电生理监测的准确性。

  3. Organ-specific activation of the gastric branch of the efferent vagus nerve by ghrelin in urethane-anesthetized rats.

    Science.gov (United States)

    Habara, Hiromi; Hayashi, Yujiro; Inomata, Norio; Niijima, Akira; Kangawa, Kenji

    2014-01-01

    Ghrelin plays multiple physiological roles such as growth hormone secretion and exerting orexigenic actions; however, its physiological roles in the electrical activity of autonomic nerves remain unclear. Here, we investigated the effects of human ghrelin on several autonomic nerve activities in urethane-anesthetized rats using an electrophysiological method. Intravenous injection of ghrelin at 3 μg/kg significantly and transiently potentiated the efferent activity of the gastric vagus nerve; however, it did not affect the efferent activity of the hepatic vagus nerve. The activated response to ghrelin in the gastric efferent vagus nerve was not affected by the gastric afferent vagotomy, suggesting that this effect was not induced via the gastric afferent vagus nerve. Ghrelin did not affect the efferent activity of the brown adipose tissue, adrenal gland sympathetic nerve, and the renal sympathetic nerve. In addition, rectal temperature and the plasma concentrations of norepinephrine, corticosterone, and renin were also not changed by ghrelin. These findings demonstrate that ghrelin stimulates the gastric efferent vagus nerve in an organ-specific manner without affecting the gastric afferent vagus nerve and that ghrelin does not acutely affect the efferent basal activity of the sympathetic nerve in rats.

  4. Clinical Analysis of Mouse Nerve Growth Factor in the Treatment of Facial Neuritis%鼠神经生长因子治疗面神经炎临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    黄开梅; 刘兵; 赵中

    2015-01-01

    通过探讨鼠神经生长因子在面神经炎患者中的临床疗效,从而得出鼠神经生长因子治疗面神经炎的临床疗效显著,值得推广使用。%Through the discussion of mouse nerve growth factor in patients with facial paralysis clinical curative ef ect,which mouse nerve growth factor treat are obtained,the clinical curative ef ect of healing facial paralysis,worthy of promotion of use.

  5. The ability to identify the intraparotid facial nerve for locating parotid gland lesions in comparison to other indirect landmark methods: evaluation by 3.0 T MR imaging with surface coils

    Energy Technology Data Exchange (ETDEWEB)

    Ishibashi, Mana; Fujii, Shinya; Nishihara, Keisuke; Matsusue, Eiji; Kodani, Kazuhiko; Kaminou, Toshio; Ogawa, Toshihide [Tottori University, Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori (Japan); Kawamoto, Katsuyuki [Tottori University, Division of Otolaryngology, Head and Neck Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori (Japan)

    2010-11-15

    It is important to know whether a parotid gland lesion is in the superficial or deep lobe for preoperative planning. We aimed to investigate the ability of 3.0 T magnetic resonance (MR) imaging with surface coils to identify the intraparotid facial nerve and locate parotid gland lesions, in comparison to other indirect landmark methods. We retrospectively evaluated 50 consecutive patients with primary parotid gland lesions. The position of the facial nerve was determined by tracing the nerve in the stylomastoid foramen and then following it on sequential MR sections through the parotid gland. The retromandibular vein and the facial nerve line (FN line) were also identified. For each radiologist and each method, we determined the diagnostic ability for deep lobe lesions and superficial lobe lesions, as well as accuracy. These abilities were compared among the three methods using the Chi-square test with Yates' correction. Mean diagnostic ability for deep lobe lesions, the diagnostic ability for superficial lobe lesions, and accuracy were 92%, 86%, 87%, respectively, for the direct identification method; 67%, 89%, 86%, respectively, for the retromandibular vein method; and 25%, 99%, 90%, respectively, for the FN line method. The direct identification method had significantly higher diagnostic ability for deep lesions than the FN line method (P < 0.01), but significantly lower diagnostic ability for superficial lobe lesions than the FN line method (P < 0.01). Direct identification of the intraparotid facial nerve enables parotid gland lesions to be correctly located, particularly those in the deep lobes. (orig.)

  6. 面神经损伤模型中的半胱氨酸天冬氨酸蛋白酶相关蛋白表达与损伤相关性%Correlation between caspase regulatory gene expression and facial nerve injury in a facial nerve injury model

    Institute of Scientific and Technical Information of China (English)

    魏海刚; 李蜀光; 陈玉婷; 蔡超雄; 许彪

    2014-01-01

    背景:半胱氨酸天冬氨酸蛋白酶在细胞凋亡中发挥着关键作用,但不同形式面神经损伤对半胱氨酸天冬氨酸蛋白酶3和8和cyto-c蛋白表达的影响及其相互关系,目前尚不清楚。  目的:构建大鼠面神经压榨伤及低位切断伤模型,观察面运动神经元的形态学改变和死亡相关基因半胱氨酸天冬氨酸蛋白酶3和8及cyto-c的表达变化并分析其相关性。  方法:制作大鼠右侧面神经的压榨伤和低位切断伤模型,左侧为正常对照侧。用甲苯胺蓝染色及透射电镜观测面运动神经元形态学变化及其死亡情况,免疫组织化学法检测切断伤及压榨伤后半胱氨酸天冬氨酸蛋白酶3和8及cyto-c的表达变化。  结果与结论:面神经切断伤及压榨伤均可引起面运动神经元死亡,死亡形式以凋亡为主。半胱氨酸天冬氨酸蛋白酶3、8,cyto-c蛋白表达阳性神经元分布于正常面神经核各亚核,切断伤组损伤侧细胞染色重于压榨伤组。损伤后3 d时各蛋白表达开始增强,半胱氨酸天冬氨酸蛋白酶3、8表达于伤后14 d而cyto-c则于伤后7 d时达到高峰。相关性分析结果显示:损伤后半胱氨酸天冬氨酸蛋白酶3、8和cyto-c蛋白表达变化与面神经损伤形式、损伤时间有关,半胱氨酸天冬氨酸蛋白酶8、cyto-c表达与半胱氨酸天冬氨酸蛋白酶3表达相关。提示:半胱氨酸天冬氨酸蛋白酶8,cyto-c可能参与了激活半胱氨酸天冬氨酸蛋白酶3的过程。半胱氨酸天冬氨酸蛋白酶级联反应在面运动神经元凋亡过程中有重要作用。%BACKGROUND:Caspase plays a crucial role in the cellapoptosis, but the influence of different facial nerve injury on caspase 1, caspase 8, cyto-c protein expression and their correlation stil remain unclear. OBJECTIVE:To construct facial nerve crush or distal transection injury models, observe the morphological changes of

  7. MR volumetry of the trigeminal nerve in patients with unilateral facial pain; MR-Volumetrie des N. trigeminus bei Patienten mit einseitigen Gesichtsschmerzen

    Energy Technology Data Exchange (ETDEWEB)

    Kress, B.; Fiebach, J.; Sartor, K.; Stippich, C. [Abt. Neuroradiologie, Neurologische Klinik, Universitaetsklinikum Heidelberg (Germany); Rasche, D.; Tronnier, V. [Neurochirurgische Klinik, Universitaetsklinikum Heidelberg (Germany)

    2004-05-01

    Purpose: to assess whether MRI can detect atrophy of the trigeminal nerve in patients with trigeminal neuralgia. Materials and methods: a prospective MRI study was conducted in 39 patients (trigeminal neuralgia, trigeminal neuropathy, or atypical facial pain) and 25 volunteers. Using a coronal orientation (T1 flash 3D; T2 CISS 3D), regions of interest were delineated in the cisternal part of the trigeminal nerve along the border of the nerve to calculate the volume of the nerve. The volume of the nerve was compared side-by-side in each patient (t-test, p < 0.05) and the volume difference compared between patients and volunteers. Results: the volume of the compromised trigeminal nerve in patients with trigeminal neuralgia was lower than on the contralateral healthy side, with the difference between healthy and compromised side statistically significant (p < 0.05). In all other patients and in all volunteers, no significant difference was found between the volume of the healthy and compromised nerve. The volume difference between the healthy and compromised side in patients with trigeminal neuralgia was significantly higher (p < 0.05) than in all other patients and volunteers. Conclusion: atrophy of the trigeminal nerve caused by a nerve-vessel conflict can be detected by MRI. Only patients with trigeminal neuralgia show this unilateral atrophy. Therefore, it is possible to demonstrate the result of the nerve-vessel conflict and to determine the consequences of such a conflict. (orig.) [German] Ziel: Die Studie wurde mit der Frage durchgefuehrt, ob die bei Patienten mit Trigeminusneuralgie durch einen Gefaess-Nerven-Konflikt bedingte Atrophie des Nervs magnetresonanztomographisch darstellbar ist. Methodik: 39 Patienten (Trigeminusneuralgie, Trigeminusneuropathie, atypischer Gesichtsschmerz) und 25 Probanden wurden prospektiv magnetresonanztomographisch untersucht. In koronaren T1- und T2-Gradientenechosequenzen wurde der zisternale Abschnitt des N. trigeminus mittels

  8. Nerve canals at the fundus of the internal auditory canal on high-resolution temporal bone CT

    Energy Technology Data Exchange (ETDEWEB)

    Ji, Yoon Ha; Youn, Eun Kyung; Kim, Seung Chul [Sungkyunkwan Univ., School of Medicine, Seoul (Korea, Republic of)

    2001-12-01

    To identify and evaluate the normal anatomy of nerve canals in the fundus of the internal auditory canal which can be visualized on high-resolution temporal bone CT. We retrospectively reviewed high-resolution (1 mm thickness and interval contiguous scan) temporal bone CT images of 253 ears in 150 patients who had not suffered trauma or undergone surgery. Those with a history of uncomplicated inflammatory disease were included, but those with symptoms of vertigo, sensorineural hearing loss, or facial nerve palsy were excluded. Three radiologists determined the detectability and location of canals for the labyrinthine segment of the facial, superior vestibular and cochlear nerve, and the saccular branch and posterior ampullary nerve of the inferior vestibular nerve. Five bony canals in the fundus of the internal auditory canal were identified as nerve canals. Four canals were identified on axial CT images in 100% of cases; the so-called singular canal was identified in only 68%. On coronal CT images, canals for the labyrinthine segment of the facial and superior vestibular nerve were seen in 100% of cases, but those for the cochlear nerve, the saccular branch of the inferior vestibular nerve, and the singular canal were seen in 90.1%, 87.4% and 78% of cases, respectiveIy. In all detectable cases, the canal for the labyrinthine segment of the facial nerve was revealed as one which traversed anterolateralIy, from the anterosuperior portion of the fundus of the internal auditory canal. The canal for the cochlear nerve was located just below that for the labyrinthine segment of the facial nerve, while that canal for the superior vestibular nerve was seen at the posterior aspect of these two canals. The canal for the saccular branch of the inferior vestibular nerve was located just below the canal for the superior vestibular nerve, and that for the posterior ampullary nerve, the so-called singular canal, ran laterally or posteolateralIy from the posteroinferior aspect of

  9. Clinical and experimental study on facial paralysis in temporal bone fracture

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To study the main prognostic factors and significanceof facial nerve decompression for facial paralysis in temporal bone fracture.Methods: The main relative prognostic factors of 64 patients with facial paralysis were analyzed. An experimental model of facial paralysis was made. The expansion rates of facial nerve in the facial canal opening group and the facial canal non-opening group were measured and observed under electron microscope.Results: The main factors affecting the prognosis were facial nerve decompression and selection of surgery time. The expansion rate of facial nerve in the facial canal opening group was significantly higher than that of the facial canal non-opening group (t=7.53, P<0.01). The injury degree of the nerve fiber in the facial canal non-opening group was severe.Conclusions: Early facial nerve decompression is beneficial to restoration of the facial nerve function.

  10. ESTUDIO ANATÓMICO DE LA RAMA SUPERFICIAL DEL NERVIO RADIAL. IMPLICACIONES QUIRÚRGICAS Superficial branch of radial nerve: an anatomical study and its surgical implications

    Directory of Open Access Journals (Sweden)

    Enrique Vergara-Amador

    2010-07-01

    Full Text Available Antecedentes. Conocer la anatomía de la rama superficial del nervio radial, es indispensable para la adecuada práctica de cirugías que involucran la mano y la muñeca. Objetivo. Determinar las relaciones del nervio radial y sus ramas con el tubérculo de Lister, la apófisis estiloides del radio y la distribución en el dorso de la mano. Material y métodos. Se disecaron 25 piezas de cadáveres frescos. Se identificó la rama superficial del nervio radial y se midió la distancia entre la salida del nervio y la apófisis estiloides del radio. Se identificaron las ramas del nervio en el antebrazo distal y en la muñeca y se midieron respecto a la apófisis estiloides y al tubérculo de Lister. Resultados. La rama superficial del nervio radial emergió en la región dorsal y radial del tercio distal del antebrazo entre el músculo braquiradialis y el extensor carpis radialis longus, a una distancia de 8,45 cm proximal a la apófisis estiloides. Su primera rama de división discurrió palmar a la apófisis estiloides radial a una distancia promedio de 0,74 cm respecto a la misma. El tronco principal se dividió en varias ramas terminales así: proximal a la apófisis estiloides del radio (28%, a nivel de la misma (12% y distal (60%. El patrón de distribución de las ramas nerviosas en la base de los dedos más frecuente fue el del primero, segundo y el lado radial del tercer dedo (56%. Discusión. Este estudio mostró la gran variabilidad de la rama superficial del nervio radial en el dorso de la mano y la alta probabilidad de daño del mismo durante los procedimientos abiertos, artroscópicos o procedimientos percutáneos en la muñeca.Background. The anatomy of the superficial branch of radial nerve is essential for the proper practice of surgery involving the hand and wrist. Objetive. Determine relationship between the superficial radial nerve and his branches with the radial styloid process level, Lister’s tubercle and the distribution of

  11. The effective stimulating pulse for restoration of blink function in unilateral facial nerve paralysis rabbits, verified by a simple FES system.

    Science.gov (United States)

    Jie, Tan; Zhiqiang, Gao; Guodong, Feng; Yubin, Xue; Xiuyong, Ding; Tingting, Cui; Yang, Zhao

    2016-10-01

    The trains of 200 ms biphasic square pulses with the width of 9 ms delivered at 50 Hz were found to be the most suitable and effective mean as stimulation in FES system of restoring the blink function in unilateral facial nerve paralysis rabbit model. FES system is a reliable tool for these patients. Facial paralysis affects thousands of people every year. Many will have long term facial difficulties and the loss of the ability to blink the eye, which can lead to potential loss of the eye. Although many treatments exist, no one approach corrects all the deficits associated with the loss of orbicularis oculi function. FES is a means of providing movement in paralysed muscles to assist with practical activities and one possible way of restoring blink and other functions in these patients. Although some previous researches had investigated the effect of simple FES system on restoration of paralyzed facial muscles, there is still controversy about the appropriate details of the most effective stimulating pulses, such as the frequency, wave pattern and pulse width. Our aim is to find out the parameters of the most appropriate and effective stimulatin verify it by a simple FES system. 24 healthy adult male New Zealand white rabbits were accepted the surgery of right side facial nerve main trunk transaction under general anesthesia as the unilateral facial nerve paralysis models. The platinum tungsten alloy electrodes were implanted in orbicularis oculi muscle. The parameters of stimulus pulses were set to a 200 ms biphasic pulse with different waveforms (square, sine and triangle), different frequencies (25, 50, 100 Hz) and different widths from 1 to 9 ms. Next, we set up a simple FES system to verify the previous results as the stimulus signal. We observed the movement of the both sides of eyelid when eye blink induced by different kinds of pulses. In all animals, the three kinds of waveforms pulse with frequency of 25 Hz could not evoke the smooth blink movement

  12. Two different repair methods of comparison of effect of facial nerve anastomosis.%两种不同修复方法对面神经吻合术效果的比较

    Institute of Scientific and Technical Information of China (English)

    杨俊勋; 莫裕惠; 何静

    2013-01-01

    Objective: To explore two different facial nerve anastomosis repairing method for clinical treatment; to obtain the better repair method. Method: a collection of nearly 12 years of facial nerve injury amputation 14 cases (male 12 female 2 cases) , were randomly divided into two groups, one group in nerve anastomosis after anastomotic nerve membrane fixed to the surrounding tissue; another group of nerve anastomosis with autogenous vein a set after fixed to the surrounding tissues. Result: nerve anastomosis with an autogenous vein sleeve joint effects were significantly better in nerve anastomosis without autologous venous vascular sheathing. Conclusion: the facial nerve trauma amputation using nerve anastomosis with an autogenous vein sleeve joint program, can achieve good clinical curative effect.%目的:探讨两种不同修复方法对离断伤的面神经吻合的临床修复效果.方法:收集近12年来面神经断离伤病例14例(男12例女2例),随机分两组,对照组在神经端端吻合后将吻合口处神经外膜固定于周围组织上;观察组在神经端端吻合后将神经吻合口用自体静脉血管一段套接后固定于周围组织上.结果:观察组的神经修复的效果明显好于对照组.结论:对于面神经外伤性断离采用神经吻合口用一段自体静脉血管套接的手术方案,可以取得良好的临床疗效.

  13. The Lesser Palatine Nerve Innervates the Levator Veli Palatini Muscle

    Science.gov (United States)

    Matsuura, Yoshitaka; Kawai, Katsuya; Yamada, Shigehito; Suzuki, Shigehiko

    2016-01-01

    Summary: When the lesser palatine nerve (LPN) is supposed to be a branch of the trigeminal nerve and innervate sensation of the soft palate, whether the LPN contains motor fibers is unclear. In this study, we monitored the electromyogram of the levator veli palatini (LVP) muscle on stimulating the LPN during palatoplasty in 3 patients. The electromyogram of the muscles showed the myogenic potential induced by electrostimulation of the LPN. Taken together with the finding from our previous anatomical study that the motor fibers come from the facial nerve, this result supports the double innervation theory of the LVP, which posits that both the pharyngeal plexus and the facial nerve innervate it. Identifying and preserving the LPN during palatoplasty might improve postoperative speech results. PMID:27757354

  14. Maxillary nerve compression in cynomolgus monkey Macaca fascicularis: altered somatic sensation and peripheral nerve firing

    Directory of Open Access Journals (Sweden)

    Guo Ning

    2012-12-01

    Full Text Available Abstract Background Trigeminal nerve is a major source of the sensory input of the face, and trigeminal neuropathology models have been reported in rodents with injury to branches of the maxillary or mandibular division of the trigeminal nerve. Non-human primates are neuroanatomically more closely related to human than rodents; however, nerve injury studies in non-human primates are limited. Results We describe here a nerve injury model of maxillary nerve compression (MNC in the cynomolgus macaque monkey, Macaca fascicularis, and the initial characterization of the consequences of damage to this trigeminal nerve branch. The nerve injury from the compression appeared to be mild, as we did not observe overt changes in home-cage behavior in the monkeys. When mechanical stimulation was applied to the facial area, monkeys with MNC displayed increased mechanical sensitivity, as the avoidance response scores were lower than those from the control animals. Such a change in mechanical sensitivity appeared to be somewhat bilateral, as the contralateral side also showed increased mechanical sensitivity, although the change on the ipsilateral side was more robust. Multiple-unit recording of the maxillary nerve showed a general pattern of increasing responsiveness to escalating force in mechanical stimulation on the contralateral side. Ipsilateral side of the maxillary nerve showed a lack of responsiveness to escalating force in mechanical stimulation, possibly reflecting a maximum stimulation threshold effect from sensitized nerve due to MNC injury. Conclusions These results suggest that MNC may produce increased sensitivity of the ipsilateral maxillary nerve, and that this model may serve as a non-human primate model to evaluate the effect of injury to trigeminal nerve branches.

  15. 面神经鼓乳段定位及术中面瘫预防%Location of tympanic segment and mastoid segment of facial nerve and prevention of prosopoplegia in operations

    Institute of Scientific and Technical Information of China (English)

    朱富高; 孙美红; 张俊瑶; 孙大为; 姜彦

    2011-01-01

    Objective:To study the location of facial nerve and prevent facial nerve injury in middle ear surgery according to dissection of temporal bone and experience of middle ear surgery.Method: Thirty sides of temporal bones were exposed tympanic and mastoid segment of facial nerve with facial nerve decompression.The course of facial nerve was located by the markers of middle ear.Result: Tympanic segment of facial nerve passed between horizontal semicircular canal and stapes,then superior and anterior to the cochleariform process.Mastoid segment of facial nerve located in posterior wall of tympanic cavity.The mastoid segment of facial nerve travelled below the level of horizontal semicircular canal and annulus membranae tympani, and the extension line of its posterior margin and posterior-one-third of horizontal semicircular canal intersected to form an included angle(117.04±2.42)°,.External genu of facial nerve located anterior and inferior to the horizontal semicircular canal.The shortest distance was(1.97±0.53) mm between middle point of horizontal semicircular canal and facial nerve, (1.03±0.29)mm between incus short process and facial nerve, (0.93 ± 0.25)mm between cochleariform process and facial nerve, (1.18±0.42)mm between head of stapes and facial nerve, (3.08±0.28)mm between tympani sulcus and facial nerve at the vestibule window level, and (2.13±0.34)mm between tympani sulcus and facial nerve at round window level,respectively.Conclusion: Horizontal semicircular canal carina, incus short process, stapes, annulus membranae tympani and cochleariform process are ideal landmarks of tympanic and mastoid segment of facial nerve, which are helpful in middle ear surgery.%目的:根据颞骨解剖结合中耳手术体会,探讨面神经走行定位,避免中耳手术中面神经损伤.方法:用30侧颞骨标本,模拟面神经减压术的手术步骤暴露面神经鼓乳段,确定面神经走行,用易见且恒定的标志进行面神经定位.结果:面神

  16. 腮腺及面神经急性损伤的急诊治疗体会%Treatment Experience for Acute Injuries of Parotid Gland and Facial Nerve

    Institute of Scientific and Technical Information of China (English)

    郝冬月; 刘超华; 何林; 孙峰; 宋保强; 夏文森

    2014-01-01

    Objective To explore the diagnosis and treatment for acute injuries of parotid and facial nerve. Methods From June 2012 to June 2013, 21 cases with parotid and facial nerve injury were performed actively emergency treatment. After sufficient preoperative preparation, the parotid gland and facial nerves were actively treated. Injury in parotid gland, parotid duct, or facial nerve were differently treated. Parotid gland ruptures were repaired instantly, and the parotid duct and facial nerve were anastomosed instantly. Results 93% of the patients with parotid gland and parotid duct injury were completely healed, while the other 7% cases had parotid gland fistula. All of the 7% patients were cured after giving anticholinergics and pressure dressing. 66% of the patients with facial nerve injury were completely cured, the other 24%cases were partly cured, and remained 10% cases were not cured. Conclusion Strict examination should be given to the patients with acute injuries of parotid gland and facial nerve, then the diagnosis and treatment could be given instantly.%目的:探讨腮腺及面神经急性损伤的诊断和治疗。方法2012年6月至2013年6月,对21例腮腺及面神经急性损伤患者进行急诊处理。充分术前准备后,针对腮腺、腮腺导管、面神经主干及各分支损伤,采取不同判断方法,即时行破裂修补及吻合术。术后随访并统计疗效。结果93%腮腺破裂及导管断裂的患者完全治愈,7%患者出现腮腺漏,经换药、抑制腺体分泌药物和加压包扎等治疗后康复;66%面神经吻合的患者基本恢复,24%的患者部分恢复,10%的患者未恢复。结论应对腮腺及面神经急性创伤进行严格检查,并对腮腺及面神经急性损伤进行及时诊断和治疗。

  17. 多层螺旋CT扫描及曲面重建在外伤性面瘫的应用价值%Applied Value of Multislice Spiral CT and Curved PlanarReformation for Traumatic Facial Nerve Paralysis

    Institute of Scientific and Technical Information of China (English)

    黄少鹏; 叶青; 林美福; 陈娟; 王一红; 李瑞玉

    2011-01-01

    目的 探讨多层螺旋CT(MSCT)扫描及面神经管曲面重建(CPR)在外伤性面瘫中的应用价值.方法 对15例外伤性面瘫患者的颞骨行MSCT高分辨率扫描,并通过工作站行CPR,观察面神经损伤平面,并选择相应的手术径路行面神经减压术.结果 术前MSCT扫描及CPR提示,3例面神经损伤主要在迷路段及膝状神经节的,采用颅中窝乳突联合径路;12例损伤主要位于膝状神经节以下,选择乳突径路.术中所见与术前CT提示均一致.术后随访6月~5年,15例患者Ⅰ级恢复7例、Ⅱ级恢复7例、Ⅲ级恢复1例.结论 MSCT扫描及CPR能清晰显示面神经管的全貌及其损伤部位,对外伤性面瘫的诊断及手术治疗具有重要意义.%Objective To investigate the applied value of multislice spiral CT(MSCT) and Curved planar reformation(CPR) for traumatic facial nerve paralysis and the guidance significance for surgery.Methods 15 cases of traumatic facial nerve paralysis were scanned by MSCT, Post processing images of facial nerve canal were completed by GE Advantage 4.2 work station. Different Surgical approaches of facial nerve decompression were selected according to the injured location described by MSCT and CPR.Results A combined middle fossa and transmastoid approach was chosen in 3 cases whose injured location above geniculate ganglion. A pure transmastoid route was performed in the other 12 cases whose injured location under geniculate ganglion. After 0.5-5 years' follow-up, 7 cases recovered to grade Ⅰ according to House-Brackmann facial nerve function scores, 7 cases recovered to grade Ⅱ and the other 1 case recovered to grade Ⅲ. Conclusion multislice spiral CT (MSCT) and Curved planar reformation (CPR)could help to study the facial nerve canal and describe precise localization for traumatic facial nerve paralysis, which provide reliable basis for clinical diagnosis and treatment.

  18. Precise orientation of brachialis muscle branch in the spinal nerve roots in rats%大鼠肱肌肌支的脊髓神经根定位

    Institute of Scientific and Technical Information of China (English)

    周文俊; 张成钢; 胡韶楠; 朱艺; 徐建光

    2008-01-01

    Objective To compare the efficacy of retrograde tracing and electrophysiologic localization in precise orientation of brachialis muscle branch in the spinal nerve roots in a rat model, and discuss the feasibility of electrophysiological orientation of brachialis muscle branch of the musculocutaneous nerve in human. Methods Adult Sprague Dawley rats were used. Retrograde tracing of brachialis muscle branch or brachialis muscle in various combinations of nerve root transection-preservation was done. Compound muscle action potentials of brachialis muscle were recorded while various roots of the brachial plexus were stimulated. Results Brachialis muscle in rat received dual innervation from the musculocutaneous nerve and radial nerve. The former was mainly from C5 and C6 spinal nerve roots and the latter from C7 spinal nerve root. The results of retrograde tracing agreed with the results of electrophysiologic testing. Conclusion Both retrograde tracing and electrophysiologic testing could be used in precise localization of spinal nerve root origin of forelimb muscles. Electrophysiological studies could be employed in precise orientation of brachialis and its motor branches in human.%目的 比较逆行示踪法及肌电图检测法在定位肱肌肌支及肱肌脊髓神经根起源中的价值,并探讨将肌电图检测法运用于定位人类肌皮神经肱肌肌支脊髓神经根起源的可能性.方法 在大鼠臂丛神经根切断-保留模型中运用神经元逆行示踪法定位肱肌肌支及肱肌的脊髓神经根起源;通过分析刺激大鼠各臂丛神经根时肱肌记录到的CMAP指标定位肱肌肌支及肱肌的脊髓神经根起源.结果 大鼠桡神经肱肌肌支的运动纤维主要来源于C7神经根,大鼠肌皮神经肱肌肌支的运动纤维主要来源于C5、6神经根;在定位大鼠肱肌的脊髓神经根起源时,肌电图法与逆行示踪法的检测结果基本一致.结论 通过分析逆行示踪和肌电图检测的结果,

  19. Contemporary facial reanimation.

    Science.gov (United States)

    Bhama, Prabhat K; Hadlock, Tessa A

    2014-04-01

    The facial nerve is the most commonly paralyzed nerve in the human body. Facial paralysis affects aesthetic appearance, and it has a profound effect on function and quality of life. Management of patients with facial paralysis requires a multidisciplinary approach, including otolaryngologists, plastic surgeons, ophthalmologists, and physical therapists. Regardless of etiology, patients with facial paralysis should be evaluated systematically, with initial efforts focused upon establishing proper diagnosis. Management should proceed with attention to facial zones, including the brow and periocular region, the midface and oral commissure, the lower lip and chin, and the neck. To effectively compare contemporary facial reanimation strategies, it is essential to employ objective intake assessment methods, and standard reassessment schemas during the entire management period.

  20. [Electrophysiological monitoring of cranial motor nerves (V, VII, IX, X, XI, XII)].

    Science.gov (United States)

    Lefaucheur, J-P; Neves, D O; Vial, C

    2009-04-01

    In various neurosurgical operations, there is a risk of cranial nerve lesion that can be avoided or minimized with intraoperative electrophysiological monitoring. Regarding motor function of the cranial nerves, stimulodetection techniques are used, including electrical stimulation of nerve trunks and electromyographic recording of evoked motor responses. These techniques can be used for monitoring the trigeminal nerve (Vth cranial nerve), facial nerve (VIIth), glossopharyngeal nerve (IXth), pneumogastric nerve (Xth), spinal accessory nerve (XIth), and hypoglossal nerve (XIIth), in particular during surgical removal of tumors of the cerebellopontine angle or skull base. When beginning an operation, electrical stimulation is only used to identify the nerve structures. As removal of the tumor progresses, the goal is to verify that a surgical injury to the nerve is avoided by looking for the absence of any change regarding amplitude, morphology, and latency of motor responses. Intraoperative electromyographic monitoring can also be applied during the surgical treatment of primary hemifacial spasm by microvascular decompression. An effective decompression is usually associated with the disappearance of "lateral spread" motor responses to facial nerve branch stimulation. Therefore, the intraoperative disappearance of the lateral spread responses can be considered a predictive factor of good postoperative clinical outcome, even if this assertion remains a matter of debate.

  1. Anatomia dos ramos linguais do nervo hipoglosso em Sus scrofa domesticus, L., 1758 = Anatomy of the lingual branches of the hypoglossal nerve in Sus scrofa domesticus, L., 1758

    Directory of Open Access Journals (Sweden)

    Patrícia Marques Fortes

    2009-01-01

    Full Text Available Estudamos as ramificações e distribuição do nervo hipoglosso após estepenetrar na raiz da língua (36 antímeros de suínos (Sus scrofa domesticus, L. 1758 adultos de ambos os sexos abatidos em frigorífico (região metropolitana de Goiânia, Estado de Goiás -Brasil. O material foi resfriado para transporte (4ºC, fixado em solução aquosa de formaldeído (7% por 72h, imerso em solução aquosa de ácido nítrico (15% por 72h, dissecado sob lupa (RASOR, II-20. Nos antímeros, observou-se o tronco e ramos nervosos primários, secundários e terciários (método de BITTENCOURT et al., 1987. Seguimos a topográfica do nervo, a partir da região retro mandibular, entre as estruturas miofaciais do milohioideo e hipoglosso. Na raiz da língua, o nervo cruza a artéria lingual, passando a sermedial em relação a esta. Subdivide-se em três ordens de grandeza em direção ao músculo longitudinal superior, como segue: antímero esquerdo, quatro a 13 ramos primários, quatro a 21 ramos secundários e zero a 16 ramos terciários; no antímero direito, oito a 18 ramosprimários, três a 13 ramos secundários e zero a 12 ramos terciários. Em 27,59% dos antímeros analisados, os ramos do nervo hipoglosso estabeleceram junções com fibras do nervo lingual do antímero correspondente.We studied the ramifications and distribution of the hypoglossalnerve after it penetrated the root of the tongue (36 antimeres of adult swine (Sus scrofa domesticus, L. 1758 from both sexes slaughtered in a slaughterhouse (metropolitan region of Goiânia, Goiás State - Brazil. The material was chilled for transportation (4°C; placed in aqueous solution of formaldehyde (7% for 72 hours; submerged in aqueous solution of nitric acid (15% for 72 hours; dissected under magnifying glass (RASOR, II-20. The torso and the primary, secondary and tertiary nervous branches were observed in the antimeres (method of BITTENCOURT et al., 1987. We followed the topography of the nerve

  2. Chapter 23: Manual stimulation of target muscles has different impact on functional recovery after injury of pure motor or mixed nerves.

    Science.gov (United States)

    Sinis, Nektarios; Manoli, Thodora; Werdin, Frank; Kraus, Armin; Schaller, Hans E; Guntinas-Lichius, Orlando; Grosheva, Maria; Irintchev, Andrey; Skouras, Emanouil; Dunlop, Sarah; Angelov, Doychin N

    2009-01-01

    Direct coaptation and interpositional nerve grafting (IPNG) of an injured peripheral nerve is still associated with poor functional recovery. Main reasons for that are thought to be an extensive collateral axonal branching at the site of transection and the polyinnervation of motor endplates due to terminal axonal and intramuscular sprouting. Moreover, severe changes occurring within the muscle after long-term denervation, like loss of muscle bulk and circulation as well as progressive fibrosis, have a negative effect on the quality of functional recovery after reinnervation. We have recently shown that manual stimulation (MS) of paralyzed vibrissal muscles in rat promotes full recovery after facial nerve coaptation. Furthermore, MS improved functional recovery after hypoglossal nerve repair, hypoglossal-facial IPNG of the facial nerve in rat. In contrary, MS did not improve recovery after injury of the median nerve in rat, which is however a mixed peripheral nerve comparing to the facial nerve. It is speculated that manually stimulated recovery of motor function requires an intact sensory input, which is affected in case of mixed peripheral nerves but not in case of pure motor nerves. In this article, we summarize our results of MS in several peripheral nerve injury models in order to illustrate the application potential of this method and to give insights into further investigations on that field.

  3. Bilateral conjugacy of movement initiation is retained at the eye but not at the mouth following long-term unilateral facial nerve palsy.

    Science.gov (United States)

    Coulson, Susan E; O'Dwyer, Nicholas J; Adams, Roger D; Croxson, Glen R

    2006-08-01

    Voluntary eyelid closure and smiling were studied in 11 normal subjects and 11 patients with long-term unilateral facial nerve palsy (FNP). The conjugacy of eyelid movements shown previously for blinks was maintained for voluntary eye closures in normal subjects, with movement onset being synchronous in both eyes. Bilateral onset synchrony of the sides of the mouth was also observed in smiling movements in normal subjects. In FNP patients, initiation of movement of the paretic and non-paretic eyelids was also synchronous, but markedly delayed relative to normal (by 136 ms = 32%). The initiation of bilateral movements at the mouth was similarly delayed, but in contrast to the eyes, it was not synchronous. Central neural processing in the FNP subjects was normal, however, since unilateral movements at the mouth were not delayed. The delays therefore point to considerable additional information processing needed for initiating bilateral facial movements after FNP. The maintenance of bilateral onset synchrony in eyelid closure and its loss in smiling following FNP is an important difference in the neural control of these facial regions. Bilateral conjugacy of eyelid movements is probably crucial for coordinating visual input and was achieved apparently without conscious effort on the part of the patients. Bilateral conjugacy of movements at the sides of the mouth may be less critical for normal function, although patients would very much like to achieve it in order to improve the appearance of their smile. Since the everyday frequency of eyelid movements is considerably greater than that of smiling, it is possible that the preserved eyelid conjugacy in these patients with long-term FNP is merely a product of greater experience. However, if synchrony of movement onset is found to be preserved in patients with acute FNP, then it would suggest that eyelid conjugacy has a privileged status in the neural organisation of the face.

  4. ANASTOMOSIS ENTRE LA RAMA PROFUNDA DEL NERVIO CUBITAL Y EL NERVIO MEDIANO EN LA MANO. Anastomosis between the deep branch of the ulnar nerve and the median nerve in the hand

    Directory of Open Access Journals (Sweden)

    Luis E Criado del Río

    2016-03-01

    Full Text Available Introducción: La anastomosis de Riche-Cannieu (ARC es una variación anatómica formada entre la rama tenar del nervio mediano (NM y la rama profunda del nervio cubital (NC. Debido a la importancia clínica y electromiográfica su descripción anatómica es de gran interés, ya que debido a esta variación anatómica existen distintas formas de inervación motora a nivel de la mano. Materiales y Métodos: Se realizaron disecciones cadavéricas en 38 manos (19 cadáveres de ambos sexos formolizados en solución al 5 %, de entre 50 y 70 años de edad. Se utilizó instrumental y técnicas convencionales de disección. Resultados: En la rama profunda del NC no se evidenciaron variaciones y finalizaba su recorrido en el músculo aductor del pulgar. En el 86,84%  de los casos emerge una rama que se anastomosa con el NM de diferentes formas. Esta rama anastomótica, en el 50% de las manos, era una arcada nerviosa de considerable calibre entre el NC y NM, que daba ramas motoras a los músculos de la eminencia tenar. Discusión: El conocimiento de esta anastomosis es muy importante ya que, en casos de lesión del nervio mediano o cubital, puede causar confusión clínica, quirúrgica y en los hallazgos electromiográficos. Debido a su alta frecuencia fue considerada un rasgo anatómico normal. Introduction: The Riche-Cannieu anastomosis (RCA is an anatomic variation formed between the thenar branch of the median nerve and the deep branch of the ulnar nerve. Its anatomical description is of great interest because of its clinical and electromyographic relevance. Due to the RCA, there are various types of hand motor innervation. Materials and Methods: Thirty eight hands from 19 corpses (formolized in a 5% solution whose ages ranged from 50 to 70 years old were dissected. Conventional instruments and techn-iques were used. Results: The pathway of the deep branch of the ulnar nerve did not show variations and ended at the adductor pollicis muscle. In 86

  5. The Topography and Differentiation of Facial Nerve in Middle Ear Surgery%中耳炎手术中面神经定位和辨认的临床研究

    Institute of Scientific and Technical Information of China (English)

    赵东; 郭龙梅; 徐平

    2012-01-01

    Objective To investigate the topography and differentiation of the facial nerves in the middle car surgery. Methods From January 2008 to December 2010, radical mastoidectomy or tympanoplasty was administered in 185 patients with chronic otitis media and choicstcatoma otitis media, and analyzed the exploration of the surgery. Results 58 cases of exposed facial nerves were identified and the topography of the tympanic segments in facial nerve was located as the cochlcariform, odontoid, and proccssus brcvis incudis. 33 cochlcariform process disappeared, 25 odontoid process damaged, and 19 proccssus brcvis damaged or displatcd. 12 cochlcariform process and 14 digastric ridge damaged; chorda tympani nerve also could locate the facial nerves and 33 variations were noted. The relationship between facial nerves and granulation tissues indicated that there were 78 cases of the granulation tissue covering the surface of the nerve, 47 cases of the granulation tissue enclosing the nerve and 24 cases of the granulation tissue came from the facial nerve itself. Conclusion We can reduce and prevent the occurrence of facial nerve injuries by being familiar with the practices and variations of facial nerves within the normal temporal bones, and become skilled in basic operations%目的 探讨中耳炎手术中面神经的定位和辨认.方法 回顾性分析2008年1月~2010年12月185例行开放式乳突根治术或加鼓室成形术的慢性化脓性中耳炎及胆脂瘤中耳炎患者的手术资料,对术中面神经探查定位及辨认方法进行分析总结.结果 ①185例中,面神经探查发现58例面神经裸露;②面神经鼓室段定位标志为匙突、齿突、砧骨短突,185例中33例匙突消失,25例齿突遭到破坏,19例砧骨短突破坏或移位;乳突段定位标志为水平半规管、二腹肌脊,185例中12例水平半规管遭破坏,14例二腹肌脊被破坏;33例鼓索神经变异;③面神经与肉芽组织的关系为肉

  6. Facial Grading System: Physical and Psychological Impairments to Be Considered

    Institute of Scientific and Technical Information of China (English)

    ZHAI Meng-yao; FENG Guo-dong; GAO Zhi-qiang

    2008-01-01

    In the past half century, more than twenty facial grading systems have been developed to assess the facial nerve function after the onset of facial nerve paralysis and during rehabilitation. Patients' selfevaluation on disability caused by facial paralysis and its impact on quality of life are also useful information in planning treatment strategies and defining outcomes.

  7. Anesthesia mumps resulting in temporary facial nerve paralysis after the auditory brainstem implantation in a 3-year-old child.

    Science.gov (United States)

    Özdek, Ali; Bayır, Ömer; Işık, Murat Eray; Tatar, Emel Çadallı; Saylam, Güleser; Korkmaz, Hakan

    2014-01-01

    An acute transient sialadenitis of the major salivary glands in the early postoperative period is called 'anesthesia mumps'. It has been reported in different surgical procedures especially in neurosurgical procedures. Anesthesia mumps develops very fast after the extubation period but it usually regresses with no sequelae within a few hours. However, sometimes serious complication can occur such as respiratory distress. In this report, we present a 3-year-old girl with an anesthesia mumps and facial palsy occurring after successful auditory brainstem implantation and we discuss the cause and the management of this rare complication in this report.

  8. Hepatic branch vagus nerve plays a critical role in the recovery of post-ischemic glucose intolerance and mediates a neuroprotective effect by hypothalamic orexin-A.

    Science.gov (United States)

    Harada, Shinichi; Yamazaki, Yui; Koda, Shuichi; Tokuyama, Shogo

    2014-01-01

    Orexin-A (a neuropeptide in the hypothalamus) plays an important role in many physiological functions, including the regulation of glucose metabolism. We have previously found that the development of post-ischemic glucose intolerance is one of the triggers of ischemic neuronal damage, which is suppressed by hypothalamic orexin-A. Other reports have shown that the communication system between brain and peripheral tissues through the autonomic nervous system (sympathetic, parasympathetic and vagus nerve) is important for maintaining glucose and energy metabolism. The aim of this study was to determine the involvement of the hepatic vagus nerve on hypothalamic orexin-A-mediated suppression of post-ischemic glucose intolerance development and ischemic neuronal damage. Male ddY mice were subjected to middle cerebral artery occlusion (MCAO) for 2 h. Intrahypothalamic orexin-A (5 pmol/mouse) administration significantly suppressed the development of post-ischemic glucose intolerance and neuronal damage on day 1 and 3, respectively after MCAO. MCAO-induced decrease of hepatic insulin receptors and increase of hepatic gluconeogenic enzymes on day 1 after was reversed to control levels by orexin-A. This effect was reversed by intramedullary administration of the orexin-1 receptor antagonist, SB334867, or hepatic vagotomy. In the medulla oblongata, orexin-A induced the co-localization of cholin acetyltransferase (cholinergic neuronal marker used for the vagus nerve) with orexin-1 receptor and c-Fos (activated neural cells marker). These results suggest that the hepatic branch vagus nerve projecting from the medulla oblongata plays an important role in the recovery of post-ischemic glucose intolerance and mediates a neuroprotective effect by hypothalamic orexin-A.

  9. Hepatic branch vagus nerve plays a critical role in the recovery of post-ischemic glucose intolerance and mediates a neuroprotective effect by hypothalamic orexin-A.

    Directory of Open Access Journals (Sweden)

    Shinichi Harada

    Full Text Available Orexin-A (a neuropeptide in the hypothalamus plays an important role in many physiological functions, including the regulation of glucose metabolism. We have previously found that the development of post-ischemic glucose intolerance is one of the triggers of ischemic neuronal damage, which is suppressed by hypothalamic orexin-A. Other reports have shown that the communication system between brain and peripheral tissues through the autonomic nervous system (sympathetic, parasympathetic and vagus nerve is important for maintaining glucose and energy metabolism. The aim of this study was to determine the involvement of the hepatic vagus nerve on hypothalamic orexin-A-mediated suppression of post-ischemic glucose intolerance development and ischemic neuronal damage. Male ddY mice were subjected to middle cerebral artery occlusion (MCAO for 2 h. Intrahypothalamic orexin-A (5 pmol/mouse administration significantly suppressed the development of post-ischemic glucose intolerance and neuronal damage on day 1 and 3, respectively after MCAO. MCAO-induced decrease of hepatic insulin receptors and increase of hepatic gluconeogenic enzymes on day 1 after was reversed to control levels by orexin-A. This effect was reversed by intramedullary administration of the orexin-1 receptor antagonist, SB334867, or hepatic vagotomy. In the medulla oblongata, orexin-A induced the co-localization of cholin acetyltransferase (cholinergic neuronal marker used for the vagus nerve with orexin-1 receptor and c-Fos (activated neural cells marker. These results suggest that the hepatic branch vagus nerve projecting from the medulla oblongata plays an important role in the recovery of post-ischemic glucose intolerance and mediates a neuroprotective effect by hypothalamic orexin-A.

  10. A patient with bilateral facial palsy associated with hypertension and chickenpox: learning points.

    Science.gov (United States)

    Al-Abadi, Eslam; Milford, David V; Smith, Martin

    2010-11-26

    Bilateral facial nerve paralysis is an uncommon presentation and even more so in children. There are reports of different causes of bilateral facial nerve palsy. It is well-established that hypertension and chickenpox causes unilateral facial paralysis and the importance of checking the blood pressure in children with facial nerve paralysis cannot be stressed enough. The authors report a boy with bilateral facial nerve paralysis in association with hypertension and having recently recovered from chickenpox. The authors review aspects of bilateral facial nerve paralysis as well as hypertension and chickenpox causing facial nerve paralysis.

  11. Dissection and Exposure of the Whole Course of Deep Nerves in Human Head Specimens after Decalcification

    Directory of Open Access Journals (Sweden)

    Longping Liu

    2012-01-01

    Full Text Available The whole course of the chorda tympani nerve, nerve of pterygoid canal, and facial nerves and their relationships with surrounding structures are complex. After reviewing the literature, it was found that details of the whole course of these deep nerves are rarely reported and specimens displaying these nerves are rarely seen in the dissecting room, anatomical museum, or atlases. Dissections were performed on 16 decalcified human head specimens, exposing the chorda tympani and the nerve connection between the geniculate and pterygopalatine ganglia. Measurements of nerve lengths, branching distances, and ganglia size were taken. The chorda tympani is a very fine nerve (0.44 mm in diameter within the tympanic cavity and approximately 54 mm in length. The mean length of the facial nerve from opening of internal acoustic meatus to stylomastoid foramen was 52.5 mm. The mean length of the greater petrosal nerve was 26.1 mm and nerve of the pterygoid canal was 15.1 mm.

  12. 保留迷走神经腹腔支胃癌根治术的临床研究%Clinical Study of Abdominal Nerve Branch of Vagus Nerve-Preserving Radical Gastrectomy

    Institute of Scientific and Technical Information of China (English)

    胡英斌; 江勃年; 唐自元; 付忠平; 谢江波

    2011-01-01

    目的 探讨保留迷走神经腹腔支胃癌根治术的临床应用价值.方法 128例胃癌病例随机分为两组,各64例,分别实行保留迷走神经腹腔支胃癌根治术(观察组)和传统胃癌根治术(对照组),并进行胃肠动力学和胃肠激素分泌水平的对比.结果 观察组在术后首次排气时间、首次排便时间优于对照组(P0.05).观察组血清胃泌素和基础胃酸分泌量明显低于对照组(P=0.001或P0.05).结论 保留迷走神经腹腔支的胃癌根治术能加快病人胃肠道功能的恢复和更好的营养吸收.%Objective To explore the clinical value of celiac branch of vagus nerve-preserving radical gastrectomy. Methods A total of 128 gastric cancer patients were randomly divided into observation group ( n =64) receiving celiac branch of vagus nerve-preserving radical gastrectomy and control group ( n =64) receiving traditional classic radical resection. The two groups were compared gastro-intestinal dynamics and hormone levels. Results The first exhaust time and the first bowel movement were better in the observation group than the control group (P <0.05), while the number of lymph node dissection had no significant difference (P >0. 05).The basis levels of observed serum gastrin and gastric acid secretion were significantly lower in the observation group than those in the control group ( P < 0. 05 ). There was no significant difference of the fasting serum insulin levels (P >0.05). The fasting plasma pancreatic polypeptide levels was significantly higher in the observation group than thecontrolgroup(P<0.05). Conclusion Abdominal vagus nerve branch retention of the radical surgery for gastric cancer patients can accelerate the recovery of gastrointestinal function and get better nutrient absorption.

  13. Herpes Zoster with Post Herpetic Neuralgia Involving the Right Maxillary Branch of Trigeminal Nerve: A Case Report and Review of Literature

    Science.gov (United States)

    Subramanian, Kailasam; Sankari, S Leena; Potluri, Venkata Lakshmi Aparna; Prabakaran, Akila

    2017-01-01

    Herpes Zoster (HZ) is an acute, self-limiting, neuro cutaneous viral infection caused by the reactivation of the Varicella Zoster Virus (VZV) that remains latent in the dorsal root ganglion. About 50% of occurrence is seen in older age groups and immunocompromised patients. Less than 5% occur in children. HZ is characterized by the unilateral pain, burning and tingling sensation followed by the vesicular eruptions limited to the single dermatome that are innervated by the single cranial ganglion, sometimes it leads to Post Herpetic Neuralgia (PHN). We report a case of a HZ in a 22-year-old young female patient involving the right maxillary branch of the trigeminal nerve along with PHN. PMID:28274075

  14. Early and reliable detection of herpes simplex virus type 1 and varicella zoster virus DNAs in oral fluid of patients with idiopathic peripheral facial nerve palsy: Decision support regarding antiviral treatment?

    Science.gov (United States)

    Lackner, Andreas; Kessler, Harald H; Walch, Christian; Quasthoff, Stefan; Raggam, Reinhard B

    2010-09-01

    Idiopathic peripheral facial nerve palsy has been associated with the reactivation of herpes simplex virus type 1 (HSV-1) or varicella zoster virus (VZV). In recent studies, detection rates were found to vary strongly which may be caused by the use of different oral fluid collection devices in combination with molecular assays lacking standardization. In this single-center pilot study, liquid phase-based and absorption-based oral fluid collection was compared. Samples were collected with both systems from 10 patients with acute idiopathic peripheral facial nerve palsy, 10 with herpes labialis or with Ramsay Hunt syndrome, and 10 healthy controls. Commercially available IVD/CE-labeled molecular assays based on fully automated DNA extraction and real-time PCR were employed. With the liquid phase-based oral fluid collection system, three patients with idiopathic peripheral facial nerve palsy tested positive for HSV-1 DNA and another two tested positive for VZV DNA. All patients with herpes labialis tested positive for HSV-1 DNA and all patients with Ramsay Hunt syndrome tested positive for VZV DNA. With the absorption-based oral fluid collection system, detections rates and viral loads were found to be significantly lower when compared to those obtained with the liquid phase-based collection system. Collection of oral fluid with a liquid phase-based system and the use of automated and standardized molecular methods allow early and reliable detection of HSV-1 and VZV DNAs in patients with acute idiopathic peripheral facial nerve palsy and may provide a valuable decision support regarding start of antiviral treatment at the first clinical visit.

  15. 低频脉冲电诊断在面神经麻痹评定中的应用价值%The application value of low frequency pulse electrodiagnosis in the assessment of facial nerve paralysis

    Institute of Scientific and Technical Information of China (English)

    陈银海; 李萌; 张慧; 何井华

    2014-01-01

    Objective To explore the value and significance of low frequency pulse electrodiagnosis to assess facial nerve paralysis.Method Neuromuscular electrical diagnostic instrument was used to detect curves of time intensity for frontalis muscle,orbicularis oculi muscle,orbicularis oris muscle in 50 cases of facial nerve paralysis,150 curves in all.Results In 50 cases of facial nerve paralysis,there were 7 normal patients,31 cases of part degeneration,12 cases of complete degeneration,with the positive rate of 86%.Among 150 curves of time intensity,there were 2l normal curves,96 curves of part degeneration,33 curves of complete degeneration,with the positive rate of 86%.Conclusion It has a certain value and significance of low frequency pulse electrodiagnosis for facial nerve paralysis evaluation.%目的 探讨低频脉冲电诊断对面神经麻痹评定的价值和意义.方法 采用神经肌肉电诊断仪对50例面神经麻痹患者进行强度时间检测,分别检测额肌、眼轮匝肌、口轮匝肌共150条曲线.结果 50例患者,正常7例,部分变性31例,完全变性12例,阳性率为86%; 150条曲线中,正常曲线21条,部分变性曲线96条,完全变性曲线33条,曲线的阳性率为86%.结论 低频脉冲电诊断对面神经麻痹的评定具有一定的价值和意义.

  16. Acute facial palsy in children--a 2-year follow-up study with focus on Lyme neuroborreliosis.

    Science.gov (United States)

    Skogman, B Hedin; Croner, S; Odkvist, L

    2003-06-01

    Acute facial palsy in children is believed to be a rather benign neurological condition. Follow-up-studies are sparse, especially including a thorough otoneurological re-examination. The aim of this study was to examine children with a history of facial palsy in order to register the incidence of complete recovery and the severity and nature of sequelae. We also wanted to investigate whether there was a correlation between sequelae and Lyme Borreliosis, treatment or other health problems. Twenty-seven children with a history of facial palsy were included. A re-examination was performed by an Ear-Nose-Throat (ENT) specialist 1-2.9 years (median 2) after the acute facial palsy. The otoneurological examination included grading the three branches of the facial nerve with the House-Brackman score, otomicroscopy and investigation with Frenzel glasses. A paediatrician interviewed the families. Medical files were analysed. The incidence of complete recovery was 78% at the 2-year follow-up. In six out of 27 children (22%), the facial nerve function was mildly or moderately impaired. Four children reported problems with tear secretion and pronunciation. There was no correlation between sequelae after the facial palsy and gender, age, related symptoms, Lyme neuroborreliosis (NB), treatment, other health problems or performance. One fifth of children with an acute facial palsy get a permanent dysfunction of the facial nerve. Other neurological symptoms or health problems do not accompany the sequelae of the facial palsy. Lyme NB or treatment seems to have no correlation to clinical outcome. Factors of importance for complete recovery after an acute facial palsy are still not known.

  17. Overview of the Cranial Nerves

    Science.gov (United States)

    ... they were damaged. Cranial nerve disorders can affect smell, taste, vision, sensation in the face, facial expression, ... Cranial Nerve Number Name Function Test 1st Olfactory Smell The ability to smell is tested by asking ...

  18. Correlation between the elbow flexion and the hand and wrist flexion after neurotization of the fascicles of the ulnar nerve to the motor branch to the biceps

    Directory of Open Access Journals (Sweden)

    Ricardo Boso Escudero

    Full Text Available ABSTRACT OBJECTIVE: Gain in elbow flexion in patients with brachial plexus injury is extremely important. The transfer of a fascicle from the ulnar nerve to the motor branch of the musculocutaneous nerve (Oberlin surgery is a treatment option. However, in some patients, gain in elbow flexion is associated with wrist and finger flexion. This study aimed to assess the frequency of this association and the functional behavior of the limb. METHODS: Case-control study of 18 patients who underwent the Oberlin surgery. Group 1 included patients without disassociation of range of elbow flexion and that of the fingers and wrist; Group 2 included patients in whom this disassociation was present. In the functional evaluation, the Sollerman and DASH tests were used. RESULTS: It was observed that 38.89% of the patients did not present disassociation of elbow flexion with flexion of the wrist and fingers. Despite the existence of a favorable difference in the group with disassociation of the movement, when the Sollerman protocol was applied to the comparison between both groups, this difference was not statistically significant. With the DASH test, however, there was a statistically significant difference in favor of the group of patients who managed to disassociate the movement. CONCLUSION: The association of elbow flexion with flexion of the wrist and fingers, in the group studied, was shown to be a frequent event, which influenced the functional result of the affected limb.

  19. A Contemporary Approach to Facial Reanimation.

    Science.gov (United States)

    Jowett, Nate; Hadlock, Tessa A

    2015-01-01

    The management of acute facial nerve insult may entail medical therapy, surgical exploration, decompression, or repair depending on the etiology. When recovery is not complete, facial mimetic function lies on a spectrum ranging from flaccid paralysis to hyperkinesis resulting in facial immobility. Through systematic assessment of the face at rest and with movement, one may tailor the management to the particular pattern of dysfunction. Interventions for long-standing facial palsy include physical therapy, injectables, and surgical reanimation procedures. The goal of the management is to restore facial balance and movement. This article summarizes a contemporary approach to the management of facial nerve insults.

  20. Early-onset severe neuromatous pain of the infrapatellar branch of the saphenous nerve after total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Kanto Nagai

    2014-07-01

    Full Text Available While performing total knee arthroplasty (TKA using a standard midline skin incision, the transection of the infrapatellar branch of the saphenous nerve (ISN or its terminal branches is relatively common. This usually causes an area of numbness in the distribution of the ISN, but rarely results in painful neuroma. Usually, the progress of neuromatous pain is relatively slow and the degree of the pain is not so severe, but in our present case the progress of neuromatous pain was rapid and severe, and therefore, the patient could not be discharged from our hospital after TKA. To our knowledge, there has been no previous report demonstrating early-onset neuromatous knee pain after TKA in the English literature. We present a rare case in which early-onset severe neuromatous pain was encountered after TKA and partial denervation of the ISN was effective. Neuromatous knee pain can occur shortly after TKA, and, in these cases, surgeons should consider partial denervation for patients who have intractable neuromatous pain before functional loss occurs.

  1. Assessment of denervation in facial nerve function evaluation%失神经支配程度测试对判断面神经功能的价值

    Institute of Scientific and Technical Information of China (English)

    柳斌; 魏宏权; 任重

    2004-01-01

    BACKGROUND: Nerve excitability test(NET) is used to assess the degree of denervation, whose role in relation to the pathological changes of the facial nerve in the functional. recovery of the damaged facial nerve has not been fully understood.OBJECTIVE: To study the impact of the degree of the facial nerve denerration on the functional recovery of the facial nerve.DESIGN: Clinical cross-sectional study and non-randomized uncontrolled experiment with animal models.SETTING and PARTICIPANTS: Thirty volunteers with no history of facial paralysis(FP) from the Department of Otorhinolaryngology, the First Affiliated Hospital of China Medical University, were enrolled in the clinical study, including 17 male and 13 female normal subjects aged from 15 to 60 years old. Also included 190 FP patients from the same department with no history of FP, no use of hormone or physical therapy, consisting of 108 male and 82 female patients aged from 15 to 67 years old. The animal experiment was conducted using 40 guinea pigs of either sex(with body mass between 550 - 900 g) provided by the Department of Experimental Animals of China Medical University.INTERVENTIONS: The difference in the threshold of bilateral facial nerve excitability was examined in the normal subjects using the apparatus for NET. The degree of facial nerve denervation of FP patients was also measured. In guinea pig model of intratemporal FP, the reaction thresholds of the facial nerve action potential before and after compression of the nerve were tested by using evoked electromyography and the time for functional recovery of the facial muscle was recorded by means of blink reflex. Transmission electron microscopy was employed for obiserving the pathological changes of the facial nerve of the guinea pigs.MAIN OUTCOME MEASURES: In the clinical study, the excitability threshold of the facial nerve and the days for clinical cure in patients with facial nerve denervation were recorded. In the animal experiment, the

  2. Automatic Assessment of Facial Nerve Function Based on Infrared Thermal Imaging%红外热成像辅助面神经功能自动评估方法研究

    Institute of Scientific and Technical Information of China (English)

    刘旭龙; 付斌瑞; 许沥文; 鲁宁; 于长永; 柏禄一

    2016-01-01

    面瘫是一种多发的面神经疾病,表现为患侧面神经功能失调,严重影响患者的正常生活和人际交往。面神经功能自动评估方法对于面瘫的诊治是至关重要的。面部神经功能受损导致体表温度分布发生改变,可以通过红外热成像采集患者的面部温度分布不对称特征,基于红外热成像提出一种面神经功能自动评估新方法,融合温度特异性和边缘检测自动将面部红外热像划分为左右对称的八个区域,提取面部温度不对称特征,包括温差、有效热面积比和温度分布不对称度,采用径向基神经网络作为面神经功能自动分类器。实验收录了390幅单侧患病的面瘫患者正面红外热像图,结果显示:采用径向基神经网络的红外热成像面神经功能自动分类器的平均分类准确率为94.10%,比采用K近邻分类器和支持向量机分类器分别提高了9.31%和4.87%,优于传统的 House-Brackmann面神经功能评估方法,对面神经功能的分类精度完全符合临床应用标准,可以有效评估面瘫患者的面神经功能,有助于面瘫的临床诊断与治疗。%Facial paralysis which is mainly caused by facial nerve dysfunction is a common clinical entity.It seriously devastates a patient's daily life and interpersonal relationships.A method of automatic assessment of facial nerve function is of critical im-portance for the diagnosis and treatment of facial paralysis.The contralateral asymmetry of facial temperature distribution is one of the newly symptoms of facial paralysis patients which can be captured by infrared thermography.This paper presents a novel framework for obj ective measurement of facial paralysis based on the automatic analysis of infrared thermal image.Facial infrared thermal image is automatically divided into eight regional areas based on facial temperature distribution specificity and edge detec-tion,the facial temperature

  3. Clinical analysis of the facial nerve paralysis after the temporal bone fracture with the craniocerebral trauma%颅脑外伤伴颞骨骨折合并周围性面瘫15例

    Institute of Scientific and Technical Information of China (English)

    姜岚; 秦兆冰

    2009-01-01

    Objective To disscuse the management of facial nerve paralysis after the temporal bone fracture with the craniocerebral trauma.Methods The study design was a retrospective review of fifteen patients who underwent facial nerve paralysis after the temporal bone fracture with the craniocere-bral trauma.They all received the treatment of the neurosurgery.Results The follow up period was ran-ging from 2 months to 4 years.Two patients showed Ⅰ score of House-Brackmann recovery of facial nerve function in follow-up,eleven patients showed Ⅱ score and the last 2 showed Ⅲ score.Conclusions For the patients who underwent facial nerve paralysis after the temporal bone fracture with the craniocere-bral trauma,late facial nerve decompression may have still beneficial effects.%目的 探讨严重颅脑外伤患者的面瘫治疗时机、手术方法 及治疗效果.方法 回顾性分析2004年12月至2008年2月在我院治疗的颅脑外伤伴颞骨骨折合并周围性面瘫的病例15例,均经神经外科治疗后至我科进一步治疗周围性面瘫,进行术前评估、术中对照及术后随访的对比.结果 进行全面专科检查并综合患者全身情况,选择合适术式行面神经减压,术后随访2个月~4年,面神经功能恢复至I级2例,Ⅱ级11例,Ⅲ级2例.结论 对于颅脑外伤伴颞骨骨折合并周围性面瘫的患者,颅脑外伤急诊处理且生命体征平稳后,全面术前评估,积极进行面神经手术减压仍不失为积极有效的治疗措施.

  4. Facial palsy after blunt trauma and without facial bone fracture.

    Science.gov (United States)

    Coltro, Pedro Soler; Goldenberg, Dov Charles; Aldunate, Johnny Leandro Conduta Borda; Alessi, Mariana Sisto; Chang, Alexandre Jin Bok Audi; Alonso, Nivaldo; Ferreira, Marcus Castro

    2010-07-01

    A 14-year-old patient had a low-energy facial blunt trauma that evolved to right facial paralysis caused by parotid hematoma with parotid salivary gland lesion. Computed tomography and angiography demonstrated intraparotid collection without pseudoaneurysm and without radiologic signs of fracture in the face. The patient was treated with serial punctures for hematoma deflation, resolving with regression and complete remission of facial paralysis, with no late sequela. The authors discuss the relationship between facial nerve traumatic injuries associated or not with the presence of facial fractures, emphasizing the importance of early recognition and appropriate treatment of such cases.

  5. 不同病因的周围性面神经麻痹外科治疗分析%Surgical treatment to facial nerve paralysis of different pathogeny

    Institute of Scientific and Technical Information of China (English)

    伊海金; 刘丕楠; 郭泓; 王春红; 倪富强

    2011-01-01

    Objective:To evaluate the surgical treatment to facial nerve paralysis of different pathogeny. Method: Thirty-seven patients were reviewed, including Bell's Palsy(5 patients), temporal bone fracture ( 20 patients),media otitis(cholesteatoma) (4 patients), facial neuroma and cranio-maxilly-facial operation trauma(8 patients). All the patients were treated by different surgical methods according different pathogeny. Result: The mean percentage facial function improvement (House-Brackmann Grade Ⅰ - Ⅱ )was 80% to Bell's Palsy and temporal bone fracture,100% to media otitis(cholesteatoma). Facial function of three patients improved from House-Brackmann Grade Ⅳ to Ⅲ,two patients had no obvious improvement about facial neuroma; three patients improved from Grade Ⅴ to Ⅲ ,one improved to Ⅳ about cranio-maxilly-facial operation trauma. Conclusion:Patients of facial nerve paralysis got better curative effect if treated by proper surgical therapy according different pathogeny.%目的:探讨不同病因的周围性面神经麻痹患者外科治疗的相关问题.方法:面神经麻痹患者37例,病因包括:贝尔面瘫5例,颞骨骨折20例,中耳乳突炎4例,内耳道面神经肿瘤3例,颅脑颌面手术损伤5例,针对不同病因采取相应外科治疗方式.结果:H-B分级Ⅰ~Ⅱ级恢复率:贝尔面瘫80%,颞骨骨折80%,中耳乳突炎100%;内耳道面神经肿瘤术后1例由Ⅳ级改善至Ⅲ级,2例术后无明显变化;颅脑颌面手术损伤行面-舌吻合者4例由Ⅴ级改善至Ⅲ级3例,Ⅳ级1例,行瘢痕切除+面神经探查减压术者1例由Ⅴ级改善至Ⅳ级.结论:针对不同病因导致的面神经麻痹,选择合适的手术治疗方法,可以取得良好效果.

  6. Neurovascularized free short head of the biceps femoris muscle transfer for one-stage reanimation of facial paralysis.

    Science.gov (United States)

    Hayashi, Akiteru; Maruyama, Yu

    2005-02-01

    The single-stage technique for cross-face reanimation of the paralyzed face without nerve graft is an improvement over the two-stage procedure because it results in early reinnervation of the transferred muscle and shortens the period of rehabilitation. On the basis of an anatomic investigation, the short head of the biceps femoris muscle with attached lateral intermuscular septum of the thigh was identified as a new candidate for microneurovascular free muscle transfer. The authors performed one-stage transfer of the short head of the biceps femoris muscle with a long motor nerve for reanimation of established facial paralysis in seven patients. The dominant nutrient vessels of the short head were the profunda perforators (second or third) in six patients and the direct branches from the popliteal vessels in one patient. The recipient vessels were the facial vessels in all cases. The length of the motor nerve of the short head ranged from 10 to 16 cm, and it was sutured directly to several zygomatic and buccal branches of the contralateral facial nerve in six patients. One patient required an interpositional nerve graft of 3 cm to reach the suitable facial nerve branches on the intact side. The period required for initial voluntary movement of the transferred muscles ranged from 4 to 10 months after the procedures. The period of postoperative follow-up ranged from 5 to 42 months. Transfer of the vascularized innervated short head of the biceps femoris muscle is thought to be an alternative for one-stage reconstruction of the paralyzed face because of the reliable vascular anatomy of the muscle and because it allows two teams to operate together without the need to reposition the patient. The nerve to the short head of the biceps femoris enters the side opposite the vascular pedicle of the muscle belly, and this unique relationship between the vascular pedicle and the motor nerve is anatomically suitable for one-stage reconstruction of the paralyzed face. As much

  7. 缝合神经的指固有动脉背支血管链皮瓣修复指远端皮肤缺损%Repair of fingertip defect with proper digital artery lateral cutaneous branch-chain flap accompanied with dorsal digital nerve or dorsal branch of proper digital nerve coaptation

    Institute of Scientific and Technical Information of China (English)

    孙涛; 魏鹏; 周丹亚; 胡瑞斌; 滕晓峰; 陈宏

    2011-01-01

    Objective To explore the effect of using proper digital artery lateral cutaneous branch-chain flap with dorsal digital nerves or dorsal branch of proper digital nerye for repairing of fingertip defect.Methods From December 2008 to November 2009, 24 cases (26 digits) of fingertip defect were treated with proper digital artery lateral cutaneous branch-chain flap.The flap was designed on the lateral side of the proximal phalanx of the injured finger with its long axis running on the lateral midline of the finger.The vascular pedicle was 0.8 to 1.0 cm wide.The pivot point was at the distal 1/3 of the middle phalanx upon which the flap was reversed to repair the defect of the fingertip.The dorsal digital nerve or dorsal branch of proper digital nerve was included in the flap and coapted with the nerve in the wound to reconstruct sensation of the injured finger.Results All 26 flaps survived.Postoperative follow-up period was 6 to 8 months.All these flaps recovered with satisfying and quality, excellent sensation with 4 to 8 mm two-point discrimination.ROM of the interphalangeal joint of the injured finger was good.Conclusion Proper digital artery lateral cutaneous branchchain flap transfer with nerve coaptation is an ideal method for repairing fingertip defect.The surgery is simple.Reliable blood supply can be achieved without sacrificing the proper digital artery.Coaptation of the nerve restores sensation at the fingertip.There is minor donor site damage and very few complications.%目的 探讨缝合神经的指固有动脉背支血管链皮瓣修复指远端皮肤缺损的疗效.方法 2008年12月至2009年11月,对24例26指指远端皮肤缺损患者,以指固有动脉背侧支形成的血管链为血供,于近节指体侧方设计皮瓣,皮瓣轴线为指体侧方中线,皮瓣蒂宽0.8~1.0cm,皮瓣转折点为中节指体中远端,逆行转移修复指远端皮肤缺损,皮瓣携带指固有神经背侧支或指背神经与创面指神经断端进行缝合

  8. Recording of cochlear bioelectricities from facial nerve canal in rats%经大鼠面神经管引导耳蜗生物电反应

    Institute of Scientific and Technical Information of China (English)

    于进涛; 丁大连; 孙虹; Richard Salvi

    2014-01-01

    different structures and cells of the cochlea. Except for the EP, which is a resting potential mainly reflecting the function of stria vascularis, other cochlear potentials actually are the auditory evoked responses from cochlear sensory hair cells or auditory nerve fibers of spiral ganglion neurons respectively. Therefore, cochlear bioelectric activity recording is an ideal technique to study cochlear physiological functions. Many tradi-tional techniques for cochlear bioelectricity recording through middle ear cavity are not suited for long-term observation due to potential surgical injury or infection to the middle ear. With the expanding use of rats, rat model has been investigated to gain insights into the mechanisms underlying noise or drug-induced hearing loss. However, there lacks effective method for long-term recording of cochlear bioelectricity in rats. A stable long-term recording technique of cochlear potentials in rats is described in this report. A silver electrode was implanted into the horizontal segment of facial nerve canal via stylomastoid fora-men. Since the cochlear cavity is separated from facial nerve canal only by a thin osteal wall, the waveform of cochlear bioelec-tric activities can be easily recorded from within the facial nerve canal. In addition, this electrode insertion does not require opening the middle ear cavity and hence helps avoid surgical damage and infection to the middle ear. The CAP, CM and SP can be reliably recorded following electrode implantation. However, the amplitude of CAP and CM can vary among indivdual animals. This suggests that data analysis is probably more reliable with pre-vs post-treatment design than comparison across animals. In conclusion, electrode insert at the dissepiment of cochlea for recording of cochlear bioelectric activities may pro-vide a useful approach for hearing physiological studies in rats. Moreover, this paper also discusses the characteristics and in-trinsic relationships between different

  9. Trigeminal neuropathic pain in a patient with progressive facial hemiatrophy (parry-romberg syndrome).

    Science.gov (United States)

    Viana, Michele; Glastonbury, Christine M; Sprenger, Till; Goadsby, Peter J

    2011-07-01

    We reviewed the literature on published cases of progressive facial hemiatrophy (Parry-Romberg syndrome) to identify possible pathophysiological mechanisms of the syndrome. To describe the somatosensory phenotype of a previously unreported patient with progressive facial hemiatrophy and facial pain. Case report and 4-month follow-up period. University-based tertiary referral headache center. A 37-year-old woman with progressive facial hemiatrophy and strictly left-sided facial pain over 12 years. Greater occipital nerve blockade with lidocaine, 2% (2 mL), and methylprednisolone sodium phosphate (80 mg). Trigeminal sensory phenotype on quantitative sensory testing using thermal threshold and Von Frey hairs. The case report includes patient photographs, neuroimaging, and neurophysiological findings. On the left side, there was continuous pain in V(1) and V(2) and intermittent sharp shooting pains in V(3). The sensory examination showed areas on the left side with pinprick hyperalgesia, cold and heat hyperalgesia, and dynamic mechanical allodynia. The pain in V(1) and V(3) and the allodynia dramatically improved after greater occipital nerve blockade. In the cases reported in the literature, a constant component of the pain was always part of the phenotype, and positive or negative trigeminal sensory signs were frequently described. The phenotype of our patient suggests neuropathic pain involving all 3 branches of the trigeminal nerve, and the patient fulfills newly defined stricter criteria for neuropathic pain. Similar to our case, phenotypes of the other published cases seem to agree with trigeminal neuropathic pain rather than trigeminal neuralgia specifically.

  10. Facial Reconstruction and Rehabilitation.

    Science.gov (United States)

    Guntinas-Lichius, Orlando; Genther, Dane J; Byrne, Patrick J

    2016-01-01

    Extracranial infiltration of the facial nerve by salivary gland tumors is the most frequent cause of facial palsy secondary to malignancy. Nevertheless, facial palsy related to salivary gland cancer is uncommon. Therefore, reconstructive facial reanimation surgery is not a routine undertaking for most head and neck surgeons. The primary aims of facial reanimation are to restore tone, symmetry, and movement to the paralyzed face. Such restoration should improve the patient's objective motor function and subjective quality of life. The surgical procedures for facial reanimation rely heavily on long-established techniques, but many advances and improvements have been made in recent years. In the past, published experiences on strategies for optimizing functional outcomes in facial paralysis patients were primarily based on small case series and described a wide variety of surgical techniques. However, in the recent years, larger series have been published from high-volume centers with significant and specialized experience in surgical and nonsurgical reanimation of the paralyzed face that have informed modern treatment. This chapter reviews the most important diagnostic methods used for the evaluation of facial paralysis to optimize the planning of each individual's treatment and discusses surgical and nonsurgical techniques for facial rehabilitation based on the contemporary literature.

  11. Effects of approach and injection volume on diffusion of mepivacaine hydrochloride during local analgesia of the deep branch of the lateral plantar nerve in horses.

    Science.gov (United States)

    Claunch, Kevin M; Eggleston, Randy B; Baxter, Gary M

    2014-11-15

    To compare the effects of 2 approaches and 2 injection volumes on diffusion of mepivacaine hydrochloride for local analgesia of the deep branch of the lateral plantar nerve (DBLPN) in horses. Experimental study. 16 adult horses. Either 2 mL (low volume) or 8 mL (high volume) of mepivacaine hydrochloride-iohexol (50:50 mixture) was injected by means of 1 of 2 techniques to produce analgesia of the DBLPN. For technique 1, the needle was inserted 15 mm distal to the head of the fourth metatarsal bone and directed perpendicular to the limb. For technique 2, the needle was inserted 20 mm distal to the head of the fourth metatarsal bone and was directed in a proximodorsal direction. Lateromedial radiographs were obtained before and 5, 15, 30, and 60 minutes after injection. Radiographs were evaluated to determine the proximal and distal extent of diffusion of the contrast solution and presumably anesthetic agent and whether contrast agent appeared to be present in the tarsal sheath or tarsometatarsal joint. A high degree of variability in contrast solution diffusion was noted among injections. High-volume injections diffused significantly further proximally and distally than did low-volume injections. Contrast agent was documented within the tarsal sheath in 5 of 32 (16%) injections and within the tarsometatarsal joint in 2 of 32 (6%) injections. No significant difference was found for risk of inadvertent tarsal sheath or tarsometatarsal joint injection between the 2 techniques or the 2 volumes of anesthetic used. Mepivacaine diffused significantly further distally with technique 1 than with technique 2 but diffused significantly further proximally with technique 2 than with technique 1. For both techniques, diffusion in the distal but not the proximal direction significantly increased over time. Results indicated that the proximal and distal diffusion of the mepivacaine-iohexol solution was quite variable following either DBLPN nerve block technique.

  12. Common Hepatic Branch of Vagus Nerve-Dependent Expression of Immediate Early Genes in the Mouse Brain by Intraportal L-Arginine: Comparison with Cholecystokinin-8

    Directory of Open Access Journals (Sweden)

    Daisuke Yamada

    2017-06-01

    Full Text Available Information from the peripheral organs is thought to be transmitted to the brain by humoral factors and neurons such as afferent vagal or spinal nerves. The common hepatic branch of the vagus (CHBV is one of the main vagus nerve branches, and consists of heterogeneous neuronal fibers that innervate multiple peripheral organs such as the bile duct, portal vein, paraganglia, and gastroduodenal tract. Although, previous studies suggested that the CHBV has a pivotal role in transmitting information on the status of the liver to the brain, the details of its central projections remain unknown. The purpose of the present study was to investigate the brain regions activated by the CHBV. For this purpose, we injected L-arginine or anorexia-associated peptide cholecystokinin-8 (CCK, which are known to increase CHBV electrical activity, into the portal vein of transgenic Arc-dVenus mice expressing the fluorescent protein Venus under control of the activity-regulated cytoskeleton-associated protein (Arc promotor. The brain slices were prepared from these mice and the number of Venus positive cells in the slices was counted. After that, c-Fos expression in these slices was analyzed by immunohistochemistry using the avidin-biotin-peroxidase complex method. Intraportal administration of L-arginine increased the number of Venus positive or c-Fos positive cells in the insular cortex. This action of L-arginine was not observed in CHBV-vagotomized Arc-dVenus mice. In contrast, intraportal administration of CCK did not increase the number of c-Fos positive or Venus positive cells in the insular cortex. Intraportal CCK induced c-Fos expression in the dorsomedial hypothalamus, while intraportal L-arginine did not. This action of CCK was abolished by CHBV vagotomy. Intraportal L-arginine reduced, while intraportal CCK increased, the number of c-Fos positive cells in the nucleus tractus solitarii in a CHBV-dependent manner. The present results suggest that the CHBV

  13. 正中神经指浅屈肌肌支修复尺神经手内在肌肌支的临床应用研究%The clinical research of flexor digitorum superiicialis muscle branch of the median nerve to repair the hand intrinsic muscle branch of the ulnar nerve

    Institute of Scientific and Technical Information of China (English)

    于亚东; 马涛; 田方涛; 孙庆禄; 曹冉; 崔海斌

    2016-01-01

    Objective To investigate the clinical application of flexor digitorum superiicialis muscle branch of the median nerve to repair the hand intrinsic muscle branch of the ulnar nerve. Methods From June, 2006 to June,.2010, 7 volunteers of level ulanr never pure injuries near to the elbow were treated by transferring flexor dig-itorum superiicialis muscle branch of the median nerve to the hand intrinsic muscle branch of the ulnar nerve.The follow-up period ranged from 3 months to 5.5 years,with an average of 1.5 years..The shape and the musle power of hand intrinsic musle ,the sensory fuction of ulnar nerve ,and the results of EMG after operation were observed. Results The pinkie finger sensory recovery time was about 1.5 years ,.and two-point discrimination test showed that the sensory of the wounded hand recovered effectively ,.but was significantly worse than the healthy side. And the other sesory recover well. 7 months later , the motion relevant to ulnar nerve began to recover. The adduction and abduction functions of little finger recovered firstly. The ring , middle and index finger followed. Finally , the func tion of adductor muscle recovered. 1.5 years later , the intrinsic muscle strength grade was about 2-4 , paper clip test experiment (-), Froment sign(-). There were no obvious claw hand deformity in 6 cases,and the atrophy with varying degrees of adductor muscle occurred in 3 cases. Conclusion Flexor digitorum superiicialis muscle branch of the median nerve transfer to the hand intrinsic muscle branch of the ulnar nerve combined with functional exer-cise can effectively treated and slow down the intrinsic muscles atrophy.%目的:探讨正中神经指浅屈肌肌支修复尺神经手内在肌肌支的临床应用。方法自2006年6月至2010年6月,我们对肘关节以近的单纯尺神经高位损伤的7例志愿者患者,在常规修复尺神经的同时,采用正中神经指浅屈肌肌支的第4肌支移位修复尺神

  14. Periocular Reconstruction in Patients with Facial Paralysis.

    Science.gov (United States)

    Joseph, Shannon S; Joseph, Andrew W; Douglas, Raymond S; Massry, Guy G

    2016-04-01

    Facial paralysis can result in serious ocular consequences. All patients with orbicularis oculi weakness in the setting of facial nerve injury should undergo a thorough ophthalmologic evaluation. The main goal of management in these patients is to protect the ocular surface and preserve visual function. Patients with expected recovery of facial nerve function may only require temporary and conservative measures to protect the ocular surface. Patients with prolonged or unlikely recovery of facial nerve function benefit from surgical rehabilitation of the periorbital complex. Current reconstructive procedures are most commonly intended to improve coverage of the eye but cannot restore blink.

  15. 面神经损伤后面神经核中神经型钙黏附分子及胎盘型钙黏附分子的表达%Expression of neuronal cadherin and placental cadherin in facial motoneurons after facial nerve injury

    Institute of Scientific and Technical Information of China (English)

    李雷激; 徐超然; 覃纲; 刘跃华; 祝琳

    2015-01-01

    背景:面神经周围性损伤后,首先涉及其中枢神经元轴突的逆行性反应,神经能否再生则取决于神经元胞体的存活及功能状态。  目的:检测面神经损伤后,面神经核中神经型钙黏附分子和胎盘型钙黏附分子的表达变化。  方法:将新西兰大白兔随机分为模型组(n=48)和对照组(n=8)。模型组兔建立右侧面神经压榨损伤模型。模型组分别于损伤后1,4,7,14,21,28 d各取8只兔进行检测。运用免疫组织化学SP法及实时定量PCR法检测兔右侧面神经核运动神经元中神经型钙黏附分子和胎盘型钙黏附分子蛋白及mRNA的表达水平。  结果与结论:对照组兔右侧面神经核运动神经元中无神经型钙黏附分子或胎盘型钙黏附分子标记的阳性神经元。模型组兔右侧面神经核运动神经元中存在神经型钙黏附分子和胎盘型钙黏附分子阳性神经元,2种阳性神经元数量均在第14天时达到峰值。与对照组相比,模型组损伤后4-28 d兔面神经核中神经型钙黏附分子mRNA的表达水平明显增加,损伤后1 d时兔面神经核中胎盘型钙黏附分子mRNA的表达水平明显下降,损伤后7-28 d时兔面神经核中胎盘型钙黏附分子mRNA的表达水平明显增加。提示面神经损伤的早期即出现2种分子的阳性表达,其中胎盘型钙黏附分子的表达自神经损伤后一直存在,而神经型钙黏附分子表达时间相对较短。在面神经损伤时,面神经核中神经型钙黏附分子和胎盘型钙黏附分子均表达增加,说明面神经再生可能与黏附分子的高表达有关。%BACKGROUND:Peripheral facial nerve injury first involves the retrograde reactions of central nervous system axons, and nerve regeneration wil depend on the survival and functional status of neuronal cel bodies. OBJECTIVE:To explore the expression of neuronal cadherin and placental cadherin in facial

  16. Facial Baroparesis Caused by Scuba Diving

    Directory of Open Access Journals (Sweden)

    Daisuke Kamide

    2012-01-01

    tympanic membrane and right facial palsy without other neurological findings. But facial palsy was disappeared immediately after myringotomy. We considered that the etiology of this case was neuropraxia of facial nerve in middle ear caused by over pressure of middle ear.

  17. Contralateral reinnervation of midline muscles in nonidiopathic facial palsy.

    NARCIS (Netherlands)

    Gilhuis, H.J.; Beurskens, C.H.G.; Vries, J. de; Marres, H.A.M.; Hartman, E.H.M.; Zwarts, M.J.

    2003-01-01

    The purpose of this study was to analyze contralateral reinnervation of the facial nerve in eight patients with complete facial palsy after surgery or trauma and seven healthy volunteers. All patients had contralateral reinnervation of facial muscles as demonstrated by electrical nerve stimulation v

  18. Intraoperative neuromonitoring of the external branch of the superior laryngeal nerve during thyroidectomy: the need for evidence-based data and perioperative technical/technological standardization.

    Science.gov (United States)

    Mangano, Alberto; Lianos, Georgios D; Boni, Luigi; Kim, Hoon Yub; Roukos, Dimitrios H; Dionigi, Gianlorenzo

    2014-01-01

    The external branch of the superior laryngeal nerve (EBSLN) is surgically relevant since its close anatomical proximity to the superior thyroid vessels. There is heterogeneity in the EBSLN anatomy and EBSLN damage produces changes in voice that are very heterogenous and difficult to diagnose. The reported prevalence of EBSLN injury widely ranges. EBSLN iatrogenic injury is considered the most commonly underestimated complication in endocrine surgery because vocal assessment underestimates such event and laryngoscopic postsurgical evaluation does not show standardized findings. In order to decrease the risk for EBSLN injury, multiple surgical approaches have been described so far. IONM provides multiple advantages in the EBSLN surgical approach. In this review, we discuss the current state of the art of the monitored approach to the EBSLN. In particular, we summarize, providing our additional remarks, the most relevant aspects of the standardized technique brilliantly described by the INMSG (International Neuromonitoring Study Group). In conclusion, in our opinion, there is currently the need for more prospective randomized trials investigating the electrophysiological and pathological aspects of the EBSLN for a better understanding of the role of IONM in the EBSLN surgery.

  19. Traumatic lesions of internal saphenous nerve and branches Lesões traumáticas do nervo safeno interno e seus ramos

    Directory of Open Access Journals (Sweden)

    Flávio Freinkel Rodrigues

    2009-09-01

    Full Text Available OBJECTIVE: To show a rare lesion that sometimes simulates vascular disorder of the lower extremities. METHOD: Three patients were operated and the follow-up period was eight months, the surgical technique was neurotomy of the infrapatellar and descendent branches. RESULTS: In two cases there were almost total pain resolution, and in other case improvement only. CONCLUSION: Surgical treatment yields good results in this type of internal saphenous nerve lesion, and could be useful as an alternative to conservative treatment.OBJETIVO: Apresentar lesões raras do nervo safeno interno interno, que muitas vezes, simulam doenças vasculares dos membros inferiores. MÉTODO: Três pacientes foram operados e acompanhados por um período de oito meses. A técnica cirúrgica consistiu na neurotomia dos ramos infrapatelar e descendente do nervo safeno interno. RESULTADOS: Nos dois primeiros casos houve quase desaparecimento total da dor em pouco tempo e no terceiro apenas melhora. CONCLUSÃO: O tratamento cirúrgico dá bons resultados neste tipo de lesão do nervo safeno interno e poderia ser útil como alternativa ao tratamento conservador.

  20. Intraoperative Neuromonitoring of the External Branch of the Superior Laryngeal Nerve during Thyroidectomy: The Need for Evidence-Based Data and Perioperative Technical/Technological Standardization

    Directory of Open Access Journals (Sweden)

    Alberto Mangano

    2014-01-01

    Full Text Available The external branch of the superior laryngeal nerve (EBSLN is surgically relevant since its close anatomical proximity to the superior thyroid vessels. There is heterogeneity in the EBSLN anatomy and EBSLN damage produces changes in voice that are very heterogenous and difficult to diagnose. The reported prevalence of EBSLN injury widely ranges. EBSLN iatrogenic injury is considered the most commonly underestimated complication in endocrine surgery because vocal assessment underestimates such event and laryngoscopic postsurgical evaluation does not show standardized findings. In order to decrease the risk for EBSLN injury, multiple surgical approaches have been described so far. IONM provides multiple advantages in the EBSLN surgical approach. In this review, we discuss the current state of the art of the monitored approach to the EBSLN. In particular, we summarize, providing our additional remarks, the most relevant aspects of the standardized technique brilliantly described by the INMSG (International Neuromonitoring Study Group. In conclusion, in our opinion, there is currently the need for more prospective randomized trials investigating the electrophysiological and pathological aspects of the EBSLN for a better understanding of the role of IONM in the EBSLN surgery.

  1. [The history of facial paralysis].

    Science.gov (United States)

    Glicenstein, J

    2015-10-01

    Facial paralysis has been a recognized condition since Antiquity, and was mentionned by Hippocratus. In the 17th century, in 1687, the Dutch physician Stalpart Van der Wiel rendered a detailed observation. It was, however, Charles Bell who, in 1821, provided the description that specified the role of the facial nerve. Facial nerve surgery began at the end of the 19th century. Three different techniques were used successively: nerve anastomosis, (XI-VII Balance 1895, XII-VII, Korte 1903), myoplasties (Lexer 1908), and suspensions (Stein 1913). Bunnell successfully accomplished the first direct facial nerve repair in the temporal bone, in 1927, and in 1932 Balance and Duel experimented with nerve grafts. Thanks to progress in microsurgical techniques, the first faciofacial anastomosis was realized in 1970 (Smith, Scaramella), and an account of the first microneurovascular muscle transfer published in 1976 by Harii. Treatment of the eyelid paralysis was at the origin of numerous operations beginning in the 1960s; including palpebral spring (Morel Fatio 1962) silicone sling (Arion 1972), upperlid loading with gold plate (Illig 1968), magnets (Muhlbauer 1973) and transfacial nerve grafts (Anderl 1973). By the end of the 20th century, surgeons had at their disposal a wide range of valid techniques for facial nerve surgery, including modernized versions of older techniques.

  2. Motor unit number in a small facial muscle, dilator naris.

    Science.gov (United States)

    Patel-Khurana, Nilam; Fregosi, Ralph F

    2015-10-01

    A loss of functioning motor units underlies many neuromuscular disorders. The facial nerve innervates the muscles of facial expression, including nasal muscles, which also play an important role in the regulation of airflow resistance. It is difficult to accurately assess motor unit number in the facial muscles, because the muscles are difficult to activate in isolation. Here, we apply the manual McComas method to estimate the number of motor units in a nasal dilator muscle. EMG of the dilator naris was recorded during graded stimulation of the zygomatic branch of the facial nerve in 26 subjects (12 males and 14 females), aged 20-41 years. Each subject was studied twice, on separate days, to estimate method reproducibility. As a check on our use of the McComas method, we also estimated motor unit number in the first dorsal interosseus muscle (FDI) of six subjects, as the muscle is also small and has been studied with the McComas method. Reproducibility was evaluated with a rigorous statistical approach, the Bland-Altman procedure. We estimate that dilator naris is composed of 75 ± 15.6 (SD) motor units, compared to 144 ± 35.5 in FDI. The coefficient of variation for test-retest reproducibility of dilator naris motor unit estimates was 29.6 %, similar to separate-day reproducibility reported for other muscles. Recording and stimulation were done with surface electrodes, and the recordings were of high quality and reproducible. This simple technique could be applied clinically to track motor neuron loss and to monitor facial nerve integrity.

  3. Management of facial blushing

    DEFF Research Database (Denmark)

    Licht, Peter B; Pilegaard, Hans K

    2008-01-01

    an indication for treatment, facial blushing may be treated effectively by thoracoscopic sympathectomy. The type of blushing likely to benefit from sympathectomy is mediated by the sympathetic nerves and is the uncontrollable, rapidly developing blush typically elicited when one receives attention from other...

  4. Facial Paralysis Reconstruction.

    Science.gov (United States)

    Razfar, Ali; Lee, Matthew K; Massry, Guy G; Azizzadeh, Babak

    2016-04-01

    Facial nerve paralysis is a devastating condition arising from several causes with severe functional and psychological consequences. Given the complexity of the disease process, management involves a multispecialty, team-oriented approach. This article provides a systematic approach in addressing each specific sequela of this complex problem.

  5. 放射状扫描技术在鼓乳段面神经 MRI 中的应用%Application of MR radial scan technique in the tympanic and mastoid segment of facial nerve

    Institute of Scientific and Technical Information of China (English)

    杨军; 郑君惠; 徐焕文

    2014-01-01

    Objective:To study the value of MR radial scan technique in the clinical application of tympanic and mas-toid segment of facial nerve.The advantages and disadvantages of MR radial scan,oblique sagittal view and 3D scanning technique in displaying the tympanic and mastoid segment of facial nerve were compared.Methods:MRI was performed to demonstrate the tympanic and mastoid segment of facial nerve in 10 healthy volunteers (20 ears).A 3.0T magnetic reso-nance scanner was used.T2 WI of radial scan and oblique sagittal view as well as 3D-FIESTA MR sequences were performed respectively.The scan level which could display the most integrated tympanic and mastoid segment of facial nerve was se-lected and the length of nerve was measured.The signal noise ratio (SNR)of the nerve was measured as well.The above mentioned three sets of images were comprehensively evaluated blindly.Results:No statistic differences were existed in the above mentioned 3 sets of images in the length of tympanic and mastoid segment of facial nerve (P =0.234).Using Frei-dman rank test to analyzed the SNR of tympanic and mastoid segment of facial nerve of these three sets of images,there was no statistic difference (P =0.196 and 0.257 respectively).There was statistic difference (P =0.001)in the comprehensive evaluation scores of the 3 sets of images,3D-FIESTA got the highest score.Conclusion:Radial scan technique MRI scan could avoid the tilt angle problem,and well displayed the tympanic and mastoid segment of facial nerve.Radial scan tech-nique and oblique sagittal view could be used as an important supplement to the 3D MR scanning sequence in the diagnosis, treatment,surgery planning and prognosis prediction of facial nerve disease.%目的:探讨放射状扫描技术在鼓乳段面神经 MRI 扫描中的应用价值,比较放射状扫描、斜矢状面扫描和3D扫描技术在鼓乳段面神经 MRI 扫描中的优劣势。方法:使用3.0T 磁共振机,对无任何颅内疾病的10

  6. 解剖面神经颧支在腮腺切除术中的临床应用%Anatomy of zygomatic branch of facial never in parotidectomy.

    Institute of Scientific and Technical Information of China (English)

    李明; 朱志军

    2011-01-01

    Objective: To summarize our experiences in anatomy of zygomatic branch of facial never in parotidectomy.Method: 19 eases of parotid benign tumor were collected from 2004.10 to 2007.8.With the face lift incision, under the superficial musculo aponeurotie system (SMAS), facial never dissected from the zygomatie branches to the main trunk. According to the location of tumor, selective anatomy peripheral branches finished the parotidectomy. And using a flap with an upper pedicle taken from the stemocleidomastoid muscle repaired the defect after parotideetomy. Result: All the operations were successfully finished. The wound healed uneventfully. During the follow-up,all the patients showed good aesthetic results,with no obvious sear and deformity. Conclusion: The surgery was profit to dissect and protect the facial never, to improve the defect after parotidectomy.%目的:总结解剖面神经颧支在腮腺良性肿瘤切除术中的临床应用.方法:采用经典的面部除皱手术切口,在腮腺嚼肌筋膜下翻瓣,先在耳屏前颧弓下解剖显露面神经的颧支,然后沿该支显露面神经的颞面干及面神经总干,再根据肿瘤的位置沿总干选择性地解剖面神经颈面干及各分支,行肿瘤及腮腺部分切除术.最后采用蒂在上方的胸锁乳突肌肌瓣转移填塞腮腺切除后的凹陷区,避免了常规术式术后耳前区的凹陷畸形.结果:采用该术式对19例患者行腮腺良性肿瘤切除术,所有手术均顺利完成,术后随访3-4年,患者面部疤痕不明显,外形恢复良好,面神经损伤均完全恢复.结论:本术式更易于显露和保护面神经,改善术后面部畸形.

  7. Morphological observation on sulcus for spinal nerve and impaction of anterior branch%脊神经沟与颈神经前支嵌压关系的神经形态学观察

    Institute of Scientific and Technical Information of China (English)

    李英平; 郭瑞芳; 刘跃会; 张松岩; 孔祥玉; 吴玉林

    2003-01-01

    AIM:To observe the morphological changes of sulcus for spinal nerve and spinal nerve in the sulcus and to explore the relationship between sulcus for spinal nerve and impaction of spinal nerve. METHODS:Sixty adult corpuses(28 males and 32 females) with 120 cervical vertebrae were used.The width,depth of the sulcus and transverse diameter of anterior branch of spinal nerve in sulcus were observed and the ratio of transverse diameter of anterior branch of spinal nerve to the width of external os of sulcus was calculated. CONCLUSION:Morphosis of sulcus for spinal nerve is closely related to impaction of spinal nerve in sulcus,lower cervical segment nerves(C5,C6) have a higher probability to be affected than upper cervical segment nerves(C3,C4).%目的:观察脊神经沟及其沟内段脊神经形态学变化,探讨脊神经沟与沟内段脊神经受嵌压的关系. 方法:取 60具成尸(男 28,女 32) 120侧颈椎,对脊神经沟外口宽度、深度及其沟内段脊神经前支横径进行观察,并统计脊神经前支横径与脊神经沟外口宽度之比. 结果:①脊神经沟外口宽度、深度自 C3至 C6均逐渐增大,其平均值分别为 (4.5±1.2)mm和 (4.3±1.2)mm;② 3到 7颈神经前支横径逐渐增大,平均值为 (2.9±1.0)mm;③颈神经前支横径与脊神经沟外口宽度之比, C5最小( 1:1.54), C4次之( 1:1.67), C3最大( 1:1.75). 结论:脊神经沟与沟内段脊神经受累关系密切,下颈段 (C5,C6)颈神经受累几率可能大于上颈段( C3,C4).

  8. 腓肠肌外侧头肌支神经转移术对大鼠腓深神经损伤的修复作用%Effects of Lateral Gastrocnemius Muscle Branch Nerve Transferring on Deep Peroneal Nerve Impairment in Rats

    Institute of Scientific and Technical Information of China (English)

    李军; 王冲; 李建军; 刘长彬; 董学超; 郭韵; 唐丽; 杜良杰; 高峰; 刘宏炜; 杨德刚

    2016-01-01

    Objective To explore the feasibility and effectiveness of lateral gastrocnemius muscle branch nerve transferring for deep pe-roneal nerve injury. Methods Thirty-two adult female Sprague-Dawley rats were divided into control group (n=8), sham group (n=8), nerve direct repairing group (n=8) and nerve transferring group (n=8). Twelve weeks after the anastomosis, the nerve anastomosis was observed vi-sually, the length of lateral of gastrocnemius muscle branch (L1), the diameter at the point of entering muscle (D1), the maximum detachable length of nervus peroneus communis (L2), the diameter of deep peroneal nerve (D2) and the distance between branch point and neck of fibu-la (S) were measured. The peroneal nerve functional index (PFI), the amplitude of compound muscle action potential (CMAP), nerve con-duction velocity (NCV), the weight of the tibialis anterior and the creatine kinase (CK) activity of theanterior tibial were compared among groups. Results L10.05). Conclusion It is feasible that lateral head muscular branches of gastrocnemius nerve transferring can repair deep peroneal nerve injury, which is needed to separate superficial peroneal nerve and deep peroneal nerve in the epineurium without damaging nerve for tension free neuroanastomosis. Lateral head muscular branches of gastrocnemius nerve transferring can repair the func-tion after deep peroneal nerve injury.%目的:探讨腓肠肌肌支神经转移术修复腓深神经损伤的可行性和有效性。方法32只成年雌性Sprague-Dawley大鼠分成空白组、对照组、神经直接吻合组(腓深神经直接吻合)和神经转移组(腓肠肌外侧头肌支转移至腓深神经),每组各8只。术后12周,肉眼观察神经吻合口生长情况,测量胫神经各肌支长度(L1)、入肌点处直径(D1)、各肌支起点至腓骨颈平面的距离(S),腓总神经膜内可分离的最大长度(L2)、腓深神经的直径(D2),比较手术前后大鼠患肢腓神经功能指数(PFI)、

  9. Correlation between facial nerve functional evaluation and efficacy evaluation of acupuncture treatment for Bell's palsy%面神经功能评价对针刺治疗贝尔麻痹疗效评估的影响

    Institute of Scientific and Technical Information of China (English)

    周章玲; 李呈新; 姜岳波; 左聪; 蔡云; 王瑞

    2012-01-01

    目的:在针灸治疗贝尔麻痹的过程中,依据面神经麻痹程度进行面神经功能障碍评价分级,并观察该分级与疗效、疗程的关系及在判断预后方面的作用.方法:以面瘫常用运动功能评价量表House-Brackmann量表为准,并对眼裂和唇角设定量标准,治疗前和治疗结束时,根据该量表评分对患者面部瘫痪程度进行面神经功能障碍评估分级,依次分为轻度、中度、中重度、重度功能障碍和完全麻痹5个级别.按患者疾病分期采用针刺对症治疗,不人为设定治疗时程,全程观察,以最终疗效为准.结果:68例病例中,治愈53例,总有效率为97%.5种不同面神经功能障碍之间的治疗效果差异有统计学意义(P<0.01);疗效与病情轻重相关,等级相关分析相关系数为0.423 (P<0.01);其疗程也随着面神经功能障碍级别加重而延长(P<0.01).结论:贝尔麻痹患者存在面神经功能障碍轻重的差别,针灸治疗的效果随着面神经功能障碍的加重而下降,不同级别面神经功能障碍患者治疗所需疗程不同.临床研究中非常有必要对患者进行评估分级后再做观察治疗,并依据病情轻重程度选择不同治疗方法.%OBJECTIVE: To assess and grade facial nerve dysfunction according to the extent of facial paralysis in the clinical course of acupuncture treatment for Bell's palsy, and to observe the interrelationship between the grade, the efficacy and the period of treatment, as well as the effect on prognosis. METHODS: The authors employed the House-Brackmann scale, a commonly used evaluation scale for facial paralysis motor function, and set standards for eye fissure and lips. According to the improved scale, the authors assessed and graded the degree of facial paralysis in terms of facial nerve dysfunction both before and after treatment. The grade was divided into five levels: mild, moderate, moderately severe, severe dysfunction and complete paralysis. The

  10. Agreement between House-Brackmann Grading System and Facial Nerve Grading System 2.0 in Patients with Facial Nerve Paralysis%面神经分级2.0对周围性面神经麻痹的评价研究

    Institute of Scientific and Technical Information of China (English)

    李阳;