[Recurrent & alternating peripheral facial paralysis].
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Facial Paralysis↗
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[Current status of facial paralysis].
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Facial Paralysis↗
[On peripheral facial paralysis].
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Facial Paralysis↗
[Extratemporal surgery in facial paralysis].
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Facial Paralysis↗
Testosterone-induced acceleration of recovery from facial paralysis in male hamsters: temporal requirements of hormone exposure.
In this study, the temporal requirements of testosterone propionate (TP) exposure necessary for acceleration of recovery from facial paralysis to occur following facial nerve crush were examined. For each of two series of experiments, adult castrated male hamsters were subjected to crush axotomies of the facial nerve at its exit from the stylomastoid foramen. In the first experimental paradigm, one-half of the animals with facial nerve crush axotomies received subcutaneous TP capsules beginning on postoperative (PO) day 6 and continuing throughout the regeneration period, with the remainder of the animals sham implanted. The results indicate that, without the early exposure to TP, the accelerative effects of the hormone on facial nerve regeneration were abolished. In the second experimental paradigm, one-half of the animals with facial nerve crush axotomies received subcutaneous TP implants immediately after the crush surgeries and until PO day 7, with the remainder of the animals sham implanted. The results indicate that an early, discontinuous dose of TP immediately after crush surgeries was sufficient to produce a partial accelerative effect on the return of facial nerve function. It is hypothesized from these findings that there is a priming effect of TP that is exerted at the level of the neuron, temporally precedes behavioral recovery by a week or more and is critical to subsequent acceleration of recovery from facial paralysis.
Animals↗
Minimally invasive brow suspension for facial paralysis.
OBJECTIVE: To report a new technique for unilateral brow suspension for facial paralysis that is minimally invasive, limits supraciliary scar formation, does not require specialized endoscopic equipment or expertise, and has proved to be equal to direct brow suspension in durability and symmetry. DESIGN: Retrospective survey of a case series of 23 patients between January 1997 and December 2000. SETTING: Metropolitan tertiary care center. PATIENTS: Patients with head and neck tumors and brow ptosis caused by facial nerve paralysis. MAIN OUTCOME MEASURE: The results of the procedure were determined using the following 3-tier rating system: outstanding (excellent elevation and symmetry); acceptable (good elevation and fair symmetry); and unacceptable (loss of elevation). RESULTS: The results were considered outstanding in 12 patients, acceptable in 9 patients, and unacceptable in only 1 patient. One patient developed a hematoma, and 1 patient required a secondary adjustment. CONCLUSIONS: The technique has proved to be superior to standard brow suspension procedures with regard to scar formation and equal with respect to facial symmetry and suspension. These results have caused us to abandon direct brow suspension and to use this minimally invasive method in all cases of brow ptosis due to facial paralysis.
Facial Paralysis↗
Herpes zoster oticus. Uncommon but recognizable cause of facial paralysis.
Three cases of herpes zoster oticus illustrate the manifestations of this relatively uncommon cause of facial paralysis. Topographic analysis, in which functions of facial nerve branches are assessed, helps establish the level of facial nerve involvement. Sequential faradic stimulation testing often is a sensitive prognostic indicator of recovrey of facial nerve function, particularly if nerve excitability persists. A few recent reports support the use of systemic steroid therapy for herpes zoster oticus; opinions vary regarding the efficacy of surgical decompression for facial paralysis. Although general principles cannot be deduced from three cases, each case discussed exemplifies an important aspect of management. The prognostic significance of results of nerve stimulation tests is illustrated by the complete return of facial nerve function in our first patient. Our second patient's response to systemic steroid therapy supports recent reports of the value of such agents in herpes zoster oticus. Partial return of facial nerve function in our third patient two months after onset of paralysis accentuates the importance of a period of observation before a nerve graft or other rehabilitative procedures are undertaken.
Adult↗
[Clinical observation on isolated electroacupuncture for treatment of peripheral facial paralysis].
OBJECTIVE: To study on therapeutic effect of isolated electroacupuncture on peripheral facial paralysis. METHODS: One hundred cases were randomly divided into an observation group of 60 cases and a control group of 40 cases. The observation group were treated by isolated electroacupuncture and the control group by normal electroacupuncture. Jiache (ST 6), Yangbai (GB 14), Dicang (ST 4), Xiaguan (ST 7), Fengchi (GB 20) and Hegu (LI 4) were selected and same drugs were administrated in the two groups. Then their therapeutic effects were observed. RESULTS: Forty-five cases were cured, 11 cases were markedly effective and 4 cases improved with an effective rate of 100.0% in the observation group, and corresponding figures were 26, 2 and 10 cases, and 95.0% in the control group, the observation group being better than the control group (P < 0.01). CONCLUSION: Isolated electroacupuncture has a significant therapeutic effect on facial paralysis, being better than that of normal electroacupuncture.
Acupuncture Points↗
[Peripheral facial paralysis associated with anti-tetanic serotherapy: a case report].
INTRODUCTION: Peripheral facial paralysis (PFP) is a frequent symptom, idiopathic forms predominate. Toxin-related PFP was not common pathology and apparently has not been documented in the literature. OBSERVATION: We report a case of sudden-onset PFP which resolved rapidly in a patient given tetanic anti-serotherapy for a wound of the lower limb. Physical examination and search for a cause were unable to establish a specific etiology. The clinical course of this case of PFP (rapid regression from the fifth day and total resolution at the twentieth) was compatible with a toxic cause, although a frigorecannot be excluded. CONCLUSION: Although generally idiopathic, peripheral facial paralysis can result from a toxic cause (drug, industrial toxic, narcotic). The direct causal mechanism is often difficult to establish. History taking and imaging, particularly magnetic resonance imaging, are helpful in ruling out other causes (inflammation, tumor).
Adult↗
A clinical-functional evaluation of facial paralysis.
A clinical-functional evaluation of facial paralysis is presented in order to suggest a uniform and standard classification. The outcome of this disease treated with various modalities may be similarly appraised by all medical disciplines. A score of 50 per cent is allotted to each of the main divisions of the facial nerve, namely, eye and oral commissure; 15 per cent is given to the symmetry in repose of the eye and oral commissure respectively; and 35 per cent to the sphincteric function of the orbicularis oculus and oris respectively.
Facial Paralysis↗
Bilateral changes in cortical motor representation of the tongue after unilateral peripheral facial paralysis: evidence from transcranial magnetic stimulation.
Motor evoked potentials of the lingual muscles due to focal cortical transcranial magnetic stimulation were investigated in 5 patients with unilateral total facial paralysis with regard to amplitude as a function of the coil position on the interaural line. Maximum bilateral responses could be obtained at mean stimulus positions of about 6 to 8 cm lateral to the vertex. In comparison with healthy subjects, the patient group had significantly smaller mediolateral calculated centers for ipsilateral and contralateral responses. At the optimum stimulus positions, the patients' mean motor evoked potential amplitudes were significantly lower than those in healthy subjects. These alterations could be observed on both cortical hemispheres, but were more pronounced for the hemisphere contralateral to the side of facial paralysis. Thus, we provide strong evidence of bilateral changes in lingual cortical motor representation following facial paralysis with an invasion of the facial motor area by the tongue motor representation.
Adult↗
Objective grading of facial paralysis.
A totally objective method of grading facial palsy, based on the linear measurement of anatomic landmarks, has been tested in 34 randomly selected cases. To account for the pathologic characteristics of facial paralysis, the linear measurement index (LMI) underwent several adjustments from the ground plan devised for normal subjects. The distribution of results both from individual expressions and the entire LMI was examined.
Adult↗
[Professor ZHANG An-li's experiences on treatment of intractable facial paralysis].
Prof. Zhang An-li's clinical experiences on treatment of intractable facial paralysis are introduced. According to own many year's clinical experiences and in combination with modified heat-producing needling and fire needle therapy, Prof. Zhang summarized and created superficially needling the upper eye lid, needling Back-shu points and balance acupoint selection, and other methods to treat intractable facial paralysis, attaining clinically obvious therapeutic effect.
Acupuncture Points↗
Facial paralysis rehabilitation: retraining selective muscle control.
Traumatic facial paralysis can be improved with surgical techniques but alone will not restore full function. EMG sensory (bio) feedback can, however, facilitate rehabilitation. Four cases are described using a combined treatment technique of EMG, behavioural modification and specific action exercises. Retraining of eyelid control was also accomplished. Standardized evaluation methods are described. All four patients showed improvement, despite the failure of traditional retraining methods.
Adult↗
[Surgical treatment of leprous facial paralysis in Iran (author's transl)].
Leprous facial paralysis appears more frequent in Iran than in other countries. The damaged branch is more often the upper one inducing lagophtalmos and, sometimes, associated with a trigeminal anesthesia. The ocular risk is great. When the lower branch is struck down, it gives an inesthetic deformity and speaking difficulty. As a consequence, surgical treatment is necessary and directed: --against lagophtalmos, with static or dynamic methods, --against the ptosis of commissura labiorum with several techniques available.
Blepharoptosis↗
Spirometry and maximal respiratory pressures in patients with facial paralysis.
The study included 17 patients with facial paralysis (FP) (10 male, 7 female) aged 47.6 +/- 21.0 years. Twelve of the 17 patients had Bell's palsy. The other causes of FP were as follows: one, polyradiculoneuritis; one, war injury; one, cerebrovascular accident; one, sarcoidosis; and one, dermatomyositis. Spirometry and maximal respiratory pressures (PImax and PEmax) were performed with three different techniques: without holding the lips, with patient holding lips, and with technician holding lips. We observed significant differences for PImax and PEmax among the three methods. There were no differences for spirometric values. In nine of the patients with Bell's palsy, PImax, PEmax, and spirometry tests were repeated two months after the first determination. With respect to the first determination, the values of Pmax-w/v holding lips increased, yet spirometric values were similar. In conclusion, PImax and PEmax can be an index of clinical FP evolution. Spirometric maneuvers can be performed with either patient or technician holding lips to ensure a perfect seal between lips and mouthpiece.
Adult↗
The use of local anesthetic motor block to demonstrate the potential outcome of depressor labii inferioris resection in patients with facial paralysis.
BACKGROUND: If a patient with unilateral facial paralysis has marked depressor activity on the normal side, the appearance of the lower lip when smiling is asymmetrical. Defunctioning the muscle on the contralateral side to the palsy can restore balance. This can be achieved by resecting a portion of the depressor labii inferioris muscle on the nonparalyzed side. However, the decision to resect normal muscle may be difficult for many patients. This article presents the role of a local anesthetic motor block in temporarily paralyzing the muscle before patients decide whether permanent resection will meet their needs. METHOD: A phone questionnaire with 15 patients who received motor muscle blockage before deciding to have depressor labii inferioris muscle resection was conducted. RESULTS: Ninety-three percent of the patients who underwent the local anesthetic motor block stated that it gave them valuable information regarding the outcome of their surgery and influenced their decision to undertake definitive depressor muscle resection. CONCLUSION: A trial by local anesthetic before depressor inferioris muscle resection provides patients with valuable insight into the likely outcome of the surgery.
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