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At least 289 records · Page 16Linked to original sources
PubMed1992

Facial paralysis reconstruction with Gore-Tex Soft-Tissue Patch.

No procedure perfectly restores a face paralyzed by surgical ablation of the facial nerve. Although dynamic reconstructive procedures are preferred for treating patients with complete facial paralysis, various conditions contraindicate their use, making static suspension of the paralyzed face a reasonable surgical alternative. Expanded polytef soft-tissue patch (polytetrafluoroethylene; Gore-Tex Soft-Tissue Patch, Gore-Tex, W. L. Gore & Assoc Inc., Flagstaff, Ariz) was used to help correct midfacial and perioral asymmetries in 11 patients with complete unilateral facial paralysis. All patients had previous surgical ablation of the facial nerve and were not considered good candidates for dynamic facial reconstruction. Midfacial and perioral asymmetries were improved in all patients using this technique of static soft-tissue suspension. One postoperative infection and two cases of postoperative suture extrusion were observed in the patient population. Other complications associated with the use of Gore-Tex Soft-Tissue Patch for facial suspension were limited to technical factors.

Adolescent↗
PubMed1975

Infectious mononucleosis, mastoiditis, and facial paralysis.

To our knowledge this is the first report of a patient with infectious mononucleosis associated with a mononuclear granulomatous mastoiditis and facial paralysis. Pathologic examination of tissue from this patient, removed at the time of radical mastoidectomy, provides a basis for further speculation about the relationship between facial paralysis and infectious mononucleosis.

Adolescent↗
PubMed1978

[Facial paralysis during progressive chronic otitis. Reflections apropos of 32 cases].

The authors report their experience of 32 cases of facial paralysis occurring during progressive chronic otitis. Twenty were pre-operative. The conclusions which may be drawn are as follows: 1) It occurs in general in cases of severe chronic otitis with large destructive cholesteatomatous and osteitic lesions. 2) Surgery is often difficult, long full of unexpected findings and risks. 3) The development of facial paralysis in a case of progressive chronic otitis is an indication for immediate surgery, on the same basis as a fistula of the H.S.C.C., which is, in fact, oftan present in association. 4) The lesions encountered are much more extensive at the time of secondary (11) rather than at primary surgery (9). 5) The extent of the lesions (13 cases of fistula or laybrinthine destruction) and auditory impairment (16 cophoses or sub-cophoses) are such that tympanoplasty is useless. The authors report their long term results: 13 cases of complete recovery, 4 nil, 3 partial (2 as a result of a superficial cervical plexus graft). They raise the problem of the management when a markedly contused nerve is discovered: simple liberation with incision of its sheath or immediate graft? The other twelve were postoperative. Five were cases operated upon by the autor. There was 100% recovery in all cases, but one patient, in whom the nerve followed an atypical course, required decompression surgery. In the other seven, the autors performed 3 decompressions followed by an excellent result, apart from in one case in which the nerve was markedly contused. In 2 cases a superficial cervical plexus graft and a XII-VII anastomosis proved necessary.

Adolescent↗
PubMed1983

Rehabilitation of facial paralysis in children.

We report the experience and philosophy of the Department of Otolaryngology and Communicative Disorders at the Cleveland Clinic in rehabilitation of facial paralysis in children 12 years old and younger. The causes and evaluation of facial paralysis in children and the options available for rehabilitation are considered, and the criteria, expectations, and limitations of successful rehabilitation are outlined. Depending on the limitations imposed by the clinical situation, the aims of treatment are as follows: (1) normal resting tonus, (2) symmetry at rest, (3) symmetry in motion, (4) no synkinesis, (5) appropriate mimetic function, (6) no significant loss of adjacent function, and (7) rapid return of function. Every attempt must be made to avoid causing any significant muscular or neurologic deficit and to avoid interfering with return of function of the seventh nerve, when that possibility exists.

Child↗
PubMed1985

[Peripheral facial paralysis, polyneuritis and chronic Chagas' disease].

The author reports the case of a 42-year-old woman who developed right peripheral facial paralysis and mixed polyneuritis in the course of an undiagnosed Chagas' disease. The clinical diagnosis could be confirmed by serological reactions for Chagas' disease. A likely relationship between chronic Chagas' disease, peripheral facial paralysis and mixed polyneuritis is discussed.

Adult↗
PubMed1994

Orbicular synkinesis after facial paralysis: treatment with botulinum toxin.

Involuntary lid closure not rarely accompanies aberrant regeneration of nerve fibers after different types of facial paralysis. 23 patients with such synkinesis were treated with botulinum toxin injections into the orbicularis oculi muscle. After periocular injections all patients showed much improvement: a period of, on the average, 13 symptom-free weeks was followed by a period of minimal symptoms. There were only minor complications. Whenever repeated treatment is necessary, botulinum toxin proves to be an effective therapy for involuntary lid closure after defective healing following facial paralysis.

Adult↗
PubMed2005

[Clinical observation on plum-blossom needle therapy combined with cupping for treatment of acute facial paralysis].

OBJECTIVE: To observe clinical therapeutic effect of plum-blossom needle therapy combined with cupping at the affected side on acute facial paralysis. METHODS: The such patients were randomly divided into a treatment group and a control group, 32 cases in each group. The patients of the two groups were treated with the same Western medicines, and at the acute stage, the treatment group were treated by tapping the affected face, the surroundings of retroanricular mastoid, the region with aching pain in the neck side with plum-blossom needle and cupping, and then local radiation by TDP, and the control group were treated by TDP radiation at the same area. In the stationary phase and restoration stage, the two groups were treated by body acupuncture at the affected side with a same therapeutic course. RESULTS: The cured rate was 81.2% in the treatment group and 68.7% in the control group with a significant difference between the two groups (P < 0.05), and there was a significant difference between the two groups in therapeutic course for cure (P < 0.01). CONCLUSION: Plum-blossom needle therapy combined with cupping at the affected side can help restore functions of facial nerves, and obviously increase the cured rate and shorten the therapeutic course for acute facial paralysis.

Acupuncture Therapy↗
PubMed1986

Reanimation of the long-standing partial facial paralysis.

Those unfortunate people who suffer from permanent partial facial paralysis have great difficulty finding surgeons who can offer corrective operations. Improving their function is a most delicate procedure. Great care must be exercised to avoid injuring nerves and muscles which are still operating, although in a greatly diminished state. The pathogenesis must be understood before attempting any corrective procedure. Adequate time must elapse from the moment of injury to surgical intervention, thus allowing for maximal nerve and muscle regeneration. This paper describes techniques that could improve facial movements. The most frequently used procedure is shortening of the levator and/or the zygomatic muscles that are partially atrophied. It must be understood that total reanimation is impossible as of this time.

Adolescent↗
PubMed1994

Acute facial paralysis: is it a stroke--or something else?

Acute facial paralysis, particularly when it occurs in older patients with diabetes and/or hypertension, can raise the specter of "stroke." A careful history and clinical examination, however, may establish the diagnosis of Bell's palsy, and this is usually possible without expensive additional testing.

Acute Disease↗
PubMed1982

Facial nerve abnormalities after acoustic tumor removal. Morphological and clinical study of seven patients with postoperative facial paralysis.

Operative specimens of the tympanic segment of the facial nerve obtained from seven patients during hypoglossal-facial anastomosis surgery were studied under light and electron microscopy. All patients previously underwent acoustic tumor removal during which the facial nerve was left anatomically intact but attenuated; immediate postoperative facial paralysis was present and persisted. In all specimens, the fascicular area of the nerve had two differing zones: a smaller one with normal-looking populations of myelinated nerve fibers, and a large one with severe reduction of myelinated nerve fibers and an increase of the deposition of endoneurial collagen. The changes indicate that in all cases, the motor fibers have undergone degeneration with subsequent regeneration. However, regeneration has remained incomplete with total lack of normal-sized (7 to 10 micrometers) motor fibers. Incomplete regeneration explains the lack of functional improvement. The structural features of the distal stump of the facial nerve with numerous Schwann's cell tubes were evaluated to provide favorable preconditions for reinnervation through anastomosis. Clinical follow-up of all patients showed varying degrees of functional restoration indicating regeneration.

Adult↗
PubMed1999

Rapid simultaneous comparison system for subjective grading scales grading scales for facial paralysis.

OBJECTIVE: The senior authors developed a computer-assisted rapid, simultaneous comparison system for nine international grading scales for facial paralysis. The purpose of this study is to present the system and to compare the agreement of hand-performed House-Brackmann and Sunnybrook scales, two frequently used scales herein taken as the concurrent criterion test standards, with those like scales done simultaneously in the computed system. STUDY DESIGN: The study design was a prospective concurrent criterion validity study. Test-retest reliability and interobserver agreement were assessed using the kappa statistic (k) for ordinal data and the intraclass correlation coefficient (ICC) for semidimensional data. SETTING: The study was conducted at a university practice. PATIENTS: Ten consecutive consenting subjects with varying degrees of facial paralysis were studied. INTERVENTION: Each subject was measured, in random order, twice by each method by each of two independent observers. MAIN OUTCOME MEASURES: House-Brackmann score, Sunnybrook score, and like-scale scores done simultaneously in the computed system were measured. RESULTS: Agreement between the computed system and hand-performed criterion standards was equal to each scale compared against itself; for the House-Brackmann, agreement was moderate (k = 0.554); for the Sunnybrook, agreement was excellent (ICC = 0.976). CONCLUSIONS: The computed system has the advantage of allowing an examiner to view a rapid, simultaneous display of multiple grading scale scores at a keystroke from one clinical assessment input, obviating the labor of repeating measures by hand.

Adult↗
PubMed1988

New surgical approaches to the management of ocular exposure secondary to facial paralysis.

Restoring dynamic eyelid function in patients who experience facial paralysis is a difficult problem. Some procedures necessary to protect the globe, such as tarsorrhaphies, may be cosmetically disfiguring and functionally disabling. Several surgical procedures may be used in combination to restore function and, at the same time, achieve satisfactory cosmesis. The use of gold weights and ear cartilage grafts is described. In the author's experience, the use of this combination produces very good results.

Cartilage↗
PubMed2006

[Free micro-vascular muscle transplantation for the treatment of late facial paralysis using extensor digitorum brevis and extensor hallucis brevis].

OBJECTIVE: To investigate the result of free vascular transplantation of denervated extensor digitorum brevis and extensor hallucis brevis for the treatment of late facial paralysis. METHODS: From April 2003 to April 2005, 26 cases of facial paralyses were treated by transplantation of denervated extensor digitorum brevis and extensor hallucis brevis. During operation, the ends of the tendons were fixed at ala nasi, middle point of nasal labial fold,oral commissure and chin; the muscle belly were put around the masseter nerve to correct the nasal and oral deformity, microsurgery was applied to anastomose the tarsus lateral vessels to the superficial temporalis vessels or the facial vessels. The result of the operation was evaluated by the Standard of Douglas Harrison and the Paresis Assessment scoring system of Stennert. RESULTS The static appearance was satisfactory in 26 cases after operation, the bilateral oral commissure was symmetry and the dynamic appearance was greatly improved 6 months after operation. Among the 23 cases whose disease history was above 2 years, all could smile naturally and show their teeth symmetrically except 1 case who could only move the oral commissure. Among the 3 cases whose disease history was less than 2 years, one could smile naturally and show his teeth symmetrically, one could smile but could not show his teeth symmetrically, another could move oral commissure but have no motion appearance. The result was evaluated as "+++" according to Standard of Douglas Harrison, accounting for 88% (23/26). Evaluated according to the Paresis Assessment scoring system of Stennert, the difference before operation and after operation was more than 5, accounting for 86% (22/26). CONCLUSION: The free vascular transplantation of denervated extensor digitorum brevis and extensor hallucis brevis can reconstruct the oral appearance for the treatment of late facial paralysis.

Adolescent↗
PubMed1992

[Observation on 63 cases of facial paralysis treated with acupuncture].

Sixty-Three cases with facial paralysis were treated mainly by acupuncture combining with point injection. The main points selected were Yangbai (GB14), Wai Jingming (BL1), Sibai (ST2), Yingxiang (LI20), Dicang (ST4), Jiache (ST6), Quanliao (ST18) and Qianzheng. The points were used alternatively. Auxiliary points: for type of deficiency of both qi and blood, Zusanli (ST36), and Sanyinjiao (SP6) were added: for type of disharmony between Ying and Wei, Fengchi (GB20) and Hegu (LI4) were added; for type of stagnancy of qi and blood, Weiguan (TE5) and Taichong (LR3) were added; for type of wind-heat stagnating collaterals, Yifeng (TH17) and Yanglingquan (GB34) were added. 10 out of 60 cases, which showed no remarkable effectiveness after two courses, injection of vitamin B1 and vitamin B12 to facial points combined with Hegu (LI4) point on opposite side was performed. Therapeutic results: 31 cases (49.2%) were cured, 15 cases (23.8%) markedly effective, 16 cases (25.4%) effective and 1 case (1.6%) ineffective.

Acupuncture Points↗
PubMed2001

[Successful reanimation of facial paralysis with an indirect anastomosis between hypoglossal nerve and facial nerve, without loss of function of the tongue].

OBJECTIVE: To describe the surgical procedure and the results of the indirect hypoglossal-facial nerve anastomosis using a free nerve graft in patients with facial nerve paralysis. This technique leaves the tongue function intact. DESIGN: Prospective study. METHODS: Tongue function was assessed in 39 consecutive patients who underwent this procedure and facial reanimation was assessed in 29 of these patients who had completed at least 24 months follow-up. Facial nerve function was judged using the House-Brackmann (HB) facial nerve grading system. RESULTS: Tongue movements were normal in all operated patients; one patient had mild homolateral atrophy. Initial facial movements occurred on average 7.5 months postoperatively (range 4 to 18 months) in all but one patient. The results were graded HB II in 6 patients (20.9%), HB III in 13 (44.6%), HB IV in 7 (24.1%), HB V in 2 (6.8%) and HB VI in 1 patient (3.4%). Hemifacial synkineses were noticeable but no mass movements or gross hypertonia were observed (as are often present in direct hypoglossal-facial anastomosis). The results of facial reanimation were significantly better in young patients and when a short time interval between paralysis and surgery existed. HB grade II was achieved only if the duration of paralysis was less than 12 months. CONCLUSION: Indirect hypoglossal-facial anastomosis with interposition of a nerve graft allows preservation of tongue function together with good overall facial reanimation, and is therefore to be preferred to the classical direct hypoglossal-facial anastomosis.

Adult↗