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At least 307 records · Page 17Linked to original sources

Endoscopic forehead lift for ptosis of the brow caused by facial paralysis.

Twelve patients with ptosis of the brow caused by facial nerve paralysis were treated by endoscopic forehead lift. Four had an isolated paralysis of the temporal branch of the facial nerve and in eight the entire facial nerve was affected. In two of these patients the facial paralysis was bilateral, caused by Finnish hereditary amyloidosis. A standard subperiosteal endoforehead approach was used and the forehead was fixed by biodegradable pins (n = 8), anchor screws (n = 3), or a suture to the posterior scalp (n = 1). The procedure was a success in 10 patients, and failed in two after initially good results. The endoscopic brow lift is a good method of treating ptosis of the brow caused by paralysis of the temporal branch of the facial nerve.

Adult↗

[Idiopathic facial paralysis (Bell's palsy): a study of 180 patients].

The objective of this study was to analyze some clinical and epidemiologic aspects, as well as the follow up of 180 patients with Bell's palsy. In the study population there was a predominance of female (66.7%). Two peaks of incidence in the age distribution were identified: third-fourth and sixth decades of life. In the group of 180 patients there were 198 events of facial paralysis, 17 recurrences and in one patient the paralysis was bilateral at the onset. In 15 patients (8.3%) there were recurrences of the facial paralysis, in 12 cases (70.6%) the recurrences were ipsilateral. The left side of the face was involved in 55.6% of the cases. In eight patients the paralysis occurred during pregnancy (n=5) or puerperium (n=3). As associated conditions we found: arterial hypertension (11.7%), diabetes mellitus (11.1%), pregnancy or puerperium (4.4%; 6.7% in the women), and neurocysticercosis (1.1%). In 72.8% of the cases no association with such conditions was found. In 22.8% of the patients some kind of sequelae were identified: hemifacial spasm (12.8%), partial recovery of the motor deficit (10.6%), syndrome of the crocodile tears (3.3%), sincinetic contraction (2.8%), and the Marcus Gunn inverse phenomenon (1.1%). In conclusion, this study shows that the idiopathic facial paralysis may lead to important sequelae in more than 20% of the patients.

Adolescent↗

[On the contribution of magnets in sequelae of facial paralysis. Preliminary clinical study].

This trial was designed to evaluate the efficacy of EPOREC 1 500 magnets as an adjuvant to rehabilitation following peripheral facial paralysis. Magnetotherapy is used in many other specialties, and in particular in rheumatology. The properties of repulsion between identical poles were used to decrease the effect of sequelae in the form of contractures on the facial muscles. There were two groups of 20 patients: one group with physiotherapy only and the other with standard rehabilitation together with the use of magnets. These 40 patients had facial paralysis of various origins (trauma, excision of acoustic neuroma, Bell's palsy etc). Obviously all patients had an intact nerve. It was at the time of the development of contractures that magnets could be used in terms of evaluation of their efficacy of action on syncinesiae, contractures and spasticity. Magnets were worn at night for a mean period of six months and results were assessed in terms of disappearance of eye-mouth syncinesiae, and in terms of normality of facial tone. Improvement and total recovery without sequelae were obtained far more frequently in the group which wore magnets, encouraging us to continue along these lines.

Facial Paralysis↗

[Quantitative analysis of MRI intensity in of the major petrosal nerve in patients with idiopathic facial paralysis].

The objective of this study was to evaluate signal intensity increases in the greater petrosal nerve after contrast agent administration to gather information on the etiology of idiopathic peripheral facial paralysis. Magnetic resonance images were obtained from 18 patients who received inpatient medical treatment for acute peripheral facial nerve palsy. Images of intratemporal segments of the facial nerve were taken with a slice thickness of 0.75 mm. After multiplanar reconstruction, regions of interest (ROI) were defined in the proximal segment of the greater petrosal nerve. After multiplanar reconstruction, it was possible to visualize the greater petrosal nerves of all 18 patients. The nerve's average diameter was found to be 0.68 mm (range 0.5-0.9). Signal intensity increased by an average of 50.3% (range -10-146%) after contrast agent administration. Whereas this intensity was slightly reduced in two patients, it was increased in 16. No correlation could be established between greater signal intensity and medical history, clinical condition, laboratory findings, or electrophysiological data. In contrast to quantitative measurements in the facial nerve, ROI measurements in the greater petrosal nerve do not correlate with medical history, clinical condition, or laboratory findings. For this reason, MRI of this nerve does not enable us to draw conclusions on the etiology of idiopathic peripheral facial paralysis.

Adolescent↗

[Rehabilitation of facial paralysis by temporal muscle flap and implantation of gold weights].

Facial paralysis is a severe disability that often produces major ocular disorders, cosmetic deformities, and, in many cases, functional incapacity for something as characteristic of human beings as facial expression. For these reasons, it is necessary to correct this defect as completely as possible to produce the best physiological result. Of the many methods available for the repair of the lesion, most authors agree that direct repair of the nerve is the most reliable technique. When this is not feasible, the use of gold weights for the eyelid and a temporalis muscle flap for the mouth are two easily realized methods that are reversible and produce good esthetic and functional results. As a result, this is the technique of choice for this disorder and it has the added advantage of being compatible with other procedures.

Adolescent↗

Mandibular condylar growth alterations after unilateral partial facial paralysis: an experimental study in the rabbit.

In a previous study in the rabbit, the authors defined the macroscopic growth alterations after unilateral partial facial paralysis. Dry skull measurements revealed a reduced premaxillary, maxillary, mandibular, and anterior corpus length with a simultaneous increase in mandibular ramal height on the paralyzed side. The authors hypothesize that these mandibular growth alterations are, among others, caused by alterations in condylar growth activity and that an altered occlusal relationship may be involved in the adaptive condylar growth response after facial paralysis.A total of 84 New Zealand White rabbits were used for this study. The animals were randomly assigned to either a control group that was not operated on (n = 28), a group that underwent a sham-operation (n = 28), or an experimental group (n = 28). In the sham-operation group, the facial nerve was dissected as in the experimental group but was left intact. In the experimental group, a left-side partial facial paralysis involving the midfacial muscles was induced by an operation at the age of 12 days. After different follow-up time intervals of 3.5, 7, 14, 21, 28, 42, and 56 days, four control, four sham-operation, and four experimental animals (all randomly selected) were killed for histomorphometric measurements of the left control and sham condyles and the left-side and right-side experimental condyles. No significant differences between the control and sham-operation groups were found. The other results revealed that shortly after the paralysis in the experimental group, as compared with the controls, a decrease in condylar growth activity was seen before a catch-up increase in activity, as expressed by the time-sequenced decrease and increase in the height of the functional and hypertrophic chondroblast layer. The response on the right side was analogous, though less intense. It is suggested that the mandibular ramal growth alterations might be the result of a chain of adaptations involving the lateral pterygoid muscle and the condylar growth activity. The unilaterally restricted length increment of the maxillary snout, as a result of the loss of tensile forces caused by paralysis of the midfacial musculature, necessitated an adaptation in the position of the mandible to maintain a normal occlusal relationship. Subsequently, the function of muscles involved or influenced by an altered mandibular position, such as the lateral pterygoid muscle, were changed. These altered muscle activities induced condylar growth adaptations, which in turn explained the alterations in mandibular ramal growth.

Animals↗

Ultrasonography for the diagnosis of Lyme disease in cases of acute facial paralysis.

Ultrasonography of the parotid gland was introduced in 1989 as part of the diagnostic protocol of every patient treated in our clinics with acute facial paralysis. Ten of 50 patients so tested were found to have unilateral nonpalpable enlarged lymph nodes in the caudal portion of the parotid gland around the stylomastoid foramen. All 10 patients were eventually diagnosed as having Lyme disease. It is suggested that in patients with acute facial paralysis, ultrasonography is an inexpensive tool to improve diagnosis of Lyme disease and may have a more useful purpose in monitoring therapy.

Acute Disease↗

[Electrophysiological study of congenital facial paralysis].

The common cause of neonatal facial asymmetry is facial nerve paralysis or "asymmetric crying facies syndrome". In the not uncommon later the lower lip, symmetrical at rest, becomes tilted to the so-called normal side when the patient is smiling or crying, as the congenital hypogenesis of sublabial muscles fail to pull down the lower lip in the opposite side. The electrophysiological differentiation between the two diseases has been performed by orbicularis oculi and oris reflexes with mechanically glabellar and supralabial tapping stimulation, respectively, in addition to needle and/or surface EMG recording. In the facial nerve paralysis of the case 1, R1 and R2 were absent in the orbicularis oculi and oris reflexes. EMG activity was completely lacking over the M. orbicularis oculi and oris innervated by facial nerve. On the contrary, the orbicularis oculi and oris reflexes were normal in the asymmetric crying facial of the case 2. EMG activity was absent only in the sublabial muscles including M. depressor anguli oris and/or M. depressor labii inferioris. Furthermore, needle EMG disclosed no spontaneous activity at rest, which was suggestive of no denervation in the sublabial muscles. It was, however, not possible to determine exactly which muscle the needle was inserted, the M. deprossor anguli oris or the M. depressor labii inferioris. The case 3 might be a variant of asymmetric crying facies with hypogenesis of M. orbicularis oris and/or oculi as well as the sublabial muscle, since the latency was normal but the amplitude was significantly attenuated in the components of orbicularis oculi and oris reflexes.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnosis, Differential↗

A pseudo-malignant Warthin's tumor presenting with facial nerve paralysis.

Facial nerve paralysis, in association with a parotid mass, is generally considered pathognomonic of malignancy. However, nine cases of paralysis with benign tumors have been reported: four in association with a pleomorphic adenoma, three with a Warthin's tumor and one with an oncocytoma. The details of these cases are described and an additional case of Warthin's tumor causing a facial paralysis is reported. In all four cases of Warthin's tumor the pathology is similar, with inflammation, fibrosis and necrosis, especially in areas surrounding branches of the facial nerve. In view of the 10 cases reviewed herein, it is suggested that the pathology be confirmed at the time of surgery and every effort made to preserve facial nerve function.

Adenolymphoma↗

Blink reflex: normal values and its findings on peripheral facial paralysis.

OBJECTIVE: To establish the normal values of blink reflex (BR) in healthy subjects and investigate the manifestations of BR in patients with peripheral facial paralysis (PFP). METHODS: BR was investigated in 23 patients with PFP and 50 healthy persons serving as control. While stimulating the supraorbital nerve on one side, the reflex responses of bilateral inferior-orbicularis oculi were recorded respectively, in which the two components recorded on the ipsilateral side of stimulation were named R1, R2 and the contralateral one, R2'. RESULTS: There was no significant difference between sexes, sides and among various groups of age R1, R2 and R2'. The mean latency of R1 was 10 msec and R2, R2', 29 msec. The absolute values of the amplitude were of relatively smaller significance due to their great variance, whereas the amplitude ratio between two sides was of some value. All patients showed absent response, delayed latency or/and abnormal amplitude on the paretic side, regardless of the side of stimulation, indicating a typically efferent involvement. CONCLUSION: BR is another objective and noninvasive test for facial paralysis in evaluating the lesion site, scope and the abnormality degree, and predicting the prognosis if combined with the clinical conditions.

Adolescent↗

Current status of muscle biopsy in facial paralysis.

The six abnormalities found in pathologic muscle biopsies are described and discussed. Those changes which are indicative of nerve denervation or muscle regeneration are tabulated. Muscle biopsy, as it related to facial paralysis, must still be considered, for the most part, an experimental tool. In certain puzzling situations, eg, neonatal facial paralysis, it can be of value as an adjunct to nerve excitability and electromyographic tests.

Atrophy↗

Observation on electromyogram changes in 93 cases of peripheral facial paralysis treated by point-through-point acupuncture.

Bioelectricity of the affected muscles at acute stage, recovery stage and sequel state in 93 cases of peripheral facial paralysis was observed with EMG. Pathological potential or motor potential was found to be reduced to varying degrees in all the affected muscles. After treatment by point-through-point acupuncture, myodynamia recovered fairly rapidly, EMG showed obvious changes, pathological potential decreased, and the normal motor unit potential increased remarkably. Comparative analysis of EMG before and after acupuncture indicated that point-through-point acupuncture had an obvious therapeutic effect on the disease. It was also very significant that EMG was used in diagnosing various stages of peripheral facial paralysis, evaluation of prognosis and guidance in clinical treatment.

Acupuncture Points↗

Bilateral facial paralysis secondary to lymphoma.

We report a patient with bilateral facial palsy due to a non-Hodgkin lymphoma. He was initially diagnosed to have a facial paralysis of unknown aetiology. Three months after this original diagnosis, he developed a non-Hodgkin lymphoma which was treated successfully with chemotherapy, and his palsy consequently returned to normal.

Cranial Nerve Neoplasms↗