Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “FACIAL NERVE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 325 records · Page 18Linked to original sources
PubMed2004

[Neuronavigation-assisted microanatomical study of the facial nerve canal through the transpetrosal approach].

OBJECTIVE: To study the value of neuronavigation in the transpetroal approach, and to provide anatomic data for the protection of the nerves in the facial nerve canal (FNC) during surgeries. METHODS: Simulated surgery through the transpetroal approach was performed on 16 sides of 8 adult cadaver heads with the assistance by neuronavigation. The anatomy of the facial nerve and the relationship of related structures were observed and the distances from the utmost external edge of the mastoid to different segments of the FNC were measured. RESULTS: Neuronavigation was successful with all the FNC, with the mean error of less than 0.9 mm. The FNC could be divided into 3 segments, the labyrinthine, the tympanic and the mastoid segments, stretching 3.6+/-1.2 mm, 11.2+/-2.5 mm and 16.1+/-3.6 mm respectively and with diameters of 1.2+/-0.3 mm, 1.4+/-0.1 mm and 1.7+/-0.2 mm, respectively. CONCLUSION: Neuronavigation may help protect the FNC during surgical procedures, and a thorough knowledge of the anatomic features of the FNC can be significant for preservation of the facial nerves.

Adult↗
PubMed1999

Neurotologic evaluation of facial nerve paralysis caused by gunshot wounds.

Facial nerve injury is one of the most common neurotologic sequelae of a gunshot wound (GSW) to the head or neck. However, few neurotologic studies have been performed on the nature and time course of such facial nerve impairments. This study was designed to characterize the neurotologic manifestations and time course of facial nerve paralysis caused by GSWs to the head and neck. We conducted a battery of electrodiagnostic tests on 10 patients who had experienced traumatic facial paralysis due to a GSW to the head or neck. The etiologies of facial nerve paralysis--including direct injury, compression, fracture, and concussion of the temporal bone--were demonstrated by audiologic, radiologic, and surgical findings. Hearing loss and other cranial nerve injuries were also seen. Six of the 10 patients experienced a complete paralysis of the facial nerve and a poor recovery of its function. We also present a comprehensive case report on 1 patient as a means of discussing the evaluation of facial nerve function during the course of management.

Adult↗
PubMed1981

Surgery of the facial nerve.

The diagnosis and management of facial nerve disorders are challenging aspects of neurotological practice. In Bell's palsy and Herpes Zoster oticus facial nerve decompression is indicated in approximately 10 per cent of cases within the first three weeks if 90-95 per cent degeneration has occurred. The presence of a dry eye determines whether the lesion is proximal to the geniculate ganglion and a middle fossa approach is necessary. Injury to the facial nerve occurs most commonly as a result of temporal bone fractures, from either blunt trauma or penetrating wounds. Occasionally iatrogenic injury occurs during ear surgery. Injury resulting in immediate and total facial paralysis with degeneration confirmed by appropriate electrical testing requires facial nerve exploration. In the presence of an injury proximal to the geniculate ganglion and hearing preservation, exploration of the nerve via middle fossa approach is indicated. If the hearing is lost then the translabyrinthine approach is appropriate. In the event the entire interosseous segment requires exposure, both mastoid and middle fossa exposures are required. If the traumatized facial nerve has not been divided it is decompressed proximal and distal to the injury site. In the event the nerve is divided, a direct anastomosis is the ideal treatment. Rerouting is necessary to achieve adequate length for the anastomosis. Nerve grafting is done when required.

Accidents, Traffic↗
PubMed1990

Antidromically evoked facial nerve responses in guinea pigs: a basis for clinical applications in patients with facial palsy.

We investigated the differences in wave form in antidromically evoked facial nerve responses in guinea pigs with and without facial nerve dysfunction. The antidromic facial nerve responses were evoked with alternative stimulation of positive and negative square-wave pulses of 0.1 ms duration and recorded at the bony fallopian canal near the geniculate ganglion. One hundred responses were summed by a signal processor. The application of alternative stimulations made it possible to eliminate stimulus artifacts and to analyze precisely the waves with latencies shorter than 0.5 ms in the test animals. Normal antidromic facial nerve responses showed a triphasic wave form with two positive and one negative peaks. A blockade of the nerve between the recording and stimulating sites resulted in transformation of the wave into a monophasic one. A proximal blockade to the recording site changed the wave form to a biphasic shape. These findings suggest that the site of an intratemporal facial nerve lesion can be predicted from the wave forms evoked by antidromic facial nerve responses.

Animals↗
PubMed2003

Endoscopic dissection of recipient facial nerve for vascularized muscle transfer in the treatment of facial paralysis.

In order to prepare recipient facial nerve branches for neurovascular muscle, transfer in the treatment of facial paralysis, endoscopic facial nerve dissection was employed. Under endoscopy recipient facial nerve branches innervating the zygomaticus major muscle were successfully dissected. A stab incision was sufficient for nerve suture with the donor nerve. This method is preferable for young or female patients in whom conventional cheek incisions should be avoided.

Adolescent↗
PubMed2003

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

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.

Blepharospasm↗
PubMed1977

Management and rehabilitation of the facial nerve in parotid surgery.

The facial nerve is the single most important consideration in the surgical management of most parotid disorders. Its surgical anatomy should be well known by the head and neck surgeon. Very few conditions of the parotid gland necessitate the sacrifice of the facial nerve. When this decision is made, the benefits to be derived should be very thoughtfully measured against the tremendous cosmetic and functional sequelae that follow, and the patient should understand preoperatively to the fullest the magnitude of this decision and all its consequences. Most facial nerve deficits resulting from injury or sacrifice of the nerve can be and are best repaired by either direct anastomosis or autografting using a donor sensory nerve. Such restorations of the neuromuscular mechanism yield a physiologic result that is as close to the preinjury state as possible, and this is reflected in cosmetic and functional recoveries that are generally superior to any other of a variety of rehabilitative techniques. In all patients with a paralyzed face, extremely close attention must be given the involved eye to minimize the hazards of corneal injury.

Cervical Plexus↗
PubMed2003

Facial nerve paralysis following cochlear implant surgery.

OBJECTIVES: Facial nerve paralysis is a rare but devastating complication of cochlear implant surgery. The aims of the study were to define the incidence of facial nerve paralysis in our series and understand possible mechanisms of injury. STUDY DESIGN: Retrospective chart review and case reports. METHODS: Charts were reviewed of all 705 patients implanted between 1980 and 2002 at the authors' institutions to identify those with postoperative facial nerve weakness and determine incidence. For patients with facial nerve weakness, onset, degree, and timing of paralysis were noted; clinical findings were correlated to operative report findings. The method of treatment was noted, and the final facial nerve function outcome was recorded. RESULTS: Five patients (one child and four adults) were found to have postoperative facial nerve weakness, for an incidence of 0.71%. This complication was delayed in all cases, ranging from 18 hours to 19 days postoperatively. All patients were treated with steroids or steroids combined with antiviral medication, and all ultimately recovered normal facial function. CONCLUSIONS: In the study series, the incidence of facial nerve paralysis following cochlear implant surgery was 0.71%. Possible mechanisms of injury included heating injury and viral reactivation. All patients presented with a delayed facial nerve paralysis and did recover normal facial nerve function.

Adult↗
PubMed1988

Surgical rehabilitation of facial nerve.

The management of facial nerve lesions using microsurgical techniques should be part of the armamentarium of surgeons managing head and neck problems. One has to differentiate between techniques for repair of the nerve itself and secondary reconstructive operations. Direct nerve reconstruction, indirect nerve reconstruction and combined procedures are discussed in detail. Secondary reconstructive methods are indicated if repair of the nerve itself is not possible. The results of 31 cases of facial nerve rehabilitation are presented.

Adolescent↗
PubMed1996

A histomorphometric analysis of the cross-facial nerve graft in the treatment of facial paralysis.

One of the most unsettling sequela of facial paralysis (FP) is the loss of the blink reflex, leading to both a functional and aesthetic deformity. A successful method of treating FP and, in particular, loss of eye-sphincter function, is the use of the cross-facial nerve graft (CFNG) to reinnervate the previously denervated orbicularis oculi muscle. The present study examined the histomorphometric aspects of the entire CFNG, with respect to axon diameter and myelin area. The axon profile of the CFNG had a positive correlation with motor end-plate counts and electrophysiologic recordings. These results should help in further understanding the number of motor axons needed to restore adequate function to the paralyzed eye sphincter, and establish more rational reconstructive procedures.

Animals↗
PubMed1985

Peripheral facial nerve dysfunction: CT evaluation.

Peripheral facial nerve dysfunction may have a clinically apparent or occult cause. We reviewed the clinical and radiographic records of 36 patients with peripheral facial nerve dysfunction to obtain information on the location of the suspected lesion and the number, sequence, and type of radiographic evaluations performed. Inadequate clinical evaluations before computed tomography (CT) was done and unnecessary CT examinations were also noted. In those patients in whom the cause of peripheral facial nerve dysfunction is apparent, the clinical-radiographic workup is self-evident. When the cause of dysfunction is occult, however, a tailored CT examination should be done based on a thorough clinical evaluation. We have suggested a practical clinical and radiographic scheme to evaluate progressive peripheral facial dysfunction with no apparent cause. If this scheme is applied, unnecessary radiologic tests and delays in diagnosis and treatment may be avoided.

Adolescent↗
PubMed1979

Nerve suture and grafting to restore the extratemporal facial nerve.

A concept for dealing with extratemporal lesions of the facial nerve is based on cadaver studies performed by Meissl. In spite of plexiform arrangement and fiber exchange, areas and fascicle groups can be differentiated within the cross section of the facial nerve which contain a great percentage of the fibers supplying a certain muscle group. An attempt should be made to unite the corresponding parts by direct coaptation, or, if nerve defect exists, by nerve grafts.

Facial Muscles↗
PubMed1997

Microsurgical anatomy of the facial nerve.

Microsurgical dissection of cadaver facial nerves revealed quantifiable complexities not presented in standard description. Total branches, intraparotid connections between divisions, and extraparotid connections between divisions are more common than generally noted, and 33% of the dissections demonstrated an extraplanar buccal branch originating within the parotid gland, and innervating the perioral muscles. These details of facial nerve anatomy suggest surgical procedures such as tumor resection, facial nerve reconstruction, facial reanimation, and facelifting.

Facial Nerve↗
PubMed1998

Blood distribution in the facial nerve in temporal bones acquired from cases with subarachnoid hemorrhage.

The objectives of this study, conducted in eight temporal bones from five autopsied cases of subarachnoid hemorrhage, were to delineate the communication between the cerebrospinal fluid space and each space of the epineurium, perineurium, and area surrounding the nerve fibers in the facial nerve and to identify the site of hypertonic diuretic solution infusion most likely to decrease the facial nerve swelling at the initial stage of facial palsy. In all eight specimens, blood cells had directly entered into each space from the labyrinthine segment of the facial nerve. The subarachnoid space extended to the first genu of the nerve. The genu, which is the site of the initial lesion in Bell's palsy, is concluded to be the most effective site of intracanal decompression of the facial nerve with hypertonic diuretic solution.

Adult↗
PubMed1995

Delayed onset facial nerve dysfunction following acoustic neuroma surgery.

Delayed onset facial nerve dysfunction following acoustic neuroma surgery is an under-appreciated phenomenon. The authors have recently reviewed long-term (> 1 year) facial nerve outcome in 129 patients who underwent acoustic neuroma removal with the aid of cranial nerve monitoring between 1986 and 1990. The facial nerve was anatomically preserved in 99.2% of the patients, and at one year, 90% of all the patients had House-Brackmann (H-B) grade I or II facial nerve function. Delayed onset worsening of facial nerve function was noted in 38 of 129 (29%) patients, most of which occurred in the first few postoperative days. The incidence increases to 41% (38 of 93) when corrected for those with immediate H-B grade VI weakness, and who therefore could not manifest further deterioration. The facial nerve function either deteriorated from normal to abnormal or increased in severity of weakness. Delayed facial palsy was not related to the size of tumor or the surgical approach. The most common occurrence was that of a patient with H-B grade I or II facial nerve function worsening to H-B grade VI in the postoperative period. The prognosis for recovery of facial nerve function following delayed palsy was excellent. In the majority of cases, the recovery was complete within the first 6 months without specific treatment. Comparable to the patients without delayed palsies, 89% (34 of 38) of the cases had H-B grade I or II and 97% (37 of 38) had H-B grade III or better facial nerve function at 1 year. This review suggests a surprisingly high incidence of delayed facial palsy following acoustic neuroma surgery, which fortunately has an excellent prognosis for spontaneous recovery.

Adult↗
PubMed2006

[Diagnosis and management of facial nerve neuromas].

OBJECTIVE: To provide the experience for early diagnosis and management of facial nerve neuromas, and to discuss the clinic and imaging feature of facial nerve schwannoma and facial nerve fibroma in 22 cases. METHODS: Twenty cases facial nerve schwannoma and two cases of facial nerve neurofibroma were diagnosed and reviewed retrospectively. Surgical removal were performed through the middle cranial fossa in 2 cases, through intratemporal approach in 8 cases, through intraparotid approach in 2 cases, and combined intra-temporal with out-temporal approaches in 10 cases. Seventeen cases underwent facial nerve graft for repairing a facial nerve defect. Great auricular nerve was used in 3 cases with intratemporal approach and 1 case with intratemporal combined intraparotid approach. Sural nerve graft was used in 5 cases with intratemporal approach and 8 cases with intra-temporal combined intraparotid approach. Two cases were employed two-stage facial muscle flap-plasty. RESULTS: Facial nerve neuromas were totally removed in 21 cases and subtotal neuroma removed in 1 case. In these cases, 20 patients were no recurrence and 1 patient was lost follow-up. One patient with subtotal neuroma removal received Gamma Knife treatment before and after surgery, and this case was no recurrence. The CT imaging of the temporal bone showed that schwannoma was separated "white mass" with smooth margin along the region of facial nerve without intact canal. But neurofibroma locate in enlarge fallopian with intact canal. Magnetic resonance imaging had the advantage of evaluating all segments of the facial nerve and showed continuity of intratemporal and intraparotid mass with the facial nerve. Pathological results indicated that 20 cases were diagnosed as facial nerve schwannoma and 2 cases were neurofibroma. CONCLUSIONS: Although tumors originating from the facial nerve are extremely rare, it is possible to make early diagnosis through finding clinical feature and imaging methods. Generally, systematic surgical approach for tumor removal and facial nerve reconstruction should be considered in the cases with facial neurinoma.

Adolescent↗
PubMed1995

Meatal facial nerve decompression in acoustic neuroma resection.

Delayed facial palsy occurs after approximately 15% of acoustic neuroma resections. Whereas in most cases facial nerve function recovers satisfactorily, in about 12% of cases delayed facial palsy may have a poor functional recovery. The fate of facial nerve function was studied in 55 consecutive translabyrinthine acoustic neuroma resections, 23 of whom underwent meatal facial nerve decompression (MFND) at the time of tumor resection. The facial nerve results also were reviewed in 19 middle cranial fossa resections, of whom 14 underwent MFND. There was a bimodal distribution of the delayed palsies, with one group having the onset of palsy within hours to 2 days after surgery and the second group having onset of palsy up to 17 days after surgery. The poorest recoveries were seen in the first group. Although the effect was not statistically significant due to the small sample size, the chance of facial weakness in patients who underwent MFND after translabyrinthine surgery was about 40% less than in those who did not undergo decompression. The apparent protective effect of MFND was increased when the confounding factors of tumor size and degree of resection were taken into account, although the effect was not statistically significant. The duration of palsy was shorter and ultimate recovery better among the patients who underwent facial nerve decompression than in those who did not. Of the translabyrinthine patients who underwent MFND, 100% had House-Brackmann grade I-II function at 2 years, whereas 87% of patients who did not have MFND had grade I-II function and 13% had grade III-IV function. Without MFND, 57% of translabyrinthine patients whose onset of facial palsy was within 2 days of surgery had grade III-IV facial nerve function.

Facial Nerve↗