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At least 613 records · Page 34Linked to original sources
PubMed1998

Electromyographic guidance in injecting botulinum toxin.

BACKGROUND: Many practitioners involved with the cosmetic applications of botulinum toxin believe that electromyography (EMG) is an invaluable tool in determining the precise locations to inject. Others feel that it is unnecessary and of no value whatsoever. OBJECTIVES: The objective of this paper is to (1) demonstrate the proper technique for usage of the EMG machine, and (2) determine if its use in connection with injection of facial muscles for cosmetic purposes is worthwhile. CONCLUSIONS: The anatomy of the muscles of the face is somewhat variable from person to person. Electromyography can be a valuable adjunct when injecting botulinum toxin for cosmetic purposes by ensuring that the injecting needle is precisely in the muscle, thereby ensuring that the botulinum toxin will have the greatest possible effect.

Botulinum Toxins, Type A↗
PubMed2000

The significance of orbital anatomy and periocular wrinkling when performing laser skin resurfacing.

Knowledge of orbital anatomy and the interaction of muscle contractions, gravitational forces and photoagingis fundamental in understanding the limitations of carbon dioxide (CO2) laser skin resurfacing when rejuvenating the skin of the periocular area. Laser resurfacing does not change the mimetic behavior of the facial muscles nor does it influence gravitational forces. When resurfacing periocular tissue, the creation of scleral show and ectropion are a potential consequence when there is an over zealous attempt at improving the sagging malar fat pad and eyelid laxity by performing an excess amount of laser passes at the lateral portion of the lower eyelid. This results in an inadvertent widening of the palpebral fissure due to the lateral pull of the Orbicularis oculi. Retrospectively, 85 patients were studied, who had undergone periorbital resurfacing with a CO2 laser using anew treatment approach. The Sharplan 40C CO2 Feather Touchlaser was programmed with a circular scanning pattern and used just for the shoulders of the wrinkles. A final laser pass was performed with the same program over the entire lower eyelid skin surface, excluding the outer lateral portion (e.g. a truncated triangle-like area),corresponding to the lateral canthus. Only a single laser pass was delivered to the lateral canthal triangle to avoid widening the lateral opening of the eyelid, which might lead to the potential complications of scleral show and ectropion. When the area of the crows' feet is to be treated, three passes on the skin of this entire lateral orbital surface are completed by moving laterally and upward toward the hairline. Patients examined on days 1, 7, 15, 30, 60, and one year after laser resurfacing showed good results. At two months after treatment, the clinical improvement was rated by the patient and physician as being "very good" in 81 of the 85 patients reviewed. These patients underwent laser resurfacing without complications. The proposed technique of periocular resurfacing prevents complications of scleral show and laxity in the lateral eyelid opening and even ectropion, because treatment conforms to the osseo-muscular anatomical relationship of eyelid structures.

Aging↗
PubMed1989

Progressive hemifacial atrophy with localized scleroderma.

We describe a patient with localized scleroderma in association with homolateral atrophy of the tongue and marked ipsilateral facial hemiatrophy which was confirmed histologically. CT scan coronal sections of the face showed severe atrophy of the tongue and facial muscles. The EMG studies failed to demonstrate a neurogenic or myogenic process.

Adult↗
PubMed1984

EMG biofeedback in the modification of hypertonia in spastic dysarthria: case report.

A 22-year-old man with severe spastic dysarthria resulting from head trauma was unable to achieve mandibular closure despite traditional treatment methods. It was decided to apply the principles of electromyographic (EMG) neuromuscular re-education to increase awareness of generalized tension of the facial muscles involved in depression and elevation of the mandible. With a planned program of auditory feedback of muscle action potential, the patient displayed rapid improvement in monitoring muscle tension and achieving mandibular closure. These gains were maintained after discontinuation of biofeedback.

Adult↗
PubMed1982

[Respiratory movements of the facial musculature and respiration resistance].

Experiments were made on tracheotomized anesthetized rabbits. After trachea occlusion the increase in the nostril discharges becomes more remarkable than that in the diaphragm discharges. In the tracheotomized animals, the air passes into the lungs through the trachea. Nevertheless the respiratory movements of the facial muscles are of importance in the compensation of abnormalities caused by the increased respiratory resistance. Prevention of the respiratory movements of the face muscles results in a drastic increase in the inspiratory discharges of the diaphragm.

Airway Resistance↗
PubMed2006

Anatomic research on the perioral muscles, functional matrix of the maxillary and mandibular bones.

The aim of this research was to study, on the basis of anatomic specimen, the insertion of and the existing correlation between the orbicularis oris, the perioral and the buccinator muscles. Dissections were performed on 40 embalmed caucasian specimens. The skin and the subcutaneous stratum were removed from the perioral zone starting from the base of the nose and the zygomatic arch down to the hyoid bone. The orbicularis oris and the facial muscles were isolated in the successive planes. In the more superficial layer, the following muscles were displayed: the orbicularis oris around the oral opening, the mentalis in the lower part, the transversus menti, the depressor anguli oris and the depressor labii inferioris, the risorius, and the zygomaticus major and minor positioned on the area of the labial commissure. The buccinator muscle was situated under this superficial stratum. In 85% of the specimens we found a fourth inferior band of the buccinator muscle that runs continuously from one side to the other of the mandible. This bundle always ran cranially to the foramen mentale. The findings have been compared with magnetic resonance images obtained from ten patients. One of the main findings was that the majority of these muscles were so densely interrelated that they could be considered parts of two functional units. A deep unit is composed of the buccinator muscle and the inner ring of the orbicularis oris and a superficial unit is built up by the depressor anguli oris, the zygomaticus, the risorius and the outer ring of the orbicularis oris. MR imaging confirmed these findings.

Cadaver↗
PubMed1994

Botulinum toxin treatment in patients with hemifacial spasm.

Hemifacial spasm is nearly always a unilateral disease of the facial musculature and is characterized by involuntary tonic or clonic cramps that considerably reduce the affected patient's quality of life. In the past, a number of different conservative and operative therapeutic procedures have been applied for the treatment of hemifacial spasm. In many cases these attempts failed to control the disease permanently or resulted in unwanted, sometimes strong, side effects. We report our own experiences with botulinum therapy in 29 patients with hemifacial spasm (78 therapeutic sessions). In our patients the mean duration of an effect after treatment with botulinum toxin was 18.2 weeks. Side effects were rare. Our results since 1990 at the University of Göttingen demonstrate that subcutaneous application of toxin from Clostridium botulinum to involved facial muscles represents a reliable method for successful treatment of hemifacial spasm.

Adult↗
PubMed2000

Impression procedure for patients with severely limited mouth opening.

Patients with limited mouth opening are a common occurrence in prosthodontic practice. The majority of these patients can be treated with exercise and stretching movements before impressions are made. Some will not respond to these procedures because of facial scarring and surgical manipulation of the facial muscles. This article presents an impression procedure for overcoming such reduced mouth opening.

Dental Impression Technique↗
PubMed1992

[The clinical picture and diagnosis of the pharyngofacial form of myasthenia].

In the clinic, 564 patients with the different forms of myasthenia were operated on. A pharyngo-facial form of myasthenia was revealed in 65 (11.5%) of them. There are the following clinical peculiarities of a pharyngo-facial form of myasthenia: involvement of the pharyngeal and facial muscles, impaired phonation, jerky speech, sensation of the tongue heaviness. The direction of process generalization is commonly from the centre towards periphery, towards the skeletal muscles. Involvement of the muscles of the soft palate, epiglottis causes saliva and pharyngeal secret flowing into the bronchi which leads to asphyxia.

Adult↗
PubMed2005

Bell's palsy and Herpes simplex virus: fact or mystery?

HYPOTHESIS AND BACKGROUND: In recent years, progress has been made in the understanding of Bell's palsy, the most common form of acute facial weakness. Herpes simplex virus (HSV) reactivation within the geniculate ganglion with subsequent inflammation and entrapment of the nerve at the meatal foramen has been proposed to be the pathogenetic mechanism. We challenged its accuracy by analyzing our own data on the presence of viral genomic DNA of HSV-1 and 2, human herpes virus (HHV)-6A/B, as well as varizella zoster virus (VZV) in patients with Bell's palsy and in control patients without the disease. METHODS: Polymerase chain reaction was performed with primer sets specific for viral genomic DNA of HSV-1, HSV-2, and VZV in facial muscle biopsy specimens from patients with Bell's palsy. As control specimens, the Scarpa's ganglion of patients with Meniere's disease and the geniculate ganglion harvested at autopsy from patients without history of facial palsy. In a second study, we used polymerase chain reaction with primers specific for HSV-1, -2, and HHV-6A, -6B to analyze for the presence of these viruses in tear fluid samples from control patients and patients with acute Bell's palsy. RESULTS: HSV-1 and VZV genomic DNA were detected in 86 and 43%, respectively, of geniculate ganglion preparations from control specimen. We were not able to detect the presence of HSV-1, HSV-2, or VZV genomic DNA in ganglion scarpae or muscle biopsy results in control and Bell's palsy patients. HHV-6A could be detected in tear fluid samples in 40% of control patients and 30% of Bell's palsy patients. CONCLUSIONS: The sole presence of HSV genomic DNA within the sensory ganglion along the facial nerve does not explain the direct association with Bell's palsy. The missing link would be the identification of an active replicating virus, an investigation that has not yet been carried out.

Bell Palsy↗
PubMed2003

Juvenile xanthogranuloma invading the muscles in the head and neck: clinicopathological case report.

Juvenile xanthogranuloma (JXG) is a member of the non-Langerhans cell group of histiocytic proliferative disorders. It typically presents as a solitary, benign, rapidly growing cutaneous tumor that may regress spontaneously. Most cutaneous lesions of JXG occur in the head and neck region of infants and young children. JXG has been documented in many visceral locations including the lung, bone, testis, gastrointestinal tract, kidney, heart, eye, and oral cavity. Intramuscular location is extremely rare. The few intramuscular lesions that have been described involve the trunk, with the musculature of the back involved most frequently. The authors present a patient with juvenile xanthogranuloma on her chin deeply invading the underlying facial muscles. Histopathological analysis confirmed the intramuscular extension. To the authors' knowledge, this is the first detailed clinicopathological report of juvenile xanthogranuloma infiltrating the muscles in the head and neck.

Facial Muscles↗
PubMedDate not supplied

Transient traumatic reticular myoclonus. Case report.

Reticular myoclonus in man is a rare manifestation, generally due to uremia or post-hypoxic conditions. The case of a patient who showed transient myoclonus of sternocleidomastoid and facial muscles, immediately after direct cervical trauma, is described. Absence of paroxysmal EEG activity, topographic distribution of jerks and sequence of muscle activation suggest a reticular myoclonus. Possible physiopathological mechanisms are discussed.

Adult↗
PubMed1985

Genioplasty: a physiological approach.

Genioplasty results in aesthetic and functional changes to the chin and perioral areas. A physiological approach combines osseous and soft tissue reconstruction to produce a superior result that is especially important in individuals with bilabial incompetence. In this review, facial muscle hyperfunction and vertical maxillomandibular excess are identified and their treatment outlined. The modified Michelet genioplasty, an ideal technique for vertical chin reduction and/or advancement, is described.

Adolescent↗
PubMed2003

Accelerometry of adductor pollicis muscle predicts recovery of respiratory function from neuromuscular blockade.

BACKGROUND: Residual paralysis increases the risk of pulmonary complications but is difficult to detect. To test the hypothesis that accelerometry predicts effects of residual paralysis on pulmonary and upper airway function, the authors related tests of pulmonary and pharyngeal function to accelerometry of adductor pollicis muscle in 12 partially paralyzed volunteers. METHODS: Rocuronium (0.01 mg/kg + 2-10 microg x kg-1 x min-1) was administered to maintain train-of-four (TOF) ratios (assessed every 15 s) of approximately 0.5 and 0.8 over a period of more than 5 min. The authors evaluated pharyngeal and facial muscle functions during steady state relaxation and performed spirometric measurements every 5 min until recovery. Upper airway obstruction was defined as a mean ratio of expiratory and inspiratory flow at 50% of vital capacity of greater than 1. The TOF ratio associated with "acceptable" pulmonary recovery (forced vital capacity and forced inspiratory volume in 1 s of > or =90% of baseline) was calculated using a linear regression model. RESULTS: At peak blockade (TOF ratio 0.5 +/- 0.16), forced inspiratory flow was impaired (53 +/- 19%) to a greater degree than forced expiratory flow (75 +/- 20%) with a mean ratio of expiratory and inspiratory flow at 50% of vital capacity of 1.18 +/- 0.6. Upper airway obstruction, observed in 8 of 12 volunteers, paralleled an impaired ability to swallow reported by 10 of 12 volunteers. In contrast, all volunteers except one could sustain a head lift for more than 5 s. The authors calculated that a mean TOF ratio of 0.56 (95% confidence interval, 0.22-0.71) predicts "acceptable" recovery of forced vital capacity, whereas forced inspiratory volume in 1 s was impaired until a TOF ratio of 0.95 (0.82-1.18) was reached. A 100% recovery of TOF ratio predicts an acceptable recovery of forced vital capacity, forced inspiratory volume in 1 s, and mean ratio of expiratory and inspiratory flow at 50% of vital capacity in 93%, 73%, and 88% of measurements (calculated negative predictive values), respectively. CONCLUSION: Impaired inspiratory flow and upper airway obstruction frequently occur during minimal neuromuscular blockade (TOF ratio 0.8), and extubation may put the patient at risk. Although a TOF ratio of unity predicts a high probability of adequate recovery from neuromuscular blockade, respiratory function can still be impaired.

Adult↗
PubMed1977

Facial myokymia in the Guillain-Barré syndrome.

Facial myokymia, a unique involuntary movement of facial muscles, is described in a patient with Guillain-Barré syndrome. Although this involuntary movement is most often described with intramedullary lesions of the brain stem, it may also appear with lesions external to the neuraxis. We review the literature and propose a more widespread distribution of potential lesions along the facial nerve pathway, which may produce facial myokymia.

Adult↗
PubMed1981

Meige syndrome: a clinical and EMG study.

2 patients showing oral-facial asymptomatic dyskinesia are reported. Clinically observed involuntary movements are the same as those described by Henry Meige in 1910 for the first time. An outstanding EMG feature is the recording of spontaneous potential bursts, both short and long in duration, that show synchronism when activity is registered from different facial muscles at the same time. Clinical and EMG data allow close comparison between involuntary movements in the course of Meige syndrome and idiopathic hemifacial spasm.

Blepharospasm↗
PubMedDate not supplied

[Crossed buccofacial apraxia].

Praxis and language are considered right hemisphere functions. Buccofacial apraxia, except few occasions, are seen in right-handed patients with left hemisphere lesions with aphasia. We present a right-handed patient with buccofacial apraxia due to an ischaemic lesion of the right hemisphere seen by MRI. Language was normal and there was not limb apraxia in our patient. It is possible that in some individuals the control of voluntary movements of facial muscles is not associated neither to the control of language neither to the learning of complex movements of limbs.

Apraxias↗
PubMed1978

[Surgical treatment of hemifacial spasm associated with tortuous vertebrobasilar system (author's transl)].

Surgical treatment of hemifacial spasm associated with tortuous vertebrobasilar system was reported. A patient was 63-year-old female, who first experienced mild and intermittent muscle twitching around her left eye twenty years prior to admission. Five years later, the twitching extended to all the facial muscles on the left side. She was treated with facial nerve block, which resulted in facial palsy for about one year. Because of recurrence of the hemifacial spasm, she was admitted to the Neurosurgical Department of Bokuto Municipal Hospital on October 12, 1977. Neurological examination revealed no abnormalities except for left hemifacial spasm with slight muscular weakness. Electromyogram showed severe twitching and synkinesis of all the muscles of facial expression. Vertebral angiogram on the left side disclosed pronounced elongation of the vertebral and basilar arteries, which extended into the left cerebellopontine angle. Compression of the facial nerve root exit zone at the brainstem by the vertebral artery was considered to be the cause of the hemifacial spasm. Suboccipital craniectomy was carried out on November 29, 1977. The vertebral artery extended into the cerebellopontine angle, and adhered to the facial nerve. After mobilization of the vertebral artery from the facial nerve, a small prosthesis of non-absorbable spongy material (Teflon felt) was interposed between the vertebral artery and brainstem. Postoperatively, the hemifacial spasm disappeared, but the facial palsy, which had been observed preoperatively probably due to previous facial nerve block and long-standing hemifacial spasm, remained. The function of the acoustic nerve was preserved. Recently vascular compression of the facial nerve root exit zone has been reported as a major cause of hemifacial spasm, but such abnormal vessels are rarely demonstrated angiographically.

Basilar Artery↗