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At least 1,027 records · Page 57Linked to original sources
PubMed1996

Sociotropy, autonomy, and dysphoric emotional responses to specific classes of stress: a psychophysiological evaluation.

The aim of this study was to assess the ability of trait measures of sociotropy and autonomy to predict immediate emotional responses to imagery conditions depicting social rejection and achievement failure. Emotional responses were assessed by self-report techniques and by 2 putative psychophysiological measures of dysphoric mood: heart rate and facial muscle activity. Undergraduate volunteers (N = 100) were assessed for sociotropic and autonomous traits, general levels of depression, and sensory imagery ability, before performing a series of imagery trials depicting neutral and stressful (social rejection and achievement failure) scenes. Results provided support for the role of sociotropy as a vulnerability factor to dysphoric response to social rejection and to a lesser degree for achievement failure, but there was no support for autonomy as a vulnerability factor for either type of stressful script.

Achievement↗
PubMed1987

[Use of polytetrafluoroethylene (Gore-Tex E-PTFE Soft Tissue Patch) for suspension of former facial paralysis and as reconstructive tissue].

The insertion of autogenous fascia lata to suspend the paralyzed cheek and lips remains one of the most widely practiced procedures in correction of long term paralysis of the lower facial muscles. For 34 months we used thin layers (1 mm) of expanded polytetrafluoroethylene (E-PTFE Gore-Tex Soft Tissue Patch) to replace autogenous fascia lata, in 20 patients, with satisfactory results. 13 patients were treated by classical techniques of insertion-suspensions of the paralyzed side with a perioral loop and slings of PTFE suspended to the zygomatic arch and the infraorbital rim, by way of nasolabial angle or rhytidectomy incisions. In 7 patients, an eyelid suspension was performed with PTFE by Arion's technique, but by replacing the classical silicon thread by E-PTFE and transposing the medial part of the temporalis muscle on the external canthus, and fixing the lateral end of the sling to the muscle. This technique assures a good corneal coverage with healing of the previous ulceration and allows a voluntary occlusion of the eyelids. The PTFE soft tissue is notably successful as an implant. This biocompatible material shows excellent tissue tolerance, the porous microstructure encouraging tissue attachment and infiltration. E-PTFE holds its shape, resists to infection, and permits a notably reduction of the hospitalization because it avoids a second surgical site. We have experience of the material as a reconstructive substance in 6 cases of either bone or subcutaneous deficits, where no other satisfactory solution was available. Is these cases our follow-up is 18 months.

Biocompatible Materials↗
PubMed2005

Hemifacial spasm due to a tentorial paramedian meningioma: a case report.

Hemifacial spasm (HFS) is a movement disorder characterised by involuntary paroxysmal facial movements that usually involve the orbicularis oculi and then spread to the other facial muscles. A microvascular compression and demyelination of the seventh nerve at its exit from the brain stem is considered to be the main aetiology of HFS. In addition to rare idiopathic (cryptogenetic) cases, others causes of HFS exist: tumours or vascular malformations have been described, of both the ipsilateral and contralateral cerebellopontine angle (CPA). However, space-occupying lesions in locations other than CPA are usually not thought to be responsible for HFS. Here we describe the case of a 45-year-old woman suffering from HFS, who dramatically improved after surgical removal of a tentorial paramedian meningioma.

Cerebellum↗
PubMed2004

Chronic myokymia limited to the eyelid is a benign condition.

BACKGROUND: Eyelid myokymia, unlike myokymia of the other facial muscles, is assumed to be a benign, self-limited disorder. However, no systematic follow-up study has been performed on patients with chronic, isolated eyelid myokymia to verify its benign nature. METHODS: Retrospective single-institution chart review of 15 patients examined between 1983 and 2002 with a diagnosis of isolated eyelid myokymia who have had at least 12 months of follow-up. RESULTS: In all patients, symptoms began as unilateral, weekly or biweekly, intermittent eyelid spasms, and progressed to daily spasms over several months. The mean duration of symptoms at first examination was 91 months (range 2.5 months to 20 years). In no patient was the myokymia the first manifestation of a neurologic disease, although one patient progressed to ipsilateral hemifacial spasm. Thirteen patients (86.7%) underwent neuroimaging that gave negative results. The myokymia resolved spontaneously in four patients. Of the remaining 11 patients, eight were treated with botulinum toxin injection at regular intervals, with most reporting an improvement in symptoms. CONCLUSION: Chronic isolated eyelid myokymia is a benign condition. It tends not to progress to other facial movement disorders or to be associated with other neurologic disease. It responds well to treatment with botulinum toxin.

Adolescent↗
PubMed1981

Free muscle grafting in facial paralysis.

For the dynamic restoration of elevation of the angle of the mouth in facial paralysis six possible variations of free muscle and nerve graft techniques are described. One of the techniques using the previously denervated extensor digitorum brevis muscle with its motor nerve in continuity serving as a cross-face nerve graft, was used in eight patients. The results were disappointing and it is concluded that the method should be abandoned.

Adolescent↗
PubMed2005

The periauricular transparotid approach for open reduction and internal fixation of condylar fractures.

INTRODUCTION: Treatment of fractures of the mandibular condyle fractures varies among centres as there still is no general consensus. The aim of this paper was to determine the safety and efficiency of surgical treatment using a transparotid approach for direct plating. PATIENTS AND METHODS: A prospective clinical study was conducted on 34 patients with 36 fractures of the condyle. All 36 fractures were displaced, and 14 (39%) of them were fracture dislocations. The fractures were treated surgically with a transparotid facelift or retromandibular approach using miniplates and screws for fixation. Patients were carefully followed up and were asked to answer a survey paper 2-39 months postoperatively. RESULTS: Occlusion practically identical to the pretraumatic condition was achieved in 31 out of 33 dentate patients (94%). Postoperative interincisal distance was 30-61 mm (mean 44 mm), 4 patients (12%) had postoperative deflection to the side of injury during mouth opening. Facial symmetry was achieved in all of the patients. Eight out of 36 cases (22%) had a transient weakness of certain ipsilateral facial muscle groups, lasting for 4-8 weeks. In one of these patients, a mild weakness of the upper lip and lower eyelid persisted after 13 months. There were 5 cases of miniplate fractures (14%), all of them in patients in whom 1.7 or thinner miniplates were used. There were 5 cases of salivary fistulae (14%), all of them in patients where the parotid capsule was not closed in a watertight fashion. According to the postoperative survey completed by 32 patients, 30 of them (94%) were very satisfied with the outcome of treatment. CONCLUSION: If conducted properly, the transparotid facelift approach offers a safe and effective approach for direct fixation of condylar fractures.

Adolescent↗
PubMedDate not supplied

Emotional experience and facial expression in Alzheimer's disease.

Emotional experiences and facial muscle activity of individuals with Alzheimer's Disease (AD) (n = 13) and healthy elderly control subjects (n = 21) were measured while viewing emotion-eliciting images. Alzheimer's disease and control groups rated their emotional experiences similarly and in the expected directions on dimensions of valence and arousal. Change in corrugator activity while viewing images, compared to baseline, was comparable across groups and was greatest while viewing negative images. Change in zygomatic activity, however, was significantly different between AD and control groups, with AD subjects demonstrating an inverted pattern of activity compared to controls. These findings are discussed as possible consequences of frontal cortical system involvement accompanying the disease process.

Aged↗
PubMed1999

Evaluation of muscle graft using facial nerve on the affected side as a motor source in the treatment of facial paralysis.

To acquire symmetry of the cheek when smiling, we carried out 39 free vascularised grafts of the muscle, the motor nerve of which was sutured to a stump of the ipsilateral facial nerve, for 39 patients with facial paralysis. We used two methods: an as healthy and fresh as possible facial nerve stump (method 1A, n = 17), or an incompletely affected stump (method 1B, n = 22). The results are classified into grade 1 to 5 indicating increasing efficiency of muscle function. All patients who had method 1A and 14 patients who had method 1B were evaluated grade 4 or better. Both an incompletely affected facial nerve stump and the proximal stump of a facial nerve that had previously been resected have sufficient function to provide contraction in the grafted muscle.

Adult↗
PubMed1999

Muscle bow traction method for dynamic facial reanimation.

A muscle bow traction method was developed for dynamic facial reanimation utilizing the masseter muscle and a fascial sling. The principle of this method is that the sling around the muscle pulls the oral commissure laterally and backward by the restoring force of the muscle from its relaxed position to its contracted position. The surgical procedure is simple. The sling is passed around the anterior half of the muscle so that the muscle can be bowed anteriorly at its center by the sling. One end of the sling is sutured to the center of the orbicularis oris and the dermis in front of the nasolabial fold, and the other end is sutured to the lower lip and oral commissure. This method was applied to 3 patients with facial palsy and to 1 patient with oral cancer. The restored motion of the oral commissure ranged from 5 to 8 mm when clenching the jaws. The concept of this method differs from those of other muscle transposition methods for facial reanimation in that the force acts at a right angle to the muscle contraction. The advantage of this method is that it is less invasive to the muscle and is a simpler procedure than other conventional muscle transposition methods.

Aged↗
PubMed1998

Bell's palsy in the primary care setting: a case study.

Bell's palsy is an acute unilateral paralysis of the facial muscles innervated by the seventh cranial nerve. Although the etiology of Bell's palsy is unknown, it is thought to result from edema, entrapment, or inflammation of the seventh cranial nerve. A history of recent viral infection--especially herpes simplex--diabetes mellitus, pregnancy, or hypertension are all common risk factors that may precede the onset. This article reviews assessment findings, differential diagnoses, and the treatment of Bell's palsy, which is considered a diagnosis of exclusion. A 10-day course of oral corticosteroids is the recommended therapy for lessening its course and severity in some populations. Recent research recommends the addition of acyclovir for 10 days, suggesting a herpetic viral etiology. Close follow-up is imperative to prevent corneal injury and to monitor worsening of symptoms. Although most patients recover within 1 to 6 months, incomplete recovery may be seen in severe or recurrent cases. Indications for referral are discussed. A case study is presented to illustrate the findings in this interesting disease.

Acyclovir↗
PubMed2000

Temporalis muscle transfer for facial paralysis: a further refinement.

Facial nerve paralysis can occur due to failure of the central driving mechanism (nuclear or supranuclear pathology), failure of the conduit between the brainstem and the peripheral musculature (the facial nerve), or failure of the peripheral end organ (the neuromuscular system). Where the peripheral neuromuscular system fails, the options for dynamic reanimation include a regional muscle transfer driven by another ipsilateral cranial nerve, or a free muscle transfer driven by the contralateral facial nerve. Temporalis muscle transfer is an example of regional muscle transfer and has been used since early in the twentieth century. A further refinement, involving mobilization of the coronoid process of the mandible in continuity with the insertion of the temporalis muscle via a nasolabial fold approach, using fascial strips to re-create movement around the mouth, is presented.

Adult↗
PubMed1996

[Bell's palsy: diagnostic and therapeutical trial in childhood].

Bell's palsy is caused by a nuclear and/or infranuclear lesion of the facial nerve, producing an ipsilateral deficit of the facial muscles. The etiology is unknown. Bell's palsy has a frequency of 20:100000 individuals/year, a familiarity of 1-2% of cases, and a recurrence rate of 9% of cases. We studied 33 children (mean age 9.1 years) admitted to our Division during the period 1991-1994 because of Bell's palsy. We propose our personal diagnostic and therapeutical trial: in every patient a full neurological and otoscopic examination, and an audioimpedenzometric test. Treatment is then commenced with prednisone (1 mg/kg/day p.o. for 5-10 days and gradual reduction in 5 days), vitamins B1, B6 and B12 p.o. for 30 days, and local treatment with artificial tears, and occlusive bandage at nighttime until the lagophthalmus is resolved. Electromyography-electroneurography, and brain CT-scan are carried out after 15 days and 21 days respectively of treatment, if neurological deficit is unchanged. 80 to 90% of patients are reported to recover spontaneously from Bell's palsy. With our approach we achieved a 100% recovery rate within an average of 3 weeks (range: 1 week to 5 months).

Adolescent↗
PubMed1999

Moebius syndrome: the new finding of hypertrophy of the coronoid process.

The first detailed description of congenital facial paralysis was reported by Moebius in 1888. It is characterized by either unilateral or bilateral paralysis of the facial muscles and an associated abducens palsy. The present report is of two patients with Moebius syndrome, who were also diagnosed with trismus at birth. Each patient also demonstrated bilateral hypertrophy of the coronoid process of the mandible. In effect, the zygoma obstructed the excursion of the mandible because of a "coronoid block." A three-dimensional computed tomography scan demonstrated normal temporomandibular joints but bilateral hypertrophy of the coronoid processes and micrognathia. Both patients demonstrated less than 10 mm of oral excursion. Bilateral coronoidectomies were performed through an intraoral approach. The oral excursions after surgery increased to at least 20 mm. In each of these patients, the coronoid process was enlarged relative to the zygoma, which was of normal size and configuration. The trismus was associated with blocking of the coronoid by the anterior zygoma, preventing open or full excursion of the hypoplastic mandibles. Moebius syndrome can have a variable presentation at birth. In two patients, the authors describe a new finding of hypertrophy of the coronoid process and trismus secondary to obstruction of the coronoid by the hypertrophic zygomas during oral excursions. Each patient is described, and a review of the literature is discussed.

Abnormalities, Multiple↗
PubMed2001

Magnetic resonance spectroscopy of the masseter muscle in different facial morphological patterns.

The aims of this study were (1) to develop a reliable noninvasive method to evaluate the masseter muscle metabolism, by using (31)P-magnetic resonance spectroscopy, and (2) to evaluate the metabolic profile of the masseter muscle in subjects with various facial patterns. The maxillary-mandibular relationship, which varied from hypodivergent to hyperdivergent, was measured on lateral cephalograms of 20 adults, 22 to 35 years of age. (31)P-spectra were acquired from the masseter muscle at rest with a custom-made, single-turn, double-tuned, 3 x 5-cm oblong surface coil. The inorganic phosphate to phosphocreatine (Pi/PCr) ratios were measured and compared in relation to vertical and sagittal cephalometric measurements. A statistically significant (R(2) = 0.65, r = 0.81, P = .001) relationship was found between Pi/PCr ratio and the palatal-to-mandibular plane angle. As the maxillary-to-mandibular divergence increased, the Pi/PCr ratio decreased. This correlation suggests that muscles with a higher Pi/PCr ratio have a higher resting metabolic activity than those with a lower Pi/PCr ratio. Consequently, these muscles may keep bone under more tension and influence its growth in a more horizontal direction. Another possible explanation of the results is that the fiber type composition of the masseter muscle varies with facial morphology.

Adult↗
PubMedDate not supplied

Early perioperative use of polytef suspension for the management of facial paralysis after extirpative skull base surgery.

BACKGROUND: The satisfactory management of facial paralysis after extirpative skull base surgery has been notoriously difficult. To optimize physical and psychological recovery, early perioperative use of polytef (polytetrafluoroethylene [PTFE]) facial suspension has been used in patients with either profound electrophysiological or anatomical disruption of the facial nerve. OBJECTIVE: To review the efficacy of this clinical algorithm. STUDY DESIGN: Retrospective medical record review. SETTING: Tertiary care University Hospital Inc, University of Cincinnati College of Medicine, Cincinnati, Ohio. PATIENTS AND METHODS: Medical records review of 32 patients who underwent lateral skull base surgery with resultant facial paralysis who had facial rehabilitation using polytef suspension. RESULTS: All patients who underwent polytef facial suspension reported improvement in both facial function as well as aesthetics. One patient had a late extrusion of the polytef implant. CONCLUSION: The early peri-extirpative application of this technique provides psychological and physical support to patients with facial paralysis who are recovering from lateral skull base surgery. Arch Facial Plast Surg. 2000;2:243-248

Adult↗
PubMedDate not supplied

Functional recovery after facial and sciatic nerve crush injury in the rat.

OBJECTIVES: To systematically record rat facial nerve recovery following crush injury to the main trunk with respect to ocular and vibrissial function and to compare the rates of facial and sciatic nerve recovery from crush injury in the same animals. This serves as a means of validating the functional parameters of facial nerve recovery against the well-known measure of hind limb function, the Sciatic Function Index. METHODS: The main trunk of the facial nerve and the proximal segment of the sciatic nerve were exposed in all animals. Both nerves were subjected to standardized crush injury and subsequent daily functional testing. After a plateau of functional recovery was achieved, the animals were killed, and the distances between the sites of injury and the end musculature were measured, which allowed determination and comparison of recovery rates in both systems. RESULTS: All crush injuries resulted in loss of electrical conductivity, as proven by intraoperative proximal nerve stimulation. Recovery of ocular and vibrissial motor function occurred starting at postoperative day (POD) 9 and continuing through POD 20. Hind limb function returned later (POD 14-34); however, when corrected for distance, the sciatic recovery rate (2.26 mm/d) appeared to match that of the facial nerve (1.5-2.4 mm/d). CONCLUSIONS: Recovery after facial nerve crush injury follows a predictable time course, and the rate of recovery is consistent with that of sciatic nerve injury. Return of the blink reflex, loss of vibrissial fibrillations, and return of vibrissial sweeping function appear to be internally consistent functional measures of facial recovery. These quantitative measures will be useful for future facial nerve manipulation studies.

Animals↗