Face transplant: is it worth it?
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Animals↗
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Results for “FACIAL MUSCLES”
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Subperiosteal midface lifting: a simplified approach.
A simplified approach to subperiosteal midface lifting with suspension is described, which has been performed on 75 patients since 1986. In comparison with standard facelifting, this technique results in long-lasting vertical resuspension of ptotic midfacial tissues. To date there has been a high rate of patient satisfaction with no cases of nerve injury or hematoma. There is a rare incidence of minor complications.
Adult↗
Evaluating the effects of ice application on the pain felt during botulinum toxin type-a injections: a prospective, randomized, single-blind controlled trial.
The pain felt during botulinum toxin type-A injections and the troubled and distressed treatment it induces is common and well known for the patient and the doctor applying the treatment. This problem is further intensified on the patients who have needle phobia. The effect of ice application on the treatment zone before botulinum toxin type-A treatment on the pain felt during injections is investigated. Totally, 24 patients who underwent botulinum toxin type-A treatment in upper face region for esthetic purposes are included in the study. Ice was applied 5 minutes before the injections on the right lateral orbital zones (crow's feet area) of the patients, whereas on their left sides, toxin was injected without applying any ice. All the drugs were diluted by normal saline; 5 U of active botulinum toxin type-A was used in each diziem (0.1 mL). Total injection number was determined both in right and left areas as 8. Visual analog scale (VAS) was used for pain intensity and evaluation. On the side where ice was applied, the treatment was completed in 1 session and lasted shorter when compared with that of the control side. However, the average VAS values defining the pain that the patients felt in their right and left sides were found as 1.1 and 5.9, respectively. The clinical findings obtained indicated that pain is significantly reduced on the side where ice is applied. The statistical significance of the test results were evaluated by Student's t test, and the difference between VAS values was found statistically significant (P = 0.000).
Adult↗
Anatomic guides to precisely localize the zygomatic branches of the facial nerve.
UNLABELLED: Descriptions of superficial anatomic landmarks for the identification of the zygomatic branches of the facial nerve, and their relevance for plastic surgery, are lacking in the literature. This paper provides such a description and discusses its relevance to facial surgery. MATERIALS AND METHODS: Sixty-six specimens, including the parotid region, from 33 adult cadavers were dissected and studied. All specimens were fixed in formaldehyde, and the superficial tissues were removed and the zygomatic branches of the facial nerve, the parotid gland, the tragus and the lateral palpebral commissure were identified. The vertical and horizontal relationships were recorded and analyzed. RESULTS AND CONCLUSIONS: A total of 69.7% of the cadavers had two branches, 25.8% had three branches, and 4.5% had a single zygomatic branch. The mean horizontal distance of the zygomatic branch (the most upper one) as it emerged from the anterior border of the parotid gland and the tragus was 30.71 mm, whereas the mean vertical distance of the zygomatic branch from the midpoint between the tragus and the lateral palpebral commissure was 19.29 mm. The branching patterns with the buccal branches were reported. There were no statistical differences between the left and right sides or between the sexes. The zygomatic branches of the facial nerve were always under the oblique line between the tragus and the lateral palpebral commissure and have a close relationship with the buccal branches of the facial nerve under this anatomic landmark. Application of the results in facial surgery is discussed.
Adult↗
Transtympanic surgery for hemifacial spasm--an electrophysiological study.
Producing deliberate damage to the facial nerve in the middle ear is an established method of treating idiopathic hemifacial spasm. However, no previous electrophysiological studies have investigated the effect of this operation on facial nerve function. Eleven patients undergoing transtympanic facial nerve needling were investigated with electromyography. Following operation reduction in the abnormal discharges and synkinesis typical of hemifacial spasm was seen in the majority of patients. The success of this type of operation, although temporary in some patients, together with other neurophysiological studies conflicts with the hypothesis that this disorder is due to ephaptic transmission caused by vascular compression of the facial nerve in the cerebello-pontine angle.
Ear, Middle↗
The natural history of facial paralysis in herpes zoster.
A group of 102 patients with facial palsy caused by herpes zoster was studied in order to determine the course and prognosis without treatment. In most cases, the eruption and the paralysis appeared at the same time. The maximal degree of loss of function was usually reached within 1 week and was clearly related to the age of the patient. Recovery was better when the vesicles preceded complete loss of function. Complete recovery was achieved in about 10% of patients after a complete loss of function and in about 66% after an incomplete loss.
Adult↗
Bell's palsy--which factors determine final recovery?
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Axons↗
Clinical and electroencephalographic study of temporal lobe status.
1. The temporal lobe status appears at a rate of once every 3-5 minutes. 2. The duration of a single temporal lobe seizure is varied, ranging from 10 seconds to 140 seconds. 3. The EEG during seizures is characterized by a generalization of 15-32 Hz recruiting epileptic rhythm which may become 3-7 Hz slow waves later in some cases, 3-7 Hz paroxysmal rhythmic waves. 4. The clinical symptoms are colorful, including apnic seizures, verbal automatism, facial muscle twitching, versive seizure and tonic seizure. The clinical symptoms depend on the size and depth of focus and the scope of propagation of discharge. 5. Generalization cannot be attained merely by the firing of focus that has been formed secondarily. The firing of primary focus is indispensable as the condition for generalization. 6. The focus depends more on the time of the disappearance of discharges than on the site of the primary onset of paroxysm. Particularly important is the length of duration of ictal discharges. 7. The cortico-cortical synapse and the cortico-subcortical pathways were considered the sources of epileptic propagation.
Adult↗
Fukuyama type congenital progressive muscular dystrophy.
Clincopathological features of Fukuyama type congenital muscular dystrophy (FCMD), a combination of brain malformation and muscular dystrophy with facial muscle and CNS involvement and high prevalence in Japan, are reviewed. Evidence of progressive dystrophy, negative correlations between muscle enzyme levels and age and CT numbers of muscle and age, are presented. Skeletal muscle histopathology is reviewed. Febrile illness-induced transient exacerbation of muscle weakness is reported. Characteristic brain malformations, e.g. micropolygyria, other dysgenesis, are reviewed. Their severity correlated with maximal mental and motor function. The etiology and significance of low density areas (LDA) in white matter on CT, possibly reflecting delayed or abnormal myelination, and ventricular dilatation are discussed. Spontaneous LDA improvement makes hydrocephaly unlikely. Ophthalmological differential diagnosis from Santavouri disease and Walker-Warburg syndrome, characterized by visual disturbance/glaucoma and microphthalmia/anterior chamber defects, respectively, is discussed. A single defective gene, manifesting as a metabolic error, may produce CNS and ocular defects as well as muscle degeneration in FCMD.
Brain↗
Effects of organophosphorous compounds, oximes and atropine injected into the third ventricle of unanaesthetized dogs.
The effects of four organophosphorous compounds, three oximes and atropine sulphate, injected through an indwelling cannula into the third ventricle of unanaesthetized dogs were examined. The effects of 200 mug of dyflos were involuntary micturition, defaecation, akinesia of hind limbs and pronounced disturbances of awareness; those of 100 mug of ethyl pyrophosphate were tremor, restlessness and signs of fear; 500 mug to 5 mg of dyflos and 250 mug to 500 mug of ethyl pyrophosphate caused vomiting, salivation, twitches of facial muscles and recurrent epileptiform seizures. The injection of 40 to 80 mg of dimefox and of 50 mg of schradan elicited involuntary micturition, vomiting, salivation and defaecation. These effects occur probably after these substances have passed into the blood stream and have been converted in the liver to potent anticholinesterases. This view is supported by the finding of reduced blood cholinesterase activity. At a dose level of 12.5 mg, 1,1'-trimethylenebis(4-hydroxyiminomethylpyridinium bromide) produced strong convulsions. At this dose level pralidoxime iodide and diacetyl monoxime produced no observable effects. Atropine sulphate in a dose of 1 mg caused disturbances in consciousness and behaviour followed by convulsions. Intraventricular atropine and to a minor extent intraventricular oximes were able to antagonize the effects of intraventricular ethyl pyrophosphate. Pralidoxime iodide exerted a strong antagonistic effect also on intravenous injection.
Animals↗
Electroencephalographic characteristics of audiogenic seizures induced in metaphit-treated small rodents.
Adult male mice, rats, and guinea pigs were subjected to intense sound stimulation of an electric bell (100 dB, 12 kHz for 60 s) after a single intraperitoneal (i.p.) injection of metaphit (1-(1-(3 isothiocyanatophenyl)-cyclohexyl)piperidine) (50 mg/kg). When the animals were tested 24 h after administration of metaphit, audiogenic seizures were observed. None of the control saline-injected animals had convulsions. EEG recordings demonstrated the appearance of paroxysmal activity and spike-wave complexes in the trace from cortical and hippocampal electrodes, with frequency and amplitude increasing with time. Behaviorally, myoclonic jerks of facial muscles, ears, and neck appeared, but no correlation was noted between EEG and the motor phenomena. Auditory stimulation was necessary to elicit the full-blown sequence of seizure responses consisting of wild running followed by clonic and then tonic extension. At the time of seizures, repetitive high-amplitude spikes and waves appeared in the EEG, followed by profound EEG and behavioral depression. None of the animals died during or immediately after seizures. The seizure response to sound stimulation of mice, rats, and guinea pigs was phenomenologically similar, with minor differences in quantitative pattern of convulsive components, which suggests that all three animal species share the common property of extreme susceptibility to audiogenic stimulation caused by metaphit administration.
Acoustic Stimulation↗
Central pontine myelinolysis.
A patient is reported whose ailment meets the criteria of CPM. The illness was complicated by pneumonitis, most likely of the aspiration type. Of particular interest was the reversibility of a clinical picture of marked deterioration when attention was paid to fluid and electrolyte balance and maintenance of respiration. This patient's illness appears to meet the criteria of CPM, namely impairment of the facial muscles and tongue with dysphagia and dysarthria, flaccid quadriparesis or quadriplegia, and frequently, lack of response to painful stimuli followed by respiratory paralysis. The presence of peripheral neuropathy has been previously noted in a patient with CPM, but it is not an integral part of the disease.
Alcoholism↗
Hemifacial spasm: magnetic resonance angiography.
Twenty-three consecutive patients with hemifacial spasm were studied. Magnetic resonance imaging angiography of the brain was performed in 20 patients and 15 controls. The angiograms were evaluated by two independent observers and blinded for side-location of the spasm. Contact between an artery from the vertebrobasilar circulation and the intracranial part of the facial nerve was observed ipsilaterally to the spasm in 17 patients (85%) and in two of 30 control half-brains (7%), respectively. Treatment is discussed. The study confirms that arterial relation to the facial nerve root is the most frequent cause of hemifacial spasm. Magnetic resonance imaging is recommended to exclude mass lesions in the posterior cranial fossa, and magnetic resonance angiography is recommended in preoperative evaluation and in research.
Adult↗
Botulinum toxin A injection in the treatment of hemifacial spasm.
UNLABELLED: There are conflicting reports concerning the variation in duration of symptoms relief for patients with hemifacial spasm who have undergone several injections of botulinum A toxin (BOTX-A). We present our experience of BOTX-A injections in Taiwanese patients to analyze this issues, and to inspect whether the efficacy of treatment depends on the pre-injection severity. MATERIAL AND METHOD: From July 1992 to December 1994, 137 patients received injections of BOTX-A. We used objective and subjective score system to evaluate the efficacy and side effects of BOTX-A injection. RESULTS: The overall successful rate of substantial relief of spasm was 88%. The mean duration of response was 20 weeks. Patents with more severe spasm tended to have shorter duration of improvement. The effects of consecutive injections remained fairly constant over the first 4 injections. CONCLUSION: The BOTX-A injection is an effective and safe treatment for patients with hemifacial spasm and the effect could be sustained over the consecutive injections.
Adult↗
Experimental facial myokymia in cat.
INTRODUCTION: The objective of this study was to describe facial myokymia in experimental animals accompanying kainic acid affects on facial motor neurons. MATERIAL & METHODS: Anesthetized cats were injected with kainic acid into the pons adjacent to the facial nucleus. Facial movements appeared shortly after the injections and facial electromyographic potentials were recorded. Cats were killed up to 4 weeks later, the brainstems were processed histologically, and the number of neurons in the facial nucleus counted. RESULTS: Cats receiving injection of kainic acid adjacent to facial nucleus all developed spontaneous writhing movements of the face ipsilateral to the injection site, clinically resembling facial myokymia in humans. Transient facial paresis, lasting several weeks, appeared in some of the cats. Facial myokymia occurred independent of histological evidence of neuronal loss in facial nucleus, whereas facial paresis occurred in all but one of the animals with significant neuronal loss in the facial nucleus. Placing a needle into the superior olive without injecting kainic acid or injections of kainic acid into cochlear nucleus was not accompanied by facial myokymia or subsequent facial paresis. CONCLUSION: Facial movements in cats similar to myokymia in humans accompanies kainic acid injections adjacent to the nucleus of the facial nerve.
Animals↗
Facilitation and inhibition of facial reflexes in the cat induced by peripheral stimulation.
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Animals↗
Graphic-visual adaptation of House-Brackmann facial nerve grading for peripheral facial palsy.
OBJECTIVE: To determine if the diagram with schematic drawings of the face based on House-Brackmann facial nerve grading scale can be of easier use than the original grading scale for facial palsy patients. STUDY DESIGN: Prospective case study of 32 patients with facial palsy. SETTING: Tertiary referral center-university hospital. PATIENTS: Patients with different degrees of acute peripheral facial palsy from any cause. MAIN OUTCOME MEASURES: The patients were photographed and then classified by degree of facial palsy through analysis of the pictures. At first, three of the authors individually utilised the original classification described by House-Brackmann facial nerve grading and then, after 7 days, they employed the illustration table proposed. After 30 days, the same methods were again used by the same authors for both House-Brackmann facial nerve grading and the illustration table. RESULTS: The analysis of the obtained data reveals that the classification described by House and Brackmann (Otolaryngol. Head Neck Surg. 1985;93:146) presents several items to be evaluated, making it difficult to use and demanding greater time for correct application. On the contrary, the proposed illustration table allows faster evaluation and easier memorisation, not being subject to possible interpretation or translation mistakes, as illustrations are a universal language. Neither method presented absolute reproducibility, however, we found slightly larger concordance indexes among the authors for the proposed illustration table. We noticed average values of reproducibility were approximately 65% in the House-Brackmann classification, and 75% in the evaluation using the diagram of the schematic drawings. CONCLUSIONS: The authors concluded that the illustration table could be utilised in substitution for the original description of House-Brackmann facial nerve grading; they also concluded that the illustration table allows faster evaluation and easier memorisation.
Facial Muscles↗
Adaptation of quantal content to decreased postsynaptic sensitivity at single endplates in alpha-bungarotoxin-treated rats.
1. Rats were injected once every 48 h with alpha-bungarotoxin (alpha BTX) for periods up to 6 weeks. Injections caused weakness of facial muscles which lasted about 8 h. Hemidiaphragms were dissected for biochemical and electrophysiological measurements. 2. In muscles from animals treated for 2-3 weeks with toxin, the binding of 125I-alpha BTX was reduced to 58%, and the ACh content to 81% of control values. Choline acetyltransferase activity was unchanged. ACh release evoked by 3 Hz nerve stimulation was increased to 175% of control values. 3. The use of mu-conotoxin, which specifically blocks muscle action potentials, enabled the recording of full-sized endplate potentials (EPPs) and miniature endplate potentials (MEPPs) at normal muscle membrane potentials (-70 to -80 mV). The amplitude of MEPPs was decreased to 57% in muscles from animals treated for 3 weeks with alpha BTX. The mean of the quantal contents, calculated from the ratio of the corrected EPPs and the MEPPs, was increased to 154%. 4. Within individual muscles of both alpha BTX-treated and control rats, there was an inverse relationship between the quantal content of an endplate and its MEPP amplitude. 5. The MEPP frequency of endplates from control muscles was positively correlated with the quantal content. However, this correlation was not found in alpha BTX-affected muscles. 6. Three hours after a single injection of alpha BTX the amplitude of the MEPPs was reduced to about 60% of control values but no increase of the quantal content was found. During the first few days of alpha BTX treatment the quantal content gradually increased; it reached a plateau between 20 and 30 days. 7. The results suggest the existence of an adaptive mechanism, operating at individual endplates, in which retrograde signals at the motor nerve terminals modulate ACh release when neuromuscular transmission is endangered by block of acetylcholine receptors.
Acetylcholine↗