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At least 1,369 records · Page 76Linked to original sources
PubMed2003

Role of the zygomaticofacial foramen in the orbitozygomatic craniotomy: anatomic report.

OBJECTIVE: Elevation of the lateral orbital rim and zygomatic arch during an orbitozygomatic craniotomy requires a bone cut across the zygoma, which commonly extends into the lateral edge of the inferior orbital fissure. The zygomaticofacial foramen has been identified as a superficial landmark for the cut that extends into the inferior orbital fissure. This study examined the usefulness of the zygomaticofacial foramen during orbitozygomatic craniotomy. METHODS: One-hundred two dry hemicrania were used in this study. The zygomaticofacial foramen was considered to be related to the inferior orbital fissure when it was located on the zygoma in the area between lines extending in the medial-to-lateral direction along the long axis of the fissure and crossing the anterior and posterior ends of the lateral edge of the fissure. RESULTS: The zygomaticofacial foramen varied from being absent to representing as many as four small openings. A single foramen was observed in one-half of the specimens. Of the 115 zygomaticofacial foramina, 93 were related to the inferior orbital fissure. Among the 51 specimens with a single foramen, 49 foramina met the criteria for being related to the inferior orbital fissure; in those cases, there would have been no difference in the amount of bone resected using the inferior orbital fissure or the zygomaticofacial foramen as the landmark for the zygomatic cut. CONCLUSION: The zygomaticofacial foramen was a reliable landmark for locating the inferior orbital fissure and making the cut across the zygoma in only 50% of the specimens.

Brain Diseases↗
PubMed1976

Natural history of bell's palsy: the salivary flow test and other prognostic indicators.

Fifty-one patients with Bell's palsy were evaluated within two days of onset and followed for six months without surgical intervention or effective medical treatment in order to observe the natural history of the disease. Sixty-three percent had a complete return while 37 percent had incomplete return. Age, the presence of pain, and taste alterations had no prognostic value. The progression of the palsy, response to maximal stimulation and salivary flow testing were approximately 80 percent accurate in predicting outcome. The salivary flow test was the most useful prognostic indicator since salivary flow became reduced within two days of onset in the patients likely to develop denervation while the other tests did not become altered until 3 to 14 days after onset. In patients with Bell's palsy, the salivation test seems to be the only method capable of predicting denervation before it begins; therefore, it should be ideal for selecting patients for appropriate treatment.

Adult↗
PubMed1984

Palatal myoclonus--case report.

Palatal myoclonus is the name of a syndrome characterized by an involuntary rhythmic movement of the soft palate, occasionally involving the facial muscles, pharynx, larynx, and diaphragm. A review of the literature involving the etiology, pathology, symptoms, and treatment is presented. A case is reported with successful treatment with phenytoin sodium and phenobarbital. Also presented and discussed are the influences of acoustic and corneal stimulations on the myoclonic activity.

Adult↗
PubMed1985

Intraoperative facial nerve monitoring: a comparison of stimulating electrodes.

Preservation of the facial nerve during acoustic neuroma resection may be enhanced by the use of intraoperative electrical stimulation. Although stimulation of the extratemporal facial nerve is an effective and established procedure, anatomic differences of the intradural facial nerve and its microenvironment demand more exacting stimulus protocols. The absence of epineurium may make the intradural nerve more susceptible to mechanical or electrical trauma while intermittent pooling of cerebrospinal fluid (CSF) at the cerebellopontine angle may shunt current away from nerve. Four stimulus configurations were examined under varying conditions simulating CSF pooling. The results indicated that: 1. insulation of stimulating electrodes prevents CSF current shunting and allows utilization of a constant current source, and 2. monopolar and bipolar configurations demonstrate significantly different electrical characteristics which may be employed selectively based upon specific clinical goals.

Adult↗
PubMed1986

Fascial pulley: cross-commissure lip reanimation for inferior division facial nerve paralysis.

The risks of causing further harm to the facial nerve are greater in surgery for partial facial paralysis. We present a new active and passive reconstruction technique for paralysis of the buccal-mandibular divisions of the facial nerve. Our fascial pulley technique of reanimation and suspension of the oral commissure produces no further injury to the facial nerve and the eyelids. In addition, it adds a better technique to the armamentarium of the reconstructive surgeon dealing with partial lower facial nerve paralyses.

Facial Muscles↗
PubMed1992

Hearing prognosis and intraoperative guidance of brainstem auditory evoked potential in microvascular decompression.

Intraoperative monitoring of brainstem auditory evoked potential (BAEP) was done in 34 patients submitted to microvascular decompression (MVD). Seventeen of these patients had trigeminal neuralgia, and 17 had hemifacial spasm. Transitory postoperative hearing loss was observed in 6 (18%) of the patients, and permanent hearing loss was observed in 2 (6%) of the patients. Wave I-V interpeak latency (IPL) was calculated during each step of the MVD procedure in order to identify the dangerous steps of the surgery. Wave I-V IPL abnormalities occurred more frequently during cerebellar retraction. Of the 6 patients who had total loss of BAEP lasting throughout the surgery, 1 (17%) had definitive deafness. Ten of the 34 patients had an absence or partial diminution of BAEP without total normalization before the end of surgery. Among these 10 patients, 2 had transitory hearing loss and 1 had permanent hearing loss.

Adult↗
PubMed1993

Facial nerve dysfunction in osteopetrosis.

When facial nerve dysfunction occurs in conjunction with one of the rare temporal bone dysplasias, the physician faces a therapeutic dilemma. There is no consensus in the literature regarding the management of facial paralysis or facial spasm under these circumstances. During the past 2 years, four patients were seen with forms of osteopetroses and neurotologic symptoms. A patient with malignant, recessive osteopetrosis and a patient with Engelmann's disease were surgically managed for facial paralysis and facial spasm. The outcome of the treatment is discussed as well as the available literature on this subject. A new complication of facial nerve decompression in children with osteopetrosis is described, as well as appropriate caveats in the management of facial nerve disorders in the osteopetroses.

Child, Preschool↗
PubMed2006

Acute dystonia with low-dosage aripiprazole in Tourette's disorder.

OBJECTIVE: To report a case of an acute dystonic episode in a patient with Tourette's disorder (TD) treated with the partial dopamine agonist aripiprazole. CASE SUMMARY: An 18-year-old male with TD was prescribed aripiprazole 10 mg orally daily, which produced a significant improvement in his symptoms. However, after 3 days of treatment, he experienced an acute episode of dystonia with facial muscle spasm, oculogyric crisis, and torticolis. All symptoms resolved after a single intramuscular injection of biperidine 5 mg. The Naranjo probability scale indicated that the adverse events were probably caused by aripiprazole. DISCUSSION: To our knowledge, as of this writing, this is the first report concerning an aripiprazole-induced dystonic episode in an adult, and it is especially notable because it occurred at low dosage. Aripiprazole is a dopamine partial agonist and a serotonin(2A) antagonist with a favorable adverse effect profile. Short-term clinical trials reported a very low incidence of extrapyramidal symptoms, with akathisia being the most common, although there have been reports of severe extrapyramidal symptoms in a 3-year-old child and in an adolescent with a previous history of such symptoms. CONCLUSIONS: Acute dystonic phenomena may be caused by aripiprazole, although the drug's suggested mode of action largely precludes them.

Acute Disease↗
PubMed2005

Controlling sialorrhoea: a review of available treatment options.

Sialorrhoea (drooling or excessive salivation) is a common symptom of many neurological diseases (e.g., amyotropic lateral sclerosis, cerebral palsy and Parkinson's disease) and otolaryngologic diseases (tumours of upper aerodigestive tract). It is mostly caused by poor oral and facial muscle control in patients with swallowing dysfunction (secondary sialorrhoea). However, some cases of sialorrhoea are due to hypersecretion of saliva. These cases represent so-called primary sialorrhoea.

Botulinum Toxins, Type A↗
PubMed2006

Clinical characteristics and natural history of Freeman-Sheldon syndrome.

OBJECTIVE: Freeman-Sheldon syndrome (FSS) is a rare, multiple congenital contracture syndrome that is nonetheless relatively well-known, because affected children have a striking appearance: it was historically called "whistling-face syndrome" because of involvement of the facial muscles. FSS is often confused with other congenital contracture syndromes and, as a result, the clinical characteristics and natural history are poorly understood. The objective of this study was to analyze the presentation, natural history, and outcome of a cohort of individuals ascertained using strict diagnostic criteria for FSS. METHODS: Data from questionnaires, medical charts, examination, and photographs were analyzed to describe the physical features, therapeutic interventions, and functional outcomes in 73 individuals referred with the diagnosis of FSS. RESULTS: Only 32 referred cases (approximately 40%) met diagnostic criteria for FSS. In addition to contractures, common features in these cases included severe scoliosis (85%), strabismus (42%), and hearing loss (30%). Most infants required supplementary feedings via a nasogastric (45%) or gastrostomy tube (17%). Children walked by an average age of 19 months, but approximately 80% required ambulation-assist devices. An average of approximately 10 surgeries was performed on each child, and anesthetic and/or surgical complications were reported in 50% of individuals. All individuals were cognitively normal. CONCLUSIONS: The clinical characteristics and natural history of FSS distinguish it from other forms of arthrogryposis, yet FSS is frequently misdiagnosed. Children with FSS require considerable nutritional, surgical, and rehabilitative intervention. Such intensive therapeutic demands differ substantially from most other congenital contracture syndromes. These findings underscore the necessity of making an accurate diagnosis.

Abnormalities, Multiple↗
PubMed1985

[Muscular sarcosporidiosis: report of a case].

A case of sarcosporidiosis in a 29 year-old woman is presented. The clinical picture showed a definitive myopathic pattern with symmetrical proximal weakness of shoulder and pelvic girdle and also weakness on neck flexors; the facial muscles were intact and she denied dysphagia. The histological findings after a muscle biopsy obtained from left deltoid muscle showed many round cysts within the muscle fibres without any surrounding inflammatory reaction. The cysts diameters varied from 30 to 500 micra and the length from 300 micra to 3 millimeter (Miescher's tube). The radially striated membrane could be seen in some cysts but there was some doubt because it could represent the remaining of the peripheral muscle fibre. We could not find spores inside the cysts. Besides the largest cysts there were muscle fibre hypertrophy. The authors concluded on the diagnosis of sarcosporidiosis because of the presence, diameter and length of cysts; some remarks are made on the only other parasite that could be confused with Sarcocystis sp: Toxoplasma gondii.

Adult↗
PubMed1991

The O.M.E.N.S. classification of hemifacial microsomia.

The wide spectrum of anomalies associated with hemifacial microsomia (HFM) has made systematic and inclusive classification difficult. We propose a nosologic system in which each letter of the acronym O.M.E.N.S. indicates one of the five major manifestations of HFM. O for orbital distortion; M for mandibular hypoplasia; E for ear anomaly; N for nerve involvement; and S for soft tissue deficiency. The O.M.E.N.S. system is easily adapted for data storage, retrieval, and statistical analysis. A retrospective study of 154 patients with HFM classified according to the O.M.E.N.S. system confirmed the concept that the mandibular deformity is the cornerstone of the anomaly. Statistical analysis demonstrated a positive association between mandibular hypoplasia and the severity of orbital, auricular, neural, and soft tissue involvement. This study did not confirm a previously reported predominance of gender or sidedness. Analysis of statistical correlations failed to substantiate a Goldenhar variant as a syndromic entity. Our analysis showed that palatal deviation is probably caused by muscular hypoplasia and not by weakness of a particular cranial nerve.

Adult↗
PubMed1998

Sensitivity of a method for the analysis of facial mobility. I. Vector of displacement.

OBJECTIVE: (1) To determine which facial landmarks show the greatest movement during specific facial animations and (2) to determine the sensitivity of our instrument in using these landmarks to detect putatively abnormal facial movements. DESIGN: Movements of an array of skin-based landmarks on five healthy human subjects (2 men and 3 women; mean age, 27.6 years; range, 26 to 29 years) were observed during the execution of specific facial animations. To investigate the instrument sensitivity, we analyzed facial movements during maximal smile animations in six patients with different types of functional problems. In parallel, a panel was asked to view video recordings of the patients and to rate the degree of motor impairment. Comparisons were made between the panel scores and those of the measurement instrument. RESULTS: Specific regions of the face display movement that is representative of specific animations. During the smile animation, landmarks on the mid- and lower facial regions demonstrated the greatest movement. A similar pattern of movement was seen during the cheek puff animation, except that the infraorbital and chin regions demonstrated minimal movement. For the grimace and eye closure animations, the upper, mid-facial, and upper-lip regions exhibited the greatest movement. During eye opening, the upper and mid-facial regions, excluding the upper lip and cheek, moved the most, and during lip purse, markers on the mid- and lower face demonstrated the most movement. We used the smile-sensitive landmarks to evaluate individuals with functional impairment and found good agreement between instrument rankings based on the data from these landmarks and the panel rankings. CONCLUSION: The present method of three-dimensional tracking has the potential to detect and characterize a range of clinically significant functional deficits.

Adult↗