[Treatment of blepharospasm: injection of botulinum toxin or surgical treatment?].
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The technique and results of surgical reconstruction of different extent of the extratemporal part of the facial nerve after oncological operations and after accidental injuries are reported. Return of facial nerve function was observed in 15 out of 17 cases (87%) with follow-up over 1 year. An own modification of nerve suture is described. Attention is called to the possibility of perineural and endoneural spread of parotid malignant neoplasms.
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The Authors have studied 120 cases of Bell's palsy, who underwent regular controls along 360 days from the beginning of the disease. The study has been carried out by means of two different parameters of evaluation, a clinical and electrophysiological one, which allowed us to obtain very interesting results, especially as regards the prognostic aspect.
The medical records of 79 dogs and 16 cats admitted to the New York State College of Veterinary Medicine between January 1975 and October 1985 with facial nerve dysfunction were reviewed. In 31 dogs and 8 cats, facial neuropathy was the only abnormal finding. In 48 dogs and 8 cats, the clinical findings most often noted in the records in addition to facial neuropathy were vestibular signs. Facial neuropathy appeared unassociated with gender or right vs left sides in both dogs and cats, or with hypothyroidism in dogs. Facial neuropathy was associated with increased age, with certain breeds in both dogs and cats, and with otitis media/interna and keratoconjunctivitis sicca in dogs. Causes of facial nerve dysfunction in dogs and cats included surgical and nonsurgical trauma, neoplasia, and otitis media/interna. Facial neuropathy was judged to be idiopathic in 74.7% of dogs and 25% of cats.
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Rheography of the blood flow in the area of the major facial vessels conducted in 50 patients with damage to the facial nerve has shown changes in the regional blood flow in these patients, that are essential for choosing the optimum method of treatment.
A case of progressive facial weakness associated with an anomaly of the internal auditory canal and labyrinthine segment of the facial nerve is documented with clinical, radiological, and surgical findings. Each portion of a double internal auditory canal (aberrant facial nerve canal) was found to contain a portion of the facial nerve, and each portion of the facial nerve was explored because a tumor was suspected to be the cause of the progressive weakness. However, no mass was found. The embryologic factors that may lead to such an abnormality and the pathophysiologic mechanisms that may have resulted in the facial weakness are discussed.
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