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Comparison of 7-nitroindazole with other nitric oxide synthase inhibitors as attenuators of opioid withdrawal.

Previously, we demonstrated that two nonselective inhibitors of nitric oxide synthase (NOS), L-NG-nitroarginine (L-NNA) and L-NG-nitroarginine methyl ester (L-NAME), reduced some signs of morphine withdrawal in rats. The present work extended these studies to include 7-nitroindazole (7-NI), an inhibitor specific for cerebral NOS, and N(5)-(1-iminoethyl)-L-ornithine (L-NIO), a potent inhibitor of endothelial NOS. Behavioral effects of these four NOS inhibitors and clonidine, an alpha 2-adrenoceptor, agonist, on morphine withdrawal in rats were assessed. Rats received one 75-mg morphine pellet subcutaneously (SC). Three days later, NOS inhibitors were administered IP 1 h before withdrawal was precipitated with naloxone (0.5 mg/kg, SC) and scored. 7-NI, L-NIO, L-NAME and L-NNA produced dose-related decreases in weight loss, diarrhea, wet dog shakes and grooming. 7-NI also reduced mastication, salivation and genital effects. Clonidine produced effects similar to 7-NI. In awake, morphine-naive and morphine-dependent rats not subjected to withdrawal, 7-NI was the only NOS inhibitor that did not increase blood pressure. Because 7-NI attenuated more signs of opioid withdrawal than L-NNA, L-NAME or L-NIO without causing hypertension, 7-NI appears to warrant further testing as a potential candidate for human use.

Analysis of Variance↗

Correlation of ultrasound imaging of oral swallow with ventilatory alterations in cerebral palsied and normal children: preliminary observations.

Preliminary results of an investigation that synchronizes the videotaped output of ultrasound camera and the analog data from physiological measurements of swallowing and ventilation in normal and cerebral palsied (CP) children are presented. Four cerebral palsied children and three control children undertook a single sip-swallow of 5 ml of liquid and a solid mastication-swallow sequence on three occasions according to a defined protocol. The CP children exhibited much more variability and less control of the liquid bolus than did the controls. The ultrasound image clearly demonstrates the lack of control of the posterior of the tongue in many CP children. Some parts of the sequence of oral swallow and the time to achieve maximum anterior displacement of the hyoid bone appear to be slowed. The sequential events of swallowing show less variability as the sip-swallow proceeds from the oral voluntary to pharyngeal and lower involuntary phases. This study also identified a short-latency apnea that appears to accompany a saliva (protective) swallow and a long-latency apnea that accompanies semi-solid or liquid bolus (alimentary) swallows. Further investigations of normal and CP children utilizing a combined diagnostic imaging-physiological measurement approach will follow this initial study.

Apnea↗

Laryngologic aspects of bolus asphyxiation-bolus death.

Among 12,982 forensic autopsies, 78 cases of café coronary due to bolus impaction in the larynx (bolus death) were observed from 1947 to 1988. In all cases bolus material occluded the entry to the larynx; only once was a singular occlusion of the glottis observed. The bolus frequently extended into the mouth, trachea, and bronchial tree or esophagus. In all cases small amounts of aspirated material were observed in the deeper parts of the bronchial tree. The most commonly observed bolus was not masticated meat or a meat product. In adults and the elderly the bolus was often too large to pass the physiological narrowings of the hypopharynx. It was commonly lodged above the arytenoid cartilages. Forty-five of the bolus events were observed by bystanders. In 43 of the victims vital reactions were observed by bystanders or at the autopsy. This justifies the hope that many lives could have been saved had the right diagnosis and immediate therapy been initiated. The first step should be manual extraction or use of the Heimlich maneuver; in cases of failure of both attempts, immediate tracheotomy followed by hospitalization and bronchial lavage are indicated.

Adolescent↗

Dysphagia in progressive supranuclear palsy: radiologic features.

Progressive supranuclear palsy (PSP) is a progressive degenerative extrapyramidal disease that often masquerades as Parkinson's disease (PD). Similar to PD, dysphagia frequently complicates the course of PSP. Because there is only one published report characterizing dysphagia in PSP, we reviewed the neurologic features and dynamic videofluoroscopic swallowing function study results in 10 dysphagic PSP patients. Abnormalities during multiple stages of ingestion were recorded in each patient. Uncoordinated lingual movements, absent velar retraction or elevation, impaired posterior lingual displacement, and copious pharyngeal secretions were noted in all patients. Tongue-assisted mastication, noncohesive lingual transfer, excessive oral bolus lingual leakage to the pharynx prior to active transfer, vallecular bolus retention, abnormal epiglottic positioning, and hiatal hernias were noted in at least half of the cohort. Although ingestion abnormalities in PSP are similar to those previously reported in PD, the number of studied patients and observed differences were too few to clearly differentiate the two diseases.

Aged↗

Abnormalities of the TMJ and the musculature in the oculo-auriculo-vertebral spectrum (OAV). A CT study.

The abnormalities covered by the generic term "oculo-auriculovertebral spectrum" (OAV) form an exceptional heterogeneous dysmorphic complex characterized by unilateral malformations of miscellaneous craniofacial structures. The aim of the present study was to analyze morphometrically the developmental deficits concerning the temporomandibular joints, the mandibular rami and the mastication muscles by comparing the affected with the non-affected side. The volume, maximum horizontal diameter, and trabecular bone density of the head of the mandible, as well as the ramus height were acquired from CT data of 16 patients suffering from this syndrome. The volume and maximal cross-sectional area of the masseter muscles and the pterygoid muscles were defined by quantifying CT data of nine patients. The skeletal parameters were evaluated with VoXim software. The comparison of the mandibular structures on the affected and on the non-affected side was based on the Wilcoxon signed rank test. The results recorded on the affected side showed that the TMJ volume was reduced by a mean factor of 7.98, and the spongiodensity of the head of the mandible by a mean factor of 1.33, while the mean reduction in ramus height was 14.89 mm. The muscle volumes on the affected side had also undergone a mean reduction of 9.10 cm(3). The CT-based data analysis proved to be an excellent tool for quantitative three-dimensional evaluation of both the skeletal and the muscular parameters.

Adolescent↗

[Muscle afferent block in the treatment of oromandibular dystonia. Difference in effect between masticatory and lingual muscles].

Oromandibular dystonia is a neuromuscular disorder characterized by tonic or clonic involuntary spasms of the masticatory and lingual muscles. We treated 50 patients with this movement disorder by injection of lidocaine and alcohol into the masticatory or tongue muscles to block muscle afferents from muscle spindle. The patients were divided according to clinical features into four groups: jaw-closing, jaw-opening, jaw-deviation, and tongue dystonias. Objective evaluation of the symptoms before and after therapy was based on a clinical scaling protocol in terms of four parameters (mastication, speech, pain, and discomfort scales). Symptoms improved in all patients without major side effects. The overall objective improvement (60.2+/-29.5%) was significantly (P<0.005, ANOVA) lower in tongue dystonia (14.1%) than in jaw-closing dystonia (67.6%) and jaw-opening dystonia (68.3%). Although the response of the muscle afferent block to tongue dystonia was hardly satisfactory, this treatment is suggested to be effective for oromandibular dystonia.

Adult↗

Liquid chromatography-mass spectrometry (LC-MS): a powerful combination for selenium speciation in garlic (Allium sativum).

Liquid chromatography (LC) hyphenated with both elemental and molecular mass spectrometry has been used for Se speciation in Se-enriched garlic. Different species were separated by ion-pair liquid chromatography-inductively coupled plasma mass spectrometry (LC-ICP-MS) after hot-water extraction. They were identified by on-line reversed-phase liquid chromatography-electrospray ionization tandem mass spectrometry (RPLC-ESI-MS-MS). Se-methionine and Se-methylselenocysteine were determined by monitoring their product ions. Another compound, gamma-glutamyl-Se-methylselenocysteine, shown to be the most abundant form of Se in the garlic, was determined without any additional sample pre-treatment after extraction and without the need for a synthesized standard. Product ions for this dipeptide were detected by LC-ESI-MS-MS for three isotopes of Se-78 Se, 80Se: and 82Se. The method was extended to the species extracted during in-vitro gastrointestinal digestion. Because both Se-methylselenocysteine and gamma-glutamyl-Se-methylselenocysteine have anticarcinogenic properties, their extractability and stability during human digestion are very important. Garlic was also treated with saliva, to enable detection and analysis of species extracted during mastication. Detailed information on the extractability of selenium species by both simulated gastric and intestinal fluid are given, and variation of the distribution of Se among the different species with time is discussed. Although the main species in garlic is the dipeptide gamma-glutamyl-Se-methylselenocysteine, Se-methylselenocysteine is the main compound present in the extracts after treatment with gastrointestinal fluids. Two more, so far unknown compounds were observed in the chromatogram. The extracted species and their transformations were analysed by combining LC-ICP-MS and LC-ESI-MS-MS. In both the simulated gastric and intestinal digests, Se-methionine, Se-methylselenocysteine, and gamma-glutamyl-Se-methylselenocysteine could be determined by LC-ESI-MS-MS by measuring their typical product ions.

Chromatography, Liquid↗

Study of the microbiodegradation of terpenoid resin-based varnishes from easel painting using pyrolysis-gas chromatography-mass spectrometry and gas chromatography-mass spectrometry.

The alterations produced by microbiological attack on terpenoid resin-based varnishes from panel and canvas paintings have been evaluated using pyrolysis-gas chromatography-mass spectrometry (Py-GC-MS) and gas chromatography-mass spectrometry (GC-MS). The proposed methods include the on-line derivatisation of drying oils and diterpenoid resins using hexamethyldisilazane during pyrolysis and the application of methyl chloroformate as a derivatisation reagent for triterpenoid resins in GC-MS. Two types of specimens, consisting of model oil medium prepared from linseed oil and model spirit varnishes prepared from colophony and mastic resins dissolved in turpentine, have been used as reference materials. For a series of specimens upon which different genera of bacteria and fungi were inoculated and encouraged to grow, analyses indicated that no mechanisms that commonly occur during the attack of enzymes on drying oils and terpenoid biodegraders were observed to occur in the oil medium and varnishes studied. Thus, the degradation pathways observed in the performed trials usually occur as consequence of natural ageing. Specific trials consisting of the application of biocides to uninoculated colophony varnish resulted in the identification of processes that produce undesirable degradation of the varnish due to interactions between the biocide and the varnish components. Finally, the studied biocides--Biotin, New-Des and Nipagine--generally exhibited good inhibiting effects on the microorganisms studied, although some interesting differences were found between them regarding the application method and type of biocide.

Biodegradation, Environmental↗

Exteroceptive reflexes in jaw-closing muscle EMG during rhythmic jaw closing and clenching in man.

Exteroceptive jaw reflexes might play a role in normal functions of the mouth such as mastication. Until now these reflexes have only been studied under isometric conditions. The aim of this study was to compare exteroceptive reflexes in jaw muscle EMG during the closing phase of rhythmic open-close movements and clenching, at the same jaw gape and with similar muscle EMG. Reflexes consisting of successive waves of decreased and increased muscle activity (the Q, R, S and T waves of the post-stimulus electromyographic complex (PSEC)), evoked by light noxious electrical stimulation of the vermillion border of the lower lip, were recorded from the jaw closing muscles of 17 subjects. Differences between the two tasks occurred in two phases of the PSEC: (1) in an early phase, around the R wave, there was significantly less EMG during jaw closing (mean EMG ratio between jaw-closing and clenching 0.71), and (2) in a late phase, around the transition between the S to the T wave, there was significantly more EMG during jaw closing (mean EMG ratio: 1.40). The decrease in EMG activity around the R wave during jaw closing may be due to a change in reflex sensitivity at an interneuron level. The increase in EMG activity around the transition between the S and T waves during jaw closing might, at least in part, be due to a proprioceptive stretch reflex. This reflex is mediated by muscles spindles that are activated by the deceleration of the jaw evoked by the lip stimulus. The finding of inhibitory reflex mechanisms that predominate more during rhythmic jaw movements than during clenching in an early phase of the PSEC might be related to protecting oral tissues from trauma when the jaw is closing with potentially a large muscle force. In contrast, when food is held between the teeth, a possible inhibitory influence of light noxious stimuli is diminished.

Adolescent↗

A study on synaptic coupling between single orofacial mechanoreceptors and human masseter muscle.

The connection between individual orofacial mechanoreceptive afferents and the motoneurones that innervate jaw muscles is not well established. For example, although electrical and mechanical stimulation of orofacial afferents in bulk evokes responses in the jaw closers, whether similar responses can be evoked in the jaw muscles from the discharge of type identified single orofacial mechanoreceptive afferents is not known. Using tungsten microelectrodes, we have recorded from 28 afferents in the inferior alveolar nerve and 21 afferents in the lingual nerve of human volunteers. We have used discharges of single orofacial afferents as the triggers and the electromyogram (EMG) of the masseter as the source to generate spike-triggered averaged records to illustrate time-based EMG modulation by the nerve discharge. We have then used cross correlation analysis to quantify the coupling. Furthermore, we have also used coherence analysis to study frequency-based relationship between the nerve spike trains and the EMG. The discharge patterns of the skin and mucosa receptors around the lip and the gingiva generated significant modulation in EMGs with a success rate of 40% for both cross correlation and coherence analyses. The discharge patterns of the periodontal mechanoreceptors (PMRs) generated more coupling with a success rate of 70% for cross correlation and about 35% for coherence analyses. Finally, the discharges of the tongue receptors displayed significant coupling with the jaw muscle motoneurones with a success rate of about 40% for both analyses. Significant modulation of the jaw muscles by single orofacial receptors suggests that they play important roles in controlling the jaw muscle activity so that mastication and speech functions are executed successfully.

Action Potentials↗

Perceptual distortion of face deletion by local anaesthesia of the human lips and teeth.

As visual guidance of facial movements is impossible, accurate movements for speech and mastication require an established body image that is formed via the information from mechanoreceptors in the skin, mucosa, periodontium, and proprioceptors in the facial and masticatory muscles and in the jaw joints. In this study we aimed to investigate how the acute deafferentation of lips and teeth alters the established image of lips, teeth and the thumb. We used a psychophysical method to determine whether the perceived sizes of the upper lip and front teeth change when the sensory input from the lips and front teeth is fully blocked. We also examined the perceived size of the thumb to test for acute interactions between the thumb and facial structures. Local anaesthetic blocking of upper lip and upper front teeth significantly increased the perceived size of the upper lip by as much as 100% (range 21-100%) in ten out of eleven subjects tested (overall mean 52%; p=0.001). The perceived size of the upper teeth also significantly increased by as much as 155% (range 30-155%) in eight of the eleven subjects during anaesthesia (overall mean 41%; p=0.035). When the region of anaesthesia was increased and both upper and lower teeth and lips were anaesthetised, the perceived size of the upper lip again increased, by 53% (p=0.040), but the change in perceived size of the upper front teeth (18%) was not significant (p=0.206). In both studies there was no change in perceived size of the thumb. The results illustrate the labile central interaction between sensory inputs and the importance of feedback from peripheral afferents in generating the subjective facial image. The timing, level, and area of anaesthesia may be important modifiers of these interactions.

Adolescent↗

Jaw-muscle spindle afferent feedback to the cervical spinal cord in the rat.

Putative synaptic contacts between masticatory-muscle spindle afferents and brainstem neurons which project to the cervical spinal cord were studied in rats by combining retrograde and intracellular neuronal labeling. Spinal cord projecting neurons were retrogradely labeled via injection of horseradish peroxidase unilaterally or bilaterally into cervical spinal cord segments C2 through C5. Twenty-four hours after the injection of horseradish peroxidase, one to five jaw-muscle spindle afferent axons were physiologically identified and intracellularly stained with biotinamide on each side of the brainstem. Horseradish-peroxidase-labeled neurons were found bilaterally in the supratrigeminal region, trigeminal principal sensory nucleus, parvicellular reticular nucleus including its alpha division, spinal trigeminal subnuclei oralis and interpolaris and the medullary reticular formation. Retrogradely labeled neurons were most numerous in the spinal trigeminal subnucleus oralis, parvicellular reticular formation and the ventral part of the spinal trigeminal subnucleus interpolaris. A small number of horseradish-peroxidase-labeled neurons were also present in the trigeminal mesencephalic nucleus and spinal trigeminal subnucleus caudalis. Appositions between jaw-muscle spindle afferent boutons and spinal projecting neurons were found in the supratrigeminal region, dorsomedial portions of the trigeminal principal sensory nucleus and spinal trigeminal subnuclei oralis and interpolaris, and the parvicellular reticular formation including its alpha division. Putative synaptic contacts were most frequent in the parvicellular reticular formation and the dorsomedial portion of the trigeminal subnucleus oralis. These results indicate that some orofacial proprioceptive feedback transmitted via the mesencephalic trigeminal nucleus reaches the cervical spinal cord directly and suggests that jaw-muscle spindle afferent feedback reaches the cervical spinal cord predominately via relays in the dorsomedial part of the spinal trigeminal subnucleus oralis and the parvicellular reticular formation. It is hypothesized that these pathways are primarily involved in the coordination of jaw and neck movement during mastication and biting.

Afferent Pathways↗

Modulation of the periodontally evoked masseter reflexes by mechanical stimulation of the face.

The current study was designed to determine if facial skin stimulation has a modulatory effect on the jaw reflexes that are elicited by tooth stimulation. This was investigated in eight human volunteers. The testing involved six sessions (three control and three test runs) of 50 identical tooth stimuli of 2 N, at 400 N/s, with 0.5 N preload, to the upper left central incisor. The stimulus typically induced an inhibitory reflex that was immediately followed by an excitatory reflex. All reflexes were recorded by surface electromyogram (SEMG) from the ipsilateral masseter. During the control runs, the tooth stimulus was delivered alone while the test runs involved mechanical stimulation of the skin as the tooth stimulus was repeated. The mechanical skin stimulation was achieved by rubbing a toothbrush with approximately 5 N of force, over the area of the face innervated by the maxillary division of the trigeminal nerve. The effect of skin stimulation on the periodontally induced reflex was measured by comparing the control and test reflex activity. When the SEMG of the test reflex was subtracted from the control reflex, the difference was a net increase in the SEMG in all eight subjects. There was also a significant reduction in the decline of the bite force. It is concluded that the skin stimulation can modulate the reflexes that are induced by tooth stimulus. It is postulated that this modulation may be partly responsible for matching the size and consistency of the food bolus with the appropriate bite force during mastication.

Adult↗

Enhanced osteonectin expression in the chondroid matrix of the unloaded mandibular condyle.

Osteonectin provided a spatial and temporal marker for proliferating and differentiating chondrocytes, and during the chondroid matrix formation. The goal of this investigation was to examine early cellular and molecular regulation of mandibular growth. Unloading was induced by anterior functional mastication. The proliferative activity measured by tritiated thymidine incorporation increased 8. 3-fold at 24 hours compared with the corresponding control group. Mandibular unloading for 24 hours increased osteonectin mRNA expression 60% in the condyle over the corresponding control group. Microscopic inspection of the condyle demonstrated osteonectin immunostaining of proliferating, early hypertrophic chondrocytes, and the chondroid matrix across the sagittal section in an anterior-posterior direction. An increasing gradient intensity from a medial-superior to posterior direction was produced with treatment in direct contrast to the control group. The posterior chondroid matrix immunostaining increased 11.7-fold (P = 0.038) after 24 hours treatment over a corresponding control group. Unloading of the mouse mandible caused an increased cellular proliferation, a coincident increase of osteonectin mRNA, and a subsequent increased secretion of the osteonectin protein in the chondroid matrix formation.

Animals↗

Cyclodiene insecticide, DDE, DDT, arsenic, and mercury contamination of big brown bats (Eptesicus fuscus) foraging at a Colorado Superfund site.

Rocky Mountain Arsenal (RMA) National Wildlife Area, near Denver, Colorado, is a Superfund site contaminated by past military and industrial uses, including pesticide manufacturing. From an ecosystem standpoint, the most critical contaminants at RMA are certain cyclodiene insecticides and metabolites, p,p'-DDE, p,p'-DDT, arsenic, and mercury. Bats are important ecosystem components that can be impacted by persistent contaminants because of their position in the food chain and their potential longevity and thus duration of exposure. Big brown bats (Eptesicus fuscus) were captured (n = 51) while foraging at RMA in the summers of 1997 and 1998 for determination of concentrations of contaminants of concern in carcasses, brains, and stomach contents. Adult females (n = 15) were also tracked by radiotelemetry to determine locations of nearest maternity roosts for sampling of guano for contaminant analysis and inspection for potential contaminant-induced mortality. Bats captured while foraging at RMA had measurable quantities of dieldrin and DDE in masticated insect samples from stomach contents and significantly higher concentrations of dieldrin, DDE, DDT, and mercury (juveniles) in carcasses than big brown bats (n = 26) sampled at a reference area 80 km to the north. Concentrations of dieldrin and DDE in brains of bats captured while foraging at RMA were also greater than in bats from the reference area, but not high enough to suggest mortality. Maximum concentrations of DDE, DDT, and cyclodienes in brains of big brown bats were found in adult males from RMA. Guano from the two closest known roosts had significantly higher concentrations of dieldrin, DDE, and mercury than guano from two roosts at the reference area. Dieldrin concentrations in carcasses of bats from RMA were highest in juveniles, followed by adult males and adult females. DDE concentrations in carcasses were lowest in adult females at both sites and highest in adult males at RMA. No contaminant-related mortality was obvious at the small maternity colonies near RMA. Big brown bats show higher contamination than most other mammals previously sampled at this site. Concentrations and proportions of samples with detectable residues of dieldrin in carcasses of big brown bats from RMA were similar to or exceeded reports for this species from elsewhere in the United States some 25 years ago, prior to or just following restrictions on use of this compound.

Animals↗

Atypical herpes simplex encephalitis presenting as operculum syndrome.

This case report demonstrates the course of herpes simplex virus cerebritis in a patient aged 7 years 2 months who presented with non-specific symptoms followed by an epileptic attack. Subcortical, bilateral opercular and bilateral thalamic lesions were detected, but the temporal and inferior frontal lobes were spared. The patient developed anarthria, impairment of mastication and swallowing consistent with operculum syndrome. Diagnosis was made by magnetic resonance imaging and elevation of oligoclonal antibodies specific to herpes simplex virus in cerebrospinal fluid after an unexpectedly negative polymerase chain reaction test.

Antibodies, Viral↗

Ear pain in patients with oropharynx carcinoma: how MRI contributes to the explanation of a prognostic and predictive symptom.

Reflex otalgia is a predictive and prognostic parameter for local control in patients with oropharynx carcinoma. Can a morphologic correlate of this important symptom be detected by MRI? Thirty-six patients were prospectively evaluated by MRI before radical radiotherapy. Sixteen patients had reflex otalgia; 20 did not. The oropharynx and adjacent regions were analyzed. Alteration was defined as effacement of anatomical structures, signal alteration or enhancement after contrast medium administration. The chi(2)-test was used to compare categorical parameters. In patients with reflex otalgia, alteration of the following structures innervated by the glossopharyngeal nerve were found significantly more often: nasopharynx, hard palate, superior constrictor pharyngis muscle, palatine tonsil, palatopharyngeus muscle, palatoglossus muscle, stylopharyngeus muscle, hyoglossus muscle and preepiglottic space. No difference was found for the muscles of mastication, levator and tensor veli palatini muscles, styloglossus muscle, genioglossus muscle, intrinsic muscles of the tongue, digastric muscles, mucosal surface of the lateral and posterior pharyngeal wall, uvula, valleculae, parapharyngeal space and larynx. An alteration of structures innervated by the glossopharyngeal nerve was visualized on MRI significantly more often when reflex otalgia was present. Involvement of structures innervated by other cranial nerves did not show the same association with ear pain.

Adult↗

Trigeminal neuralgia and facial nerve paralysis.

The trigeminal nerve is the largest of the cranial nerves. It provides sensory input from the face and motor innervation to the muscles of mastication. The facial nerve is the cranial nerve with the longest extracranial course, and its main functions include motor innervation to the muscles of facial expression, sensory control of lacrimation and salivation, control of the stapedial reflex and to carry taste sensation from the anterior two-thirds of the tongue. In order to be able adequately to image and follow the course of these cranial nerves and their main branches, a detailed knowledge of neuroanatomy is required. As we are dealing with very small anatomic structures, high resolution dedicated imaging studies are required to pick up normal and pathologic nerves. Whereas CT is best suited to demonstrate bony neurovascular foramina and canals, MRI is preferred to directly visualize the nerve. It is also the single technique able to detect pathologic processes afflicting the nerve without causing considerable expansion such as is usually the case in certain inflammatory/infectious conditions, perineural spread of malignancies and in very small intrinsic tumours. Because a long course from the brainstem nuclei to the peripheral branches is seen, it is useful to subdivide the nerve in several segments and then tailor the imaging modality and the imaging study to that specific segment. This is particularly true in cases where topographic diagnosis can be used to locate a lesion in the course of these nerves.

Facial Nerve Diseases↗