Orbicularis Oculi Function Following Transfer of the Masseteric Nerve to the Main Trunk of the Facial Nerve for Complete Facial Paralysis

The recent application of arthroscopic surgical techniques to the temporomandibular joint (TMJ) has facilitated the diagnosis and treatment of TMJ disorders. However, as TMJ arthroscopy is performed more frequently, new complications are being recognized. We report three patients who developed severe otologic complications following TMJ arthroscopy. Two sustained complete or severe sensorineural hearing loss and severe vertigo from trauma to the ipsilateral ear. The third patient had complete facial paralysis from trauma to the facial nerve in the middle ear and a conductive hearing loss from incus dislocation. Complete hearing loss and facial paralysis from trauma to the main trunk of the facial nerve have not been reported previously as complications of TMJ arthroscopy.

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Intraoperative Distance Between the Main Trunk of the Facial Nerve and Surgical Landmarks Used in Parotidectomy: A Prospective Study

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v29i1.453 ◽

2014 ◽

Vol 29 (1) ◽

pp. 16-19

Author(s):

Daniel Jose C. Mendoza ◽

Samantha S. Castañeda ◽

Antonio H. Chua

Keyword(s):

Standard Deviation ◽

Facial Nerve ◽

Prospective Study ◽

Facial Paralysis ◽

Descriptive Study ◽

Suture Line ◽

Anatomic Landmarks ◽

Main Trunk ◽

The Mean ◽

A Prospective Study

Objective: to determine the mean distance of the main trunk of the facial nerve from two commonly employed surgical landmarks (tragal pointer and tympanomastoid suture line) among a sample of Filipino adults undergoing parotidectomy. Methods Study Design: Prospective Descriptive Study Setting: Tertiary Government Training Hospital Subjects: 22 patients without facial paralysis undergoing surgery for parotid neoplasms were evaluated intraoperatively. Results: The main trunk of the facial nerve was found to be 9.0mm (standard deviation of 2.8mm) from the tragal pointer and 6.1mm (standard deviation of 2.0mm) from the tympanomastoid suture line. Conclusion: The mean distance from the main trunk of the facial nerve to two of the most commonly utilized landmarks in identification of the nerve during parotidectomy was 9.0mm (standard deviation of 2.8mm) from the tragal pointer and 6.1mm (standard deviation of 2.0mm) from the tympanomastoid suture line. These may serve as reference values for surgeons in safer identification and preservation of the facial nerve during parotidectomy. Keywords: facial nerve, parotidectomy, tragal pointer, tympanomastoid suture line, anatomic landmarks

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Facial Paralysis Following Core Needle Biopsy of a Deep Lobe Parotid Tumor: A Case Report

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489418820886 ◽

2019 ◽

Vol 128 (4) ◽

pp. 357-359 ◽

Cited By ~ 1

Author(s):

William J. Moss ◽

Jesse R. Qualliotine ◽

Andrey Finegersh ◽

Kevin T. Brumund ◽

Charles S. Coffey

Keyword(s):

Case Report ◽

Facial Nerve ◽

Facial Paralysis ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Additional Patient ◽

Parotid Tumor ◽

Main Trunk ◽

Core Needle ◽

Deep Lobe

Objectives: To report a case of total facial paralysis as the result of a core needle biopsy. Methods: Case report and literature review. Results: A 70-year-old man was diagnosed with a deep lobe parotid tumor on computed tomography. During a core needle biopsy, he developed complete facial paralysis. The cause was discovered to be a direct stab injury to the main trunk of the facial nerve. Conclusions: When biopsying parotid lesions adjacent to the main trunk of the facial nerve, the use of smaller-gauge needles and additional patient counseling should be considered.

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Restoration of orbicularis oculi muscle function in rabbits with peripheral facial paralysis via an implantable artificial facial nerve system

Experimental and Therapeutic Medicine ◽

10.3892/etm.2017.5223 ◽

2017 ◽

Author(s):

Yajing Sun ◽

Cheng Jin ◽

Keyong Li ◽

Qunfeng Zhang ◽

Liang Geng ◽

...

Keyword(s):

Facial Nerve ◽

Facial Paralysis ◽

Muscle Function ◽

Orbicularis Oculi Muscle ◽

Peripheral Facial Paralysis ◽

Orbicularis Oculi ◽

Nerve System

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Differential Reanimation of the Midface and Lower Face Using the Masseteric and Hypoglossal Nerves for Facial Paralysis

Operative Neurosurgery ◽

10.1093/ons/opx217 ◽

2017 ◽

Vol 15 (2) ◽

pp. 174-178 ◽

Cited By ~ 4

Author(s):

Nobutaka Yoshioka

Keyword(s):

Facial Nerve ◽

Facial Paralysis ◽

Hypoglossal Nerve ◽

Donor Site ◽

Mass Movement ◽

Nerve Transfer ◽

Short Term ◽

Lower Face ◽

Masseteric Nerve

Abstract BACKGROUND Hypoglossal nerve transfer is frequently employed to reanimate the paralyzed facial muscles after irreversible proximal facial nerve injury. However, it can cause significant postoperative synkinesis because it involves the reinnervation of the whole mimetic musculature using a single motor source. OBJECTIVE To describe our experience with differential reanimation of the midface and lower face using separate motor sources in patients with short-term facial paralysis after brain surgery. METHODS Seven patients underwent combined nerve transfer (the masseteric nerve to the zygomatic branch and the hypoglossal nerve to the cervicofacial division of the facial nerve) and cross-facial nerve grafting with the aim of achieving a spontaneous smile. The median duration of paralysis before surgery was 7 mo and follow-up ranged from 7 to 31 mo (mean: 18 mo). For evaluation, both physical examination and video analysis were performed. RESULTS In all patients, reanimation of both the midface and the lower face was successful. A nearly symmetrical resting lip was achieved in all patients, and they were able to voluntarily elevate the corners of their mouths without visible synkinesis and to close their eyes while biting. No patient experienced impairment of masticatory function or tongue atrophy. CONCLUSION Differential reanimation of the midface and lower face with the masseteric and hypoglossal nerves is an alternative method that helps to minimize synkinetic mass movement and morbidity at the donor site.

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Masseteric–facial nerve neurorrhaphy: results of a case series

Journal of Neurosurgery ◽

10.3171/2015.12.jns14601 ◽

2017 ◽

Vol 126 (1) ◽

pp. 312-318 ◽

Cited By ~ 18

Author(s):

Federico Biglioli ◽

Valeria Colombo ◽

Dimitri Rabbiosi ◽

Filippo Tarabbia ◽

Federica Giovanditto ◽

...

Keyword(s):

Facial Nerve ◽

Facial Paralysis ◽

Postoperative Bleeding ◽

Case Series ◽

Morbidity Rate ◽

Nerve Function ◽

Facial Reanimation ◽

Grade Ii ◽

Grading Scale ◽

Masseteric Nerve

OBJECTIVE Facial palsy is a well-known functional and esthetic problem that bothers most patients and affects their social relationships. When the time between the onset of paralysis and patient presentation is less than 18 months and the proximal stump of the injured facial nerve is not available, another nerve must be anastomosed to the facial nerve to reactivate its function. The masseteric nerve has recently gained popularity over the classic hypoglossus nerve as a new motor source because of its lower associated morbidity rate and the relative ease with which the patient can activate it. The aim of this work was to evaluate the effectiveness of masseteric–facial nerve neurorrhaphy for early facial reanimation. METHODS Thirty-four consecutive patients (21 females, 13 males) with early unilateral facial paralysis underwent masseteric–facial nerve neurorrhaphy in which an interpositional nerve graft of the great auricular or sural nerve was placed. The time between the onset of paralysis and surgery ranged from 2 to 18 months (mean 13.3 months). Electromyography revealed mimetic muscle fibrillations in all the patients. Before surgery, all patients had House-Brackmann Grade VI facial nerve dysfunction. Twelve months after the onset of postoperative facial nerve reactivation, each patient underwent a clinical examination using the modified House-Brackmann grading scale as a guide. RESULTS Overall, 91.2% of the patients experienced facial nerve function reactivation. Facial recovery began within 2–12 months (mean 6.3 months) with the restoration of facial symmetry at rest. According to the modified House-Brackmann grading scale, 5.9% of the patients had Grade I function, 61.8% Grade II, 20.6% Grade III, 2.9% Grade V, and 8.8% Grade VI. The morbidity rate was low; none of the patients could feel the loss of masseteric nerve function. There were only a few complications, including 1 case of postoperative bleeding (2.9%) and 2 local infections (5.9%), and a few patients complained about partial loss of sensitivity of the earlobe or a small area of the ankle and foot, depending on whether great auricular or sural nerves were harvested. CONCLUSIONS The surgical technique described here seems to be efficient for the early treatment of facial paralysis and results in very little morbidity.

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Keyhole Endoscopic-Assisted Transcervical Approach to the Upper and Middle Retrostyloid Parapharyngeal Space: An Anatomic Feasibility Study

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0041-1722931 ◽

2021 ◽

Author(s):

Aldo Eguiluz-Melendez ◽

Sergio Torres-Bayona ◽

María Belen Vega ◽

Vanessa Hernández-Hernández ◽

Erik W. Wang ◽

...

Keyword(s):

Facial Nerve ◽

Parapharyngeal Space ◽

Jugular Bulb ◽

Occipital Condyle ◽

Digastric Muscle ◽

The Novel ◽

Main Trunk ◽

Transcervical Approach ◽

Semiquantitative Evaluation ◽

Neurovascular Structures

Abstract Objectives The aim of this study was to describe the anatomical nuances, feasibility, limitations, and surgical exposure of the parapharyngeal space (PPS) through a novel minimally invasive keyhole endoscopic-assisted transcervical approach (MIKET). Design Descriptive cadaveric study. Setting Microscopic and endoscopic high-quality images were taken comparing the MIKET approach with a conventional combined transmastoid infralabyrinthine transcervical approach. Participants Five colored latex-injected specimens (10 sides). Main Outcome Measures Qualitative anatomical descriptions in four surgical stages; quantitative and semiquantitative evaluation of relevant landmarks. Results A 5 cm long inverted hockey stick incision was designed to access a corridor posterior to the parotid gland after independent mobilization of nuchal and cervical muscles to expose the retrostyloid PPS. The digastric branch of the facial nerve, which runs 16.5 mm over the anteromedial part of the posterior belly of the digastric muscle before piercing the parotid fascia, was used as a landmark to identify the main trunk of the facial nerve. MIKET corridor was superior to the crossing of the accessory nerve over the internal jugular vein within 17.3 mm from the jugular process. Further exposure of the occipital condyle, vertebral artery, and the jugular bulb was achieved. Conclusion The novel MIKET approach provides in the cadaver straightforward access to the upper and middle retrostyloid PPS through a natural corridor without injuring important neurovascular structures. Our work sets the anatomical nuances and limitations that should guide future clinical studies to prove its efficacy and safety either as a stand-alone procedure or as an adjunct to other approaches, such as the endonasal endoscopic approach.

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Congenital unilateral facial palsy revealing a facial nerve agenesis: a case report and review of the literature

BJR|case reports ◽

10.1259/bjrcr.20180029 ◽

2019 ◽

Vol 5 (1) ◽

pp. 20180029

Author(s):

Yaotse Elikplim Nordjoe ◽

Ouidad Azdad ◽

Mohamed Lahkim ◽

Laila Jroundi ◽

Fatima Zahrae Laamrani

Keyword(s):

Case Report ◽

Facial Nerve ◽

Temporal Bone ◽

Facial Paralysis ◽

Facial Palsy ◽

Rare Condition ◽

Review Of The Literature ◽

Moebius Syndrome ◽

Temporal Bone Ct

Facial nerve aplasia is an extremely rare condition that is usually syndromic, namely, in Moebius syndrome. The occurrence of isolated agenesis of facial nerve is even rarer, with only few cases reported in the literature. We report a case of congenital facial paralysis due to facial nerve aplasia diagnosed on MRI, while no noticeable abnormality was detected on the temporal bone CT.

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Acute Otitis Media and Facial Paralysis in Children

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949610500110 ◽

1996 ◽

Vol 105 (1) ◽

pp. 58-62 ◽

Cited By ~ 36

Author(s):

Clark A. Elliott ◽

George H. Zalzal ◽

Wendy R. Gottlieb

Keyword(s):

Facial Nerve ◽

Otitis Media ◽

Facial Paralysis ◽

Acute Otitis Media ◽

Complete Recovery ◽

Rapid Improvement ◽

Nerve Decompression ◽

Complete Paralysis ◽

Prolonged Recovery ◽

Facial Nerve Decompression

We reviewed 10 children who presented with facial paralysis after the onset of acute otitis media. The objective of the study was to examine the outcome of facial paralysis in children with acute otitis media treated without facial nerve decompression. Two groups were identified: 8 patients with incomplete paralysis and 2 with complete paralysis. Seven of the 8 patients with incomplete paralysis had rapid return of function after myringotomy and intravenous antibiotics. The eighth patient had delayed recovery requiring 9 months before complete return of function. The 2 patients with complete paralysis required mastoidectomy to control otorrhea and fever after initial myringotomy and antibiotics. Both patients had a prolonged recovery requiring 3 and 7 months for complete recovery. Patients with incomplete paralysis generally show rapid improvement following wide myringotomy and antibiotic treatment. A more protracted recovery may be expected in patients with complete paralysis; excellent return of function is expected when mastoidectomy without facial nerve decompression is employed.

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