Changes in facial nerve function, morphology and neurotrophic factor expression in response to three types of nerve injury

2009 ◽  
Vol 124 (3) ◽  
pp. 265-271
Author(s):  
L Zhang ◽  
Z Fan ◽  
Y Han ◽  
L Xu ◽  
J Luo ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Nerve Injury ◽  
Neurotrophic Factor ◽  
Immunohistochemical Analysis ◽  
Blink Reflex ◽  
Nerve Function ◽  
Facial Canal ◽  
Facial Nerve Function ◽  
Complete Transection ◽  
Facial Nerves

AbstractObjective:To study the changes in facial nerve function, morphology and neurotrophic factor 3 expression in response to three types of nerve injury.Materials and methods:Changes in facial nerve function (in terms of blink reflex, vibrissae movement and position of nasal tip) were assessed in 45 rats in response to three types of nerve injury: partial section of the extratemporal segment (group one); partial section of the facial canal segment (group two); and complete transection of the facial canal segment (group three). All facial nerves were then dissected out from the sacrificed animals, on the first, seventh or 21st post-operative day, and the injured segment bisected for subsequent analysis. Morphological change and neurotrophic factor 3 expression in these facial nerve segments were evaluated by means of improved trichrome staining and immunohistochemical analysis, respectively.Results:Facial nerve function was more severely damaged and recovery was slower in group two compared with group one, although the facial nerve injury had been identical at the two sites involved. In group three (complete facial canal transection), scattered degenerative fibres were observed at the transection site on the seventh post-operative day. The number of degenerated fibres, assessed on the seventh post-operative day, was markedly increased in group two compared with group one. On the seventh post-operative day, axonal expression of neurotrophic factor 3 was strongly positive, whereas expression in Schwann cells was only weakly positive.Conclusions:The facial palsy of the group two rats was more severe than that of group one rats, although their facial nerve function had partly recovered on the 21st post-operative day. Fibre degeneration was not only dispersed throughout the injury site but also occurred throughout the length of the nerve. Neurotrophic factor 3 immunoreactivity increased in facial nerve fibres after partial transection.

scholarly journals DHI increases the proliferation and migration of Schwann cells through PI3K/AKT pathway and the expression of CXCL12 and GDNF to promote facial nerve function repair

2021 ◽  
Author(s):  
Dekun Gao ◽  
Lianhua Sun ◽  
Xiayu Sun ◽  
Jun Yang ◽  
Jingchun He
Keyword(s):  
Facial Nerve ◽  
Western Blot ◽  
Schwann Cells ◽  
Nerve Injury ◽  
Akt Pathway ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Facial Nerve Injury ◽  
And Migration ◽  
Proliferation And Migration

Abstract BackgroundDanhong injection (DHI) is a commonly used drug in the treatment of cardiovascular and cerebrovascular diseases, and its neuroprotective research has been fully confirmed. Schwann cells, as myelin forming cells of peripheral nerve, play an important role in the process of injury and repair. The purpose of this study was to explore the effect of DHI on Schwann cells and its role in facial nerve injury.MethodsRSC 96 Schwann cells were treated with different concentrations (0 –2%) of DHI for different time intervals (12 and 36 h). Effect of DHI on cell viability and migration were determined by CCK8 and Transwell assays. The levels of PI3K-Akt signaling related proteins were measured by western blotting analysis, and the effects of DHI on GDNF and CXCL12 using Western Blot, RT-qPCR, and ELISA assays at the cellular and animal levels, respectively. Then LY294002, an inhibitor of PI3K, was used to study the effect of DHI on cell migration and secretion of CXCL12 and GDNF in RSC96 cells by Transwell, Western Blot, RT-qPCR, and ELISA assays. Finally, facial nerve scoring and S-100 immunofluorescence staining were used to study the therapeutic effects of DHI on facial nerve injury.ResultsOur study found that DHI can promote the proliferation and migration of RSC96 cells, and this effect is related to the activation of PI3K/AKT pathway. LY294002 inhibits the proliferation and migration of RSC96 cells. Besides, DHI can also promote the expression of CXCL12 and GDNF at gene and protein levels, and CXCL12 is, while GDNF is not, PI3K/AKT pathway-dependent. Animal experiments confirmed that DHI could promote CXCL12 and GDNF expression, and promote facial nerve function recovery and myelin regeneration. Conclusion Our in vitro and in vivo experiments demonstrated that DHI could promote proliferation and migration of Schwann cells through the PI3K/AKT pathway, and increase the expression of CXCL12 and GDNF to promote facial nerve function repair.

Facial nerve injury in acoustic neuroma (vestibular schwannoma) surgery: etiology and prevention

1997 ◽  
Vol 87 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Prakash Sampath ◽  
Michael J. Holliday ◽  
Henry Brem ◽  
John K. Niparko ◽  
Donlin M. Long
Keyword(s):  
Facial Nerve ◽  
Nerve Injury ◽  
Acoustic Neuroma ◽  
Facial Nerve Palsy ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Content Type ◽  
Facial Nerve Injury ◽  
Acoustic Neuroma Surgery ◽  
Fine Print

✓ Facial nerve injury associated with acoustic neuroma surgery has declined in incidence but remains a clinical concern. A retrospective analysis of 611 patients surgically treated for acoustic neuroma between 1973 and 1994 was undertaken to understand patterns of facial nerve injury more clearly and to identify factors that influence facial nerve outcome. Anatomical preservation of the facial nerve was achieved in 596 patients (97.5%). In the immediate postoperative period, 62.1% of patients displayed normal or near-normal facial nerve function (House—Brackmann Grade 1 or 2). This number rose to 85.3% of patients at 6 months after surgery and by 1 year, 89.7% of patients who had undergone acoustic neuroma surgery demonstrated normal or near-normal facial nerve function. The surgical approach appeared to have no effect on the incidence of facial nerve injury. Poor facial nerve outcome (House—Brackmann Grade 5 or 6) was seen in 1.58% of patients treated via the suboccipital approach and in 2.6% of patients treated via the translabyrinthine approach. When facial nerve outcome was examined with respect to tumor size, there clearly was an increased incidence of facial nerve palsy seen in the immediate postoperative period in cases of larger tumors: 60.8% of patients with tumors smaller than 2.5 cm had normal facial nerve function, whereas only 37.5% of patients with tumors larger than 4 cm had normal function. This difference was less pronounced, however, 6 months after surgery, when 92.1% of patients with tumors smaller than 2.5 cm had normal or near normal facial function, versus 75% of patients with tumors larger than 4 cm. The etiology of facial nerve injury is discussed with emphasis on the pathophysiology of facial nerve palsy. In addition, on the basis of the authors' experience with these complex tumors, techniques of preventing facial nerve injury are discussed.

Differential Facial Nerve Function in Tumors of the Internal Auditory Meatus

1983 ◽  
Vol 92 (1) ◽  
pp. 39-41 ◽  
Author(s):  
J. Gail Neely ◽  
Charles R. Neblett
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
Postoperative Period ◽  
Tumor Infiltration ◽  
Nerve Function ◽  
Internal Auditory Meatus ◽  
Facial Nerve Function ◽  
Eighth Nerve ◽  
Auditory Dysfunction ◽  
Facial Nerves

Fifty-five consecutive cases of neoplastic involvement of the internal auditory meatus resulting in ipsilateral retrocochlear auditory dysfunction were reviewed. The majority of these tumors (89%) were solitary schwannomas of the eighth nerve. Eleven percent were other tumors. Preoperative facial paralysis was unusual in eighth nerve schwannomas (6.1%) and much more common in other tumors (66.6%). These data tend to suggest that facial paralysis preoperatively increases the probability that the tumor is other than an eighth nerve schwannoma. Furthermore, facial paralysis resulting from an eighth nerve schwannoma indicates a poorer prognosis for ultimate facial nerve function. The small numbers in this series, though far from conclusive, suggest that normally functioning facial nerves may be infiltrated by eighth nerve schwannomas. Failure of eventual recovery of facial nerve function in the postoperative period may suggest tumor infiltration.

Facial nerve injury in acoustic neuroma (vestibular schwannoma) surgery: etiology and prevention

1998 ◽  
Vol 5 (3) ◽  
pp. E8 ◽  
Author(s):  
Prakash Sampath ◽  
Michael J. Holliday ◽  
Henry Brem ◽  
John K. Niparko ◽  
Donlin M. Long
Keyword(s):  
Facial Nerve ◽  
Nerve Injury ◽  
Acoustic Neuroma ◽  
Postoperative Period ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Facial Nerve Injury ◽  
Acoustic Neuroma Surgery

Facial nerve injury associated with acoustic neuroma surgery has declined in incidence but remains a clinical concern. A retrospective analysis of 611 patients surgically treated for acoustic neuroma between 1973 and 1994 was undertaken to understand patterns of facial nerve injury more clearly and to identify factors that influence facial nerve outcome. Anatomical preservation of the facial nerve was achieved in 596 patients (97.5%). In the immediate postoperative period, 62.1% of patients displayed normal or near-normal facial nerve function (House-Brackmann Grade 1 or 2). This number rose to 85.3% of patients at 6 months after surgery and by 1 year, 89.7% of patients who had undergone acoustic neuroma surgery demonstrated normal or near-normal facial nerve function. The surgical approach appeared to have no effect on the incidence of facial nerve injury. Poor facial nerve outcome (House-Brackmann Grade 5 or 6) was seen in 1.58% of patients treated via the suboccipital approach and in 2.6% of patients treated via the translabyrinthine approach. When facial nerve outcome was examined with respect to tumor size, there clearly was an increased incidence of facial nerve palsy seen in the immediate postoperative period in cases of larger tumors: 60.8% of patients with tumors smaller than 2.5 cm had normal facial nerve function, whereas only 37.5% of patients with tumors larger than 4 cm had normal function. This difference was less pronounced, however, 6 months after surgery, when 92.1% of patients with tumors smaller than 2.5 cm had normal or near normal facial function, versus 75% of patients with tumors larger than 4 cm. The etiology of facial nerve injury is discussed with emphasis on the pathophysiology of facial nerve palsy. In addition, on the basis of the authors' experience with these complex tumors, techniques of preventing facial nerve injury are discussed.

scholarly journals Efficacy of surgical repair for the functional restoration of injured facial nerve

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Li ◽  
Zhaomin Fan ◽  
Haibo Wang ◽  
Yuechen Han
Keyword(s):  
Facial Nerve ◽  
Nerve Injury ◽  
Sural Nerve ◽  
Surgical Repair ◽  
Functional Restoration ◽  
Nerve Lesion ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Great Auricular Nerve ◽  
Facial Nerve Lesion

Abstract Background Early surgical repair to restore nerve integrity has become the most commonly practiced method for managing facial nerve injury. However, the evidence for the efficacy of surgical repair for restoring the function of facial nerves remains deficient. This study evaluated the outcomes of surgical repair for facial nerve lesions. Methods This retrospective observational study recruited 28 patients with the diagnosis of facial nerve injury who consecutively underwent surgical repairs from September 2012 to May 2019. All related clinical data were retrospectively analyzed according to age, sex, location of the facial nerve lesion, size of the facial nerve defect, method of repair, facial electromyogram, and blink reflex. Facial function was then stratified with the House-Brackmann grading system pre-operation and 3, 9, 15, and 21 months after surgical repair. Results The 28 patients enrolled in this study included 17 male and 11 female patients with an average age of 34.3 ± 17.4 years. Three methods were applied for the repair of an injured facial nerve, including great auricular nerve transplantation in 15 patients, sural nerve grafting in 7 patients, and hypoglossal to facial nerve anastomosis in 6 patients. Facial nerve function was significantly improved at 21 months after surgery compared with pre-operative function (P = 0.008). Following surgical repair, a correlation was found between the amplitude of motor unit potential (MUP) and facial nerve function (r = -6.078, P = 0.02). Moreover, the extent of functional restoration of the facial nerve at 21 months after surgery depended on the location of the facial nerve lesion; lesions at either the horizontal or vertical segment showed significant improvement(P = 0.008 and 0.005), while no functional restoration was found for lesions at the labyrinthine segment (P = 0.26). Conclusions For surgical repair of facial nerve lesions, the sural nerve, great auricular nerve, and hypoglossal-facial nerve can be grafted effectively to store the function of a facial nerve, and MUP may provide an effective indicator for monitoring the recovery of the injured nerve.

Predominance of M1 subtype among tumor-associated macrophages in phenotypically aggressive sporadic vestibular schwannoma

2020 ◽  
Vol 133 (6) ◽  
pp. 1637-1645 ◽  
Author(s):  
Avital Perry ◽  
Christopher S. Graffeo ◽  
Lucas P. Carlstrom ◽  
Aditya Raghunathan ◽  
Colin L. W. Driscoll ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Immunohistochemical Analysis ◽  
Tumor Control ◽  
Subtotal Resection ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Tumor Associated Macrophages ◽  
Clinical Endpoints ◽  
Percent Positivity

OBJECTIVETumor-associated macrophages (TAMs) have been implicated as pathologic actors in phenotypically aggressive vestibular schwannoma (VS), potentially mediated via programmed death-ligand 1 (PD-L1). The authors hypothesized that PD-L1 is a key regulator of the VS immune microenvironment.METHODSForty-six consecutive, radiation-naïve, sporadic VSs that were subtotally resected at primary surgery were assessed via immunohistochemical analysis, including analysis of CD163 and PD-L1 expression. Pathologic data were correlated with clinical endpoints, including tumor control, facial nerve function, and complications.RESULTSBaseline parameters were equivalent between stable and progressive post–subtotal resection (STR) VS. CD163 percent positivity and M2 index were significantly increased among tumors that remained stable (34% vs 21%, p = 0.02; 1.13 vs 0.99, p = 0.0008), as well as patients with favorable House-Brackmann grade I or II facial nerve function (31% vs 13%, p = 0.04; 1.11 vs 0.97, p = 0.05). PD-L1 percent positivity was significantly associated with tumor progression (1% vs 11%, p = 0.01) and unfavorable House-Brackmann grade III–VI facial nerve function (1% vs 38%, p = 0.02). On multivariate analysis, PD-L1 was independently significant in all models (likelihood ratio 4.4, p = 0.04), while CD163 was dependent in all iterations.CONCLUSIONSIn contrast to prior reports, in this study, the authors observed significantly increased levels of M1, CD163+ TAMs in association with VS that progressed after STR. Progressive tumors are characterized by increased PD-L1, potentially highlighting a mechanism of immune evasion that results in TAM deactivation, tumor growth, and further infiltration of anti-tumor immune cells. Targeting PD-1/PD-L1 may offer therapeutic promise, particularly in the setting of disease control after STR.

scholarly journals Retrospective Study of Facial Nerve Function following Temporomandibular Joint Arthroplasty Using the Endaural Approach

2015 ◽  
Vol 8 (2) ◽  
pp. 88-93 ◽  
Author(s):  
Frederick Liu ◽  
Helen Giannakopoulos ◽  
Peter D. Quinn ◽  
Eric J. Granquist
Keyword(s):  
Facial Nerve ◽  
Temporomandibular Joint ◽  
Nerve Injury ◽  
Total Joint Replacement ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Retrospective Case ◽  
Facial Nerve Injury ◽  
Nerve Dysfunction

The aim of this retrospective case–control study is to evaluate the incidence of facial nerve injury associated with temporomandibular joint (TMJ) arthroplasty using the endaural approach for the treatment of TMJ pathology. The sample consisted of 36 consecutive patients who underwent TMJ arthroplasty. A total of 39 approaches were performed through an endaural incision. Patients undergoing total joint replacement and/or with preexisting facial nerve dysfunction were excluded from the study. Five patients were lost to follow-up and were excluded from the study. Facial nerve function of all patients was clinically evaluated by resident physicians preoperatively, postoperatively, and at follow-up appointments. Facial nerve injury was determined to have occurred if the patient was unable to raise the eyebrow or wrinkle the forehead (temporalis branch), completely close the eyelids (zygomatic branch), or frown (marginal mandibular branch). Twenty-one of the 36 patients or 22 of the 39 approaches showed signs of facial nerve dysfunction following TMJ arthroplasty. This included 12 of the 21 patients who had undergone previous TMJ surgery. The most common facial nerve branch injured was the temporal branch, which was dysfunctional in all patients either as the only branch injured or in combination with other branches. By the 18th postoperative month, normal function had returned in 19 of the 22 TMJ approaches. Three of the 22 TMJ approaches resulted in persistent signs of facial nerve weakness 6 months after the surgery. This epidemiological study revealed a low incidence of permanent facial nerve dysfunction. A high incidence of temporary facial nerve dysfunction was seen with TMJ arthroplasty using the endaural approach. Current literature reveals that the incidence of facial nerve injury associated with open TMJ surgery ranges from 12.5 to 32%. The temporal branch of the facial nerve was most commonly affected, followed by 4 of the 22 approaches with temporary zygomatic branch weakness. Having undergone previous TMJ surgery did not increase the incidence of facial nerve injury using the endaural approach. This information is important for patients and surgeons in the postoperative period, as a majority of patients will experience recovery of nerve function.

Intraoperative facial motor evoked potential monitoring for pontine cavernous malformation resection

2020 ◽  
Vol 132 (1) ◽  
pp. 265-271
Author(s):  
Ridzky Firmansyah Hardian ◽  
Tetsuya Goto ◽  
Yu Fujii ◽  
Kohei Kanaya ◽  
Tetsuyoshi Horiuchi ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Cavernous Malformation ◽  
Motor Evoked Potentials ◽  
Motor Evoked Potential ◽  
Warning Signs ◽  
Constant Current ◽  
Karnofsky Performance Scale ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Cavernous Malformations

OBJECTIVEThe aim of this study was to predict postoperative facial nerve function during pontine cavernous malformation surgery by monitoring facial motor evoked potentials (FMEPs).METHODSFrom 2008 to 2017, 10 patients with pontine cavernous malformations underwent total resection via the trans–fourth ventricle floor approach with FMEP monitoring. House-Brackmann grades and Karnofsky Performance Scale (KPS) scores were obtained pre- and postoperatively. The surgeries were performed using one of 2 safe entry zones into the brainstem: the suprafacial triangle and infrafacial triangle approaches. Six patients underwent the suprafacial triangle approach, and 4 patients underwent the infrafacial triangle approach. A cranial peg screw electrode was used to deliver electrical stimulation for FMEP by a train of 4 or 5 pulse anodal constant current stimulation. FMEP was recorded from needle electrodes on the ipsilateral facial muscles and monitored throughout surgery by using a threshold-level stimulation method.RESULTSFMEPs were recorded and analyzed in 8 patients; they were not recorded in 2 patients who had severe preoperative facial palsy and underwent an infrafacial triangle approach. Warning signs appeared in all patients who underwent the suprafacial triangle approach. However, after temporarily stopping the procedures, FMEP findings during surgery showed recovery of the thresholds. FMEPs in patients who underwent the infrafacial triangle approach were stable during the surgery. House-Brackmann grades were unchanged postoperatively in all patients. Postoperative KPS scores improved in 3 patients, decreased in 1, and remained the same in 6 patients.CONCLUSIONSFMEPs can be used to monitor facial nerve function during surgery for pontine cavernous malformations, especially when the suprafacial triangle approach is performed.

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