Deep Temporal Nerve Transfer for Facial Reanimation: Anatomic Dissections and Surgical Case Report

2017 ◽  
Vol 15 (1) ◽  
pp. 81-88
Author(s):  
Mark A Mahan ◽  
Walavan Sivakumar ◽  
David Weingarten ◽  
Justin M Brown
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Nerve Transfer ◽  
Lateral Approach ◽  
Multiple Sources ◽  
Facial Muscles ◽  
First Case ◽  
The Face ◽  
Facial Reanimation ◽  
History Of

Abstract BACKGROUND Facial nerve palsy is a disabling condition that may arise from a variety of injuries or insults and may occur at any point along the nerve or its intracerebral origin. OBJECTIVE To examine the use of the deep temporal branches of the motor division of the trigeminal nerve for neural reconstruction of the temporal branches of the facial nerve for restoration of active blink and periorbital facial expression. METHODS Formalin-fixed human cadaver hemifaces were dissected to identify landmarks for the deep temporal branches and the tension-free coaptation lengths. This technique was then utilized in 1 patient with a history of facial palsy due to a brainstem cavernoma. RESULTS Sixteen hemifaces were dissected. The middle deep temporal nerve could be consistently identified on the deep side of the temporalis, within 9 to 12 mm posterior to the jugal point of the zygoma. From a lateral approach through the temporalis, the middle deep temporal nerve could be directly coapted to facial temporal branches in all specimens. Our patient has recovered active and independent upper facial muscle contraction, providing the first case report of a distinct distal nerve transfer for upper facial function. CONCLUSION The middle deep temporal branches can be readily identified and utilized for facial reanimation. This technique provided a successful reanimation of upper facial muscles with independent activation. Utilizing multiple sources for neurotization of the facial muscles, different potions of the face can be selectively reanimated to reduce the risk of synkinesis and improved control.

scholarly journals Wholly Endoscopic Permeatal Removal of a Petrous Apex Cholesteatoma

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Todd Kanzara ◽  
Jagdeep Singh Virk ◽  
Sanjiv Chawda ◽  
Anthony O. Owa
Keyword(s):  
Case Report ◽  
Facial Palsy ◽  
Relevant Literature ◽  
Epileptic Seizures ◽  
Petrous Apex ◽  
Initial Decision ◽  
Profound Deafness ◽  
The Face ◽  
Facial Reanimation ◽  
History Of

We report a case of a petrous apex cholesteatoma which was managed with a wholly endoscopic permeatal approach. A 63-year-old Caucasian male presented with a 10-year history of right-sided facial palsy and profound deafness. On examination in our clinic, the patient had a grade VI House-Brackmann paresis, otoscopic evidence of attic cholesteatoma behind an intact drum, and extensive scarring of the face from previous facial reanimation surgery. Imaging review was suggestive of petrous apex cholesteatoma. An initial decision to manage the patient conservatively was later reviewed on account of the patient suffering recurrent epileptic seizures. A wholly endoscopic permeatal approach was used with successful outcomes. In addition to the case report we also provide a brief description of the technique and a review of the relevant literature.

scholarly journals First report of chronic invasive fungal rhinosinusitis in a patient with ovarian cancer caused by Didymella pedeiae and successful treatment with voriconazole: A case report

2021 ◽  
Author(s):  
Omid Raiesi ◽  
Seyed Jamal Hashemi ◽  
Muhammad Ibrahim Getso ◽  
Pegah Ardi ◽  
Mojtaba Mohammadi Ardehali ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Case Report ◽  
Human Infection ◽  
Tissue Mass ◽  
First Case ◽  
Dematiaceous Fungus ◽  
Human Sample ◽  
The Face ◽  
History Of ◽  
Ethmoid Sinuses

Background and Purpose: Didymella pedeiae is a dematiaceous fungus that belongs to the Coelomycetes class. While species within this class are known to cause human infection, D. pedeiae had previously only been known as phytopathogens and had never been isolated from a human sample. Case report: A 51-year-old Iranian female patient with ovarian cancer was admitted with unilateral lesions in paranasal sinuses and a five-month history of nasal obstruction,headache, postnasal drainage, swelling on the left side of the face, and orbital pain.Paranasal sinus computerized tomography scan revealed a soft tissue mass that filled the left nasal cavity, ethmoid, sphenoid, and frontal sinuses with more involvement in the maxillary and ethmoid sinuses. Antifungal treatment was simultaneously initiated with itraconazole+prednisolone 15 mg/day, and levofloxacin. Due to poor clinical response,IV voriconazole and amphotericin B were added to the treatment as well. The patient recovered completely after 10 weeks of therapy. Conclusion: Here, we report the first case of human D. pedeiae infection in a patientwith ovarian cancer.

Case Report: Management of a Patient with mTBI and Vestibular Hypofunction with the Binasal Occlusion Technique

2018 ◽  
pp. 87-90
Keyword(s):  
Case Report ◽  
Visual Motion ◽  
Hand Movement ◽  
Motion Sensitivity ◽  
Vestibular Hypofunction ◽  
First Case ◽  
Neurological Exam ◽  
History Of ◽  
Occlusion Technique ◽  
Visual Vertigo

Background: Binasal Occlusion (BNO) is a clinical technique used by many neurorehabilitative optometrists in patients with mild traumatic brain injury (mTBI) and increased visual motion sensitivity (VMS) or visual vertigo. BNO is a technique in which partial occluders are added to the spectacle lenses to suppress the abnormal peripheral visual motion information. This technique helps in reducing VMS symptoms (i.e., nausea, dizziness, balance difficulty, visual confusion). Case Report: A 44-year-old AA female presented for a routine eye exam with a history of mTBI approximately 33 years ago. She was suffering from severe dizziness for the last two years that was adversely impacting her ADLs. The dizziness occurred in all body positions and all environments throughout the day. She was diagnosed with vestibular hypofunction and had undergone vestibular therapy but reported little improvement. Neurological exam revealed dizziness with both OKN drum and hand movement, especially in the left visual field. BNO technique resulted in immediate relief of her dizziness symptoms. Conclusion: To our knowledge, this is the first case that illustrates how the BNO technique in isolation can be beneficial for patients with mTBI and vestibular hypofunction. It demonstrates the success that BNO has in filtering abnormal peripheral visual motion in these patients.

scholarly journals COMPLETE MANAGEMENT OF ARDITA (BELL’S PALSY) AS PER AYURVEDA CHIKITSA SUTRA – A CASE REPORT

2021 ◽  
Vol 09 (3) ◽  
pp. 650-656
Author(s):  
Ram Lakhan Meena ◽  
Santoshkumar Bhatted ◽  
Nilam Meena
Keyword(s):  
Case Report ◽  
Adverse Effects ◽  
Facial Nerve ◽  
Present Report ◽  
Complete Recovery ◽  
Bell’S Palsy ◽  
Bell's Palsy ◽  
Contemporary Science ◽  
The Face ◽  
Grading Scale

Bell’s palsy, also known as acute idiopathic lower motor neuron facial paralysis, is characterized by sud-den onset paralysis or weakness of the muscles to one side of the face controlled by the facial nerve. In contemporary science, administration of steroids is the treatment of choice for complete facial palsy. Cer-tain Panchakarma procedures and internal Ayurvedic medicines have been proved to be beneficial in the management of Ardita vata. The present report deals with a case of 62-year-old male patient diagnosed as Ardita vata was treated with various Panchakarma procedures like Nasya, Shirobasti, Kukkutanda Swedana, Dashmoola Ksheer Dhoom, Gandoosh and oral Ayurveda medicines. Criteria of assessment was based on the scoring of House-Brackmann Facial Nerve Grading scale. After completion of Ayurveda treatment, the patient Shown almost complete recovery without any adverse effects. This case is an evi-dence to demonstrate the effectiveness of Ayurveda treatment in case of Ardita vata (Bell’s palsy).

scholarly journals Rhino-orbital COVID-19 associated mucormycosis- A case report

2021 ◽  
Vol 7 (4) ◽  
pp. 304-307
Author(s):  
Shanmuga Vadivoo Natarajan ◽  
B Usha
Keyword(s):  
Diabetes Mellitus ◽  
Infectious Disease ◽  
Case Report ◽  
Tertiary Care ◽  
Notifiable Disease ◽  
Health Ministry ◽  
First Case ◽  
Uncontrolled Diabetes ◽  
History Of ◽  
Second Wave

COVID-19 Associated Mucormycosis (CAM) is an emerging infectious disease that has caused increased mortality & morbidity in India during this second wave of the pandemic. The country has reported more than 30,000 cases and over 2,000 deaths by Mucormycosis so far, according to sources from Union Health Ministry. CAM is now a notifiable disease. At our Tertiary care teaching hospital, which caters for COVID 19 management, we are reporting the first case of Rhino orbital CAM, which was caused by Rhizopus spp. Our patient had a history of contact with a suspected COVID 19 patient and was recently diagnosed with uncontrolled diabetes mellitus. A direct KOH microscopic examination of purulent material aspirated from the sinonasal polyp of the patient revealed fungal elements, and Rhizopus spp was isolated. Due to a shortage of Amphotericin B, the patient was referred to a government higher speciality centre for further management. The patient was followed up & was noted that he was treated with antifungal and discharged following recovery.

scholarly journals Metastatic Pancreatic Cancer with BRAF and P53 Mutations: Case Report of Therapeutic Response to Doublet Targeted Therapy

2020 ◽  
Vol 13 (3) ◽  
pp. 1239-1243
Author(s):  
Shenthol Sasankan ◽  
Lorraine Rebuck ◽  
Gloria Darrah ◽  
Moises Harari Turquie ◽  
Ian Rabinowitz
Keyword(s):  
Pancreatic Cancer ◽  
Case Report ◽  
Targeted Therapy ◽  
Therapeutic Response ◽  
Case Reports ◽  
Clinical History ◽  
P53 Mutation ◽  
Metastatic Pancreatic Cancer ◽  
First Case ◽  
History Of

We report on the clinical history of a 49-year-old female with metastatic pancreatic cancer. She was initially treated with standard chemotherapy as per current guidelines. She was found to have both a BRAF and P53 mutation, and received dabrafenib and trametinib with deep responses, both radiographically and biochemically (CA19-9). Her response has been more clinically relevant than responses in previous case reports of patients with BRAF-positive pancreatic cancer treated with targeted therapy. To the best of our knowledge, this is the first case report showing a dramatic therapeutic response to combination therapy with dabrafenib and trametinib in metastatic pancreatic cancer.

scholarly journals Primary Adenosquamous Cell Carcinoma of the Ileum in a Dog

2020 ◽  
Vol 7 (4) ◽  
pp. 155
Author(s):  
Masashi Yuki ◽  
Roka Shimada ◽  
Tetsuo Omachi
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Cell Carcinoma ◽  
Surgical Resection ◽  
Clinical Course ◽  
Mass Lesion ◽  
Abdominal Radiography ◽  
First Case ◽  
History Of

A 9-year-old male, castrated Chihuahua was examined because of a 7-day history of intermittent vomiting. A mass in the small intestine was identified on abdominal radiography and ultrasonography. Laparotomy revealed a mass lesion originating in the ileum, and surgical resection was performed. The mass was histologically diagnosed as adenosquamous cell carcinoma. Chemotherapy with carboplatin was initiated, but the dog was suspected to have experienced recurrence 13 months after surgery and died 3 months later. To our knowledge, this is the first case report to describe the clinical course of adenosquamous cell carcinoma in the small intestine of a dog.

scholarly journals Clinical Study of Bell's Palsy at Tertiary Care: Our Experience

2019 ◽  
Vol 02 (01) ◽  
pp. 16-20
Author(s):  
M. B. Bharathi ◽  
Thanzeem Unisa ◽  
Swathi Chandresh ◽  
Venkatesh C. R. ◽  
Harsha S.
Keyword(s):  
Facial Nerve ◽  
Tertiary Care ◽  
Bell’S Palsy ◽  
Cross Sectional Study ◽  
Bell's Palsy ◽  
Cross Sectional ◽  
Tertiary Referral Center ◽  
Number Of Patients ◽  
The Face ◽  
History Of

Abstract Introduction Bell's palsy (BP) is the common cause of facial palsy. This study aims to report and analyze the age, sex distribution, symptomatology, site of lesion, and prognosis in 101 patients with (BP). Materials and Methods This is a cross-sectional study conducted at tertiary referral center, JSS Hospital, Mysuru. All patients consenting to participate in this study, of all ages, of either sex, both outpatients and inpatients with a diagnosis of BP during this study period were included. Results Of the 101 patients analyzed, maximum cases (25.7%) were in third decade of age; 55.4% were males, and both right and left sides of the face were equally involved. Maximum number of patients (50.5%) had a history of postaural pain at presentation Topodiagnostic tests showed majority of BP cases involving geniculate or suprageniculate regions (67.3%) in our study. 20.8% had lesion above the nerve to stapedius, and 11.9% had lesion below the nerve to stapedius. Electrodiagnostic test—electroneuromyography (ENMG)—was abnormal in 57 (67.1%) individuals at day 4. 50.4% of patients had a House-Brackmann (HB) facial nerve grade IV at presentation. 90% of the BP group in our study recovered normal to near-normal facial nerve function by the end of 28 days’ time. Conclusion Each case of BP should be evaluated with thorough clinical examination, topodiagnostic tests, and electrodiagnostic tests. Appropriate management will help in almost full recovery of disease.

scholarly journals Miller Fisher syndrome with early intracranial hypertension and delayed bilateral simultaneous facial nerve palsy: a case report

2019 ◽  
Vol 48 (3) ◽  
pp. 030006051986749
Author(s):  
Yu-Ming Liu ◽  
Yan-Li Chen ◽  
Yan-Hua Deng ◽  
Yan-Ling Liang ◽  
Wei Li ◽  
...  
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Intracranial Hypertension ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Miller Fisher Syndrome ◽  
Ivig Treatment ◽  
Fisher Syndrome ◽  
Igm Antibodies ◽  
History Of

Miller Fisher syndrome (MFS), a variant of Guillain–Barré syndrome, is characterized by ataxia, areflexia and ophthalmoplegia. This case report describes a 40-year old male that presented with a 3-day history of unsteady walking and numbness on both hands, and a 2-day history of seeing double images and unclear articulation. Lumbar puncture revealed an opening pressure of 260 mm H2O. Plasma serology was positive for anti-ganglioside M1-immunoglobulin M (anti-GM1-IgM) antibodies and negative for anti-ganglioside Q1b (anti-GQ1b) antibodies. The patient was diagnosed with MFS based on the clinical course and neurophysiological findings. On the 4th day of treatment with intravenous immunoglobulin (IVIG), his ataxia and unsteady walking improved, but his bilateral eyeballs were fixed, and over the next few days he developed bilateral peripheral facial paralysis. After 5 days of IVIG treatment, methylprednisolone treatment was offered and the patient's symptoms gradually improved. Early intracranial hypertension and delayed facial nerve palsy may be atypical presentations of MFS. Anti-GM1-IgM antibodies may be the causative antibodies for MFS. If the IVIG therapy does not stop the progression of the disease, the addition of corticosteroid therapy may be effective. However, the relationship between IgM type, anti-GM1 antibody and MFS remains unclear and requires further research.

Coincidental Pituitary Adenoma and Parasellar Meningioma: Case Report

Neurosurgery ◽  
1986 ◽  
Vol 19 (2) ◽  
pp. 267-270 ◽  
Author(s):  
Kenji Yamada ◽  
Takashi Hatayama ◽  
Masahiro Ohta ◽  
Katsuaki Sakoda ◽  
Tohru Uozumi
Keyword(s):  
Case Report ◽  
Pituitary Adenoma ◽  
Head Injury ◽  
Ct Scan ◽  
The Other ◽  
Histopathological Findings ◽  
Computed Tomographic ◽  
First Case ◽  
History Of

Abstract We report a patient who had pituitary adenoma and parasellar meningioma coincidentally, with neither irradiation nor a history of head injury. Preoperative computed tomographic (CT) scan had shown a large intrasellar mass with ringlike enhancement; in contact with this mass, another well-enhanced mass had been shown. Histopathologically, the intrasellar mass was diagnosed as chromophobic pituitary adenoma and the other mass as meningotheliomatous meningioma. We present clinical, radiological, and histopathological findings and discuss previously reported cases of coincidental pituitary adenoma and meningioma without irradiation. This is the first case report since the advent of CT that pituitary adenoma and parasellar meningioma in contact with each other could be clearly demonstrated by CT.

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