scholarly journals Effect of Penetration Electroacupuncture Combined with Intermediate Frequency Electrotherapy, Facial Acupoint Massage, and Cervical Reduction on Facial Nerve Function and Curative Effect of Senile Refractory Facial Paralysis

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Xiao-Jun Wang ◽  
Ni-Na He ◽  
Wen-Bin Ji ◽  
Li Yu ◽  
Ping Zhang
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
Remission Rate ◽  
Combined Treatment ◽  
Intermediate Frequency ◽  
Control Group ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Tcm Syndrome ◽  
Better Than

Objective. This study aimed to explore the curative effects on senile refractory facial paralysis treated by penetration electroacupuncture combined with intermediate frequency electrotherapy, facial acupoint massage, and cervical reduction on facial nerve. Methods. 106 elderly patients with intractable facial paralysis that were retrospectively analyzed were all admitted from January 2019 to June 2020. The 106 patients were evenly divided into 2 groups according to the treatment method. The control group was treated with penetration electroacupuncture, while the observation group was treated with penetration electroacupuncture plus intermediate frequency electrotherapy + facial acupoint massage + cervical reduction treatment. Then, House–Brackmann (H-B) facial nerve function evaluation, RPA score, TCM syndrome score, disease remission rate, and incidence of adverse events were evaluated and compared between the two groups. Results. After 4 weeks of treatment, the H-B facial nerve function grading in the observation group was better than that in the control group ( P  < 0.05). And the disease remission rate after 1 week, 2 weeks, and 4 weeks of treatment was higher than that in the control group ( P  < 0.05). Meanwhile, the TCM syndrome score and RPA score after 2 weeks and 4 weeks of treatment were better than that in the control group ( P  < 0.05). Conclusion. For the elderly patients with refractory facial paralysis, the application of the combined treatment that penetration electroacupuncture + medium frequency electrotherapy + facial acupoint massage + cervical adjustment can significantly improve the facial nerve function and reduce various diseases, and the effect of this combined treatment plan is more significant than that of penetration electroacupuncture treatment.

Congenital facial nerve agenesis

2001 ◽  
Vol 115 (1) ◽  
pp. 53-54 ◽  
Author(s):  
P. N. Jervis ◽  
P. D. Bull
Keyword(s):  
Surgical Treatment ◽  
Parotid Gland ◽  
Facial Nerve ◽  
Facial Paralysis ◽  
Facial Palsy ◽  
Surgical Procedure ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Stylomastoid Foramen ◽  
Unrelated Condition

We present a case of a seven-year-old child with a congenital facial palsy, diagnosed at birth, who subsequently developed a non-tuberculous mycobacterial (NTM) infection of the ipsilateral parotid gland. This required parotid exploration to treat the NTM disease with the intention of identifying and protecting the facial nerve to preserve any residual facial nerve function. At operation, thorough exploration revealed the complete absence of the nerve both at the stylomastoid foramen and more peripherally within the substance of the parotid gland. Exploration of the facial nerve for congenital facial paralysis is not normally indicated. Surgical treatment, if required, tends to involve the use of techniques such as cross facial nerve and free vascularized muscle grafting. To our knowledge this is the first reported case of complete congenital facial nerve agenesis, diagnosed incidentally during a surgical procedure for an unrelated condition.

Prophylactic nimodipine treatment for cochlear and facial nerve preservation after vestibular schwannoma surgery: a randomized multicenter Phase III trial

2016 ◽  
Vol 124 (3) ◽  
pp. 657-664 ◽  
Author(s):  
Christian Scheller ◽  
Andreas Wienke ◽  
Marcos Tatagiba ◽  
Alireza Gharabaghi ◽  
Kristofer F. Ramina ◽  
...  
Keyword(s):  
Treatment Group ◽  
Facial Nerve ◽  
Hydroxyethyl Starch ◽  
Phase Iii ◽  
Control Group ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Phase Iii Trial ◽  
Nerve Preservation ◽  
Multicenter Phase

OBJECT A pilot study of prophylactic nimodipine and hydroxyethyl starch treatment showed a beneficial effect on facial and cochlear nerve preservation following vestibular schwannoma (VS) surgery. A prospective Phase III trial was undertaken to confirm these results. METHODS An open-label, 2-arm, randomized parallel group and multicenter Phase III trial with blinded expert review was performed and included 112 patients who underwent VS surgery between January 2010 and February 2013 at 7 departments of neurosurgery to investigate the efficacy and safety of the prophylaxis. The surgery was performed after the patients were randomly assigned to one of 2 groups using online randomization. The treatment group (n = 56) received parenteral nimodipine (1–2 mg/hr) and hydroxyethyl starch (hematocrit 30%–35%) from the day before surgery until the 7th postoperative day. The control group (n = 56) was not treated prophylactically. RESULTS Intent-to-treat analysis showed no statistically significant effects of the treatment on either preservation of facial nerve function (35 [67.3%] of 52 [treatment group] compared with 34 [72.3%] of 47 [control group]) (p = 0.745) or hearing preservation (11 [23.4%] of 47 [treatment group] compared with 15 [31.2%] of 48 [control group]) (p = 0.530) 12 months after surgery. Since tumor sizes were significantly larger in the treatment group than in the control group, logistic regression analysis was required. The risk for deterioration of facial nerve function was adjusted nearly the same in both groups (OR 1.07 [95% CI 0.34–3.43], p = 0.91). In contrast, the risk for postoperative hearing loss was adjusted 2 times lower in the treatment group compared with the control group (OR 0.49 [95% CI 0.18–1.30], p = 0.15). Apart from dose-dependent hypotension (p < 0.001), no clinically relevant adverse reactions were observed. CONCLUSIONS There were no statistically significant effects of the treatment. Despite the width of the confidence intervals, the odds ratios may suggest but do not prove a clinically relevant effect of the safe study medication on the preservation of cochlear nerve function after VS surgery. Further study is needed before prophylactic nimodipine can be recommended in VS surgery.

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.

scholarly journals Evaluation of the effectiveness of the use of functional electrical stimulation after VII-XII anastomosis in patients with facial nerve damage of various etiologies

2019 ◽  
pp. 21-27
Author(s):  
Andrej Bobrov ◽  
Oleg Borisenko ◽  
Volodimir Jus ◽  
Alexander Papp
Keyword(s):  
Electrical Stimulation ◽  
Surgical Treatment ◽  
Facial Nerve ◽  
Postoperative Period ◽  
Nerve Fibers ◽  
Main Group ◽  
Control Group ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Facial Muscles

Surgical treatment of lesions of the facial nerve by an hypoglossal-facial anastomosis takes a long time to re-sprout of the nerve fibers to the facial muscles. The recovery time of facial function after surgical treatment of patients with paralysis of the facial nerve is long enough and can start from 6-8 months after surgery and last up to 2 years. Thus, all this time the mimic muscles are in a state of denervation. The purpose of this work was to determine the effect of electrical stimulation of facial muscles in patients with lesions of the facial nerve of different etiology after hypoglossal -facial anastomosis. Materials and methods: To evaluate the results of the use of early postoperative transcutaneus electrical stimulation, a low frequency FES was used, starting from the 2nd month after performing a XII-VII anastomosis. Assessment of the recovery of facial nerve function was performed 1 year after surgery. The study included 88 patients who underwent surgery to restore facial nerve function - hypoglossal -facial anastomosis. The survey was divided into 2 groups. The first (main) group consisted of 28 patients who underwent FES of facial muscles in the postoperative period, and the second group (comparison) consisted of 60 patients who underwent XII-VII anastomosis according to the following by the same method, but no further pharmacological or physiotherapeutic agents were used that could affect facial nerve regeneration. Results and discussion: According to this scale, the surveyed control group after 12 months. After the operation of XII-VII anastomosis according to the classical method, the following distribution was observed: The 1st degree of recovery of facial nerve function was not present in any of the patients, the 2nd degree had 2 (3.33%) patients, the thirds - 28 (46, 66%), IV - 20 (33,33%), V - 6 (10%) and VI - 4 (6,66%). In patients in the main group (where FES was used), distribution by degrees of recovery of facial nerve function on the House-Brackman scale after 12 months. after surgery it had the following character: II degree had 2 (6.45%) examined, III - 17 (54.83%), IV - 5 (22.58%), V - 2 (7.4%) and VI - 2 (7.4%). Conclusions: A statistically significant difference was observed in the postoperative period when comparing the mean M-responses of mimic muscles registered at different times after surgery in control subjects compared with patients in the main group in which FES was used. In addition, in the main group, a significantly larger number of patients reported a recovery of FN function to grade III-IV on the House-Brackman scale. Therefore, based on the results of the evaluation of the function of FN on the House-Brackman scale and electromyographic examination data in patients who underwent XII-VII anastomosis, it can be argued that with the use of FES in the postoperative period of recovery of facial nerve function is significantly faster and more complete in compared to the control group.

Microsurgical management of vestibular schwannoma after failed previous surgery

2016 ◽  
Vol 125 (5) ◽  
pp. 1198-1203 ◽  
Author(s):  
Madjid Samii ◽  
Hussam Metwali ◽  
Venelin Gerganov
Keyword(s):  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Multivariate Regression Analysis ◽  
Control Group ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Control Group Group

OBJECTIVE Microsurgical treatment of recurrent vestibular schwannoma (VS) is difficult and poses specific challenges. The authors report their experience with 53 cases of surgically treated recurrent VS. Outcome of these tumors was compared to that of primarily operated on VS. Special attention was given to the facial nerve functional outcome. METHODS A retrospective analysis was performed of the patients who underwent surgery for recurrent VS at one institution from 2000 to 2013. The preoperative data, intraoperative findings, and outcome in terms of facial nerve function and improvement of the preoperative symptoms were analyzed and compared with those in a control group of 30 randomly selected patients with primarily operated on VS. A multivariate regression analysis was performed to test the factors that could affect the facial nerve outcome in each group. RESULTS Fifty-three consecutive patients underwent surgery for recurrent VS. Seventeen patients were previously operated on and received postoperative radiosurgery (Group A). Thirty-six patients were previously operated on but did not receive postoperative radiosurgery (Group B). The overall postoperative facial nerve function was significantly worse in Groups A and B in comparison with the control group (Group C). Interestingly, there was no significant difference in the facial nerve outcome among the 3 groups in patients who had good preoperative facial nerve function. The tumor size and the preoperative facial nerve function are variables that significantly affect the facial nerve outcome. Most of the patients showed improvement of the preoperative symptoms, such as trigeminal hypesthesia, gait disturbance, and headache. CONCLUSIONS Complete microsurgical tumor removal is the optimal management for patients with recurrent or regrowing VS. The procedure is safe, associated with favorable facial nerve outcome, and may also improve existing neurological symptoms.

scholarly journals Patient- versus physician-reported facial disability in vestibular schwannoma: an international cross-sectional study

2017 ◽  
Vol 127 (5) ◽  
pp. 1015-1024 ◽  
Author(s):  
Øystein Vesterli Tveiten ◽  
Matthew L. Carlson ◽  
Frederik Goplen ◽  
Erling Myrseth ◽  
Colin L. W. Driscoll ◽  
...  
Keyword(s):  
Risk Factors ◽  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Well Being ◽  
Control Group ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
The Social ◽  
Patient Reported ◽  
Nerve Dysfunction

OBJECTIVEPatient-reported outcomes are increasingly used in studies of vestibular schwannoma (VS); however, few studies have examined self-evaluated facial nerve function and its relation to physician-reported outcomes. The primary objective of this study was to compare patient self-evaluations of facial disability with physician-evaluated facial nerve status and with self-evaluations of a healthy control group. The second objective was to provide insight into the controversial subject of the optimal initial management of small- and medium-sized VSs; consequently, the authors compared patient-reported facial nerve disability following treatment via observation (OBS), Gamma Knife surgery (GKS), or microsurgery (MS). Lastly, the authors sought to identify risk factors for facial nerve dysfunction following treatment for small- and medium-sized VSs.METHODSAll patients with a VS 3 cm or smaller that was singly treated with OBS, GKS, or MS at either of 2 independent treatment centers between 1998 and 2008 were retrospectively identified. Longitudinal facial nerve measures and clinical data, including facial nerve evaluation according to the House-Brackmann (HB) grading system, were extracted from existing VS databases. Supplementing the objective data were Facial Disability Index (FDI) scores, which were obtained via survey of patients a mean of 7.7 years after initial treatment.RESULTSThe response rate among the 682 eligible patients was 79%; thus, data from a total of 539 patients were analyzed. One hundred forty-eight patients had been managed by OBS, 247 with GKS, and 144 with MS. Patients who underwent microsurgery had larger tumors and were younger than those who underwent OBS or GKS. Overall, facial nerve outcomes were satisfactory following treatment, with more than 90% of patients having HB Grade I function at the last clinical follow-up. Treatment was the major risk factor for facial nerve dysfunction. Almost one-fifth of the patients treated with MS had an objective decline in facial nerve function, whereas only 2% in the GKS group and 0% in the OBS cohort had a decline. The physical subscale of the FDI in the VS patients was highly associated with HB grade; however, the social/well-being subscale of the FDI was not. Thus, any social disability caused by facial palsy was not detectable by use of this questionnaire.CONCLUSIONSThe majority of patients with small- and medium-sized VSs attain excellent long-term facial nerve function and low facial nerve disability regardless of treatment modality. Tumor size and microsurgical treatment are risk factors for facial nerve dysfunction and self-reported disability. The FDI questionnaire is sensitive to the physical but not the social impairment associated with facial dysfunction.

scholarly journals Electroacupuncture Is Effective for Peripheral Facial Paralysis: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Wei-Hua Wang ◽  
Ruo-Wen Jiang ◽  
Na-Chuan Liu
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
Meta Analysis ◽  
Poor Quality ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Peripheral Facial Paralysis ◽  
Eligibility Criteria ◽  
Quality Of Evidence

Objective. To explore the status of electroacupuncture (EA) among other treatments for peripheral facial paralysis (PFP). Methods. Randomized controlled trials comparing EA with other treatments that met the eligibility criteria published in databases were included. The differences were observed and quantified through the risk ratio (RR) for dichotomous outcomes and the standardized mean difference (SMD) for continuous outcomes. Then, their 95% confidence intervals (CI) were recorded. Results. Twenty-three studies involving 1985 participants were included. META-analysis results showed that EA was better than manual acupuncture for PFP (RR: 1.16, 95% CI 1.11 to 1.22, for responding rate; SMD: 2.26, 95% CI 0.15 to 4.37, for facial nerve function) and current promoted recovery (RR: 1.21, 95% CI 1.15 to 1.27, for responding rate; SMD: 2.87, 95% CI 1.16 to 4.58, for facial nerve function). When combined with other treatments, EA improved their effectiveness (RR: 1.19, 95% CI 1.12 to 1.28, responding rate; SMD: 1.85, 95% CI 0.67 to 3.03, facial nerve function). Conclusion. Patients with PFP received EA (used separately or combined with other treatments) resulting in a better prognosis. However, the quality of evidence was very low-to-moderate. Considering the poor quality of evidence, we are not very confident in the results. We look forward to more research and update results in the future and improve the evidence quality.

scholarly journals Complete Facial Paralysis Caused by Stabbing With a Car Key at the Stylomastoid Foramen

2021 ◽  
pp. 014556132110565
Author(s):  
Bo Yang ◽  
Fang Zhang ◽  
Ying Tian ◽  
Huijun Yang
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
Bone Fracture ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Peripheral Facial Paralysis ◽  
Nerve Branch ◽  
Temporal Bone Fracture ◽  
Stylomastoid Foramen ◽  
Great Auricular Nerve

Non-iatrogenic traumatic facial paralysis is most common in intratemporal facial nerve injury caused by temporal bone fracture, followed by intraparotid facial nerve branch injury. Facial paralysis caused by injury to the extratemporal trunk of the facial nerve is extremely rare. We present a case of a 60-year-old man suffering from immediate complete left peripheral facial paralysis due to blunt transection of extratemporal trunk of facial nerve by stabbing with a car key. There was a facial nerve defect about 1 cm in length. The great auricular nerve was grafted to repair the facial nerve. Over 12 months, his facial nerve function improved to a House–Brackmann III/VI.

scholarly journals RESULTS OF STUDY OF THE HYPOGLOSSAL NERVE FUNCTIONS IN PATIENTS AFTER HYPOGLOSSAL-FACIAL ANASTOMOSIS

InterConf ◽  
2021 ◽  
pp. 285-293
Author(s):  
Andrey Bobrov ◽  
Oleg Borysenko ◽  
Nina Mischanchuk ◽  
Alexandr Papp
Keyword(s):  
Facial Nerve ◽  
Hypoglossal Nerve ◽  
Main Group ◽  
Control Group ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Suppurative Otitis Media ◽  
Muscle Response ◽  
Tongue Muscles ◽  
Total Muscle

Hypoglossal-facial anastomosis is a common method of restoring and/or replacing lost facial nerve function. At the same time, there are works that compare functional disorders of the XII pair of cranial nerves that arise in patients with various types of hypoglossal-facial anastomosis, which, in turn, indicates the rather great importance of this problem, as well as the need for further research. There are several modifications of the hypoglossal-facial anastomosis, which differ significantly, including the effect on the function of the tongue muscles. An important instrumental method for studying the function of the hypoglossal nerve is electromyography, namely, the determination of the total evoked potentials of the tongue muscles. In order to study complications in the form of dysfunction of the tongue muscles due to hypoglossal-facial anastomosis, a comparative analysis of the data of the tongue electromyography in patients after performing these interventions was carried out. Materials and methods. The study included 55 patients with chronic suppurative otitis media, with tumors of the cerebello-pontine angle (acoustic and vestibular schwannomas, tumors of the jugular glomus) complicated by a lesion of the facial nerve. In the main group of patients (20 patients), the original technique of the modified hypoglossal-facial anastomosis was used to restore the facial nerve function. Patients (n=35) in the control group underwent a classic hypoglossal-facial anastomosis. Results. As can be seen from the above data, when comparing the tongue muscles contraction amplitude 3, 6 and 12 months after the formation of the hypoglossal-facial anastomosis, a statistically significant decrease in this indicator is observed on the side of performing the hypoglossal-facial anastomosis in comparison with the intact side at all stages of the study (p <0.05) (p <0.05) (p <0.01), respectively. When comparing the indicators of the total muscle response in patients after using the modified and classical methods of XII-VII anastomosis, there was a statistically significant increase in the compound muscle response of the tongue in the main group - by an average of 10.94% (p <0.05). Conclusion. Performing hypoglossal-facial anastomosis leads to gross dysfunction of the hypoglossal nerve on the side of the intervention, manifested in the form of a significant decrease in the amplitude of muscle contraction according to electromyography of the tongue. The use of the modified technique of XII-VII anastomosis provided the restoration of the total muscle potential of the tongue by 8.82% after 3 months, by 8.7% – after 6 months. and by 15.38% – after 12 months after surgery in comparison with the group where the classic hypoglossal-facial anastomosis was performed.

Sign in / Sign up

Export Citation Format

Share Document