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.

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.

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 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.

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.

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 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.

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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