Facial nerve repair accomplished by the interposition of a collagen nerve guide

Object. Facial nerve paralysis due to a surgical procedure or trauma is a frequently observed complication. The authors evaluated facial nerve repair achieved by the interposition of a collagen nerve guide.Methods. Ten cats were divided into three groups. Group 1 consisted of six animals in which a 5-mm facial nerve segment on one side was resected and replaced by a collagen tube that was sutured to bridge both nerve stumps. On the opposite side a 5-mm segment of facial nerve was resected, reversed 180°, and sutured to the stumps as an autograft nerve. Group 2 consisted of two cats in which the collagen nerve guide was interposed on one side and the nerve on the other side was left intact. Group 3 consisted of two cats in which a reversed autograft nerve was placed on one side and the nerve on the other side was left intact. Histological, electrophysiological, and horseradish peroxidase labeling examinations were performed starting 3 weeks after surgery.Light and electron microscopic examinations of collagen tube—implanted specimens revealed a well-vascularized regenerated nerve. The electrophysiological study confirmed the recovery of electrical activity in regenerated axons. Horseradish peroxidase labeling also confirmed restoration of the whole facial nerve tract.Conclusions. The collagen nerve guide shows great promise as a nerve conduit.

Download Full-text

Resection of large vestibular schwannomas: facial nerve preservation in the context of surgical approach and patient-assessed outcome

Journal of Neurosurgery ◽

10.3171/jns.2005.102.4.0643 ◽

2005 ◽

Vol 102 (4) ◽

pp. 643-649 ◽

Cited By ~ 77

Author(s):

Douglas E. Anderson ◽

John Leonetti ◽

Joshua J. Wind ◽

Denise Cribari ◽

Karen Fahey

Keyword(s):

Facial Nerve ◽

Vestibular Schwannomas ◽

Facial Nerve Paralysis ◽

Nerve Paralysis ◽

Nerve Monitoring ◽

Content Type ◽

Nerve Preservation ◽

Facial Nerve Monitoring ◽

Facial Function ◽

Fine Print

Object. Vestibular schwannoma surgery has evolved as new therapeutic options have emerged, patients' expectations have risen, and the psychological effect of facial nerve paralysis has been studied. For large vestibular schwannomas for which extirpation is the primary therapy, the goals remain complete tumor resection and maintenance of normal neurological function. Improved microsurgical techniques and intraoperative facial nerve monitoring have decreased the complication rate and increased the likelihood of normal to near-normal postoperative facial function. Nevertheless, the impairment most frequently reported by patients as an adverse effect of surgery continues to be facial nerve paralysis. In addition, patient assessment has provided a different, less optimistic view of outcome. The authors evaluated the extent of facial function, timing of facial nerve recovery, patients' perceptions of this recovery and function, and the prognostic value of intraoperative facial nerve monitoring following resection of large vestibular schwannomas; they then analyzed these results with respect to different surgical approaches. Methods. The authors retrospectively reviewed a database of 67 patients with 71 vestibular schwannomas measuring 3 cm or larger in diameter. The patients had undergone surgery via translabyrinthine, retrosigmoid, or combined approaches. Clinical outcomes were analyzed with respect to intraoperative facial nerve activity, responses to intraoperative stimulation, and time course of recovery. Eighty percent of patients obtained normal to near-normal facial function (House—Brackmann Grades I and II). Patients' perceptions of facial nerve function and recovery correlated well with the clinical observations. Conclusions. Trends in the data lead the authors to suggest that a retrosigmoid exposure, alone or in combination with a translabyrinthine approach, offers the best chance of facial nerve preservation in patients with large vestibular schwannomas.

Download Full-text

Neurinomas of the facial nerve

Journal of Neurosurgery ◽

10.3171/jns.1975.43.5.0608 ◽

1975 ◽

Vol 43 (5) ◽

pp. 608-613 ◽

Cited By ~ 21

Author(s):

Fabian Isamat ◽

Federico Bartumeus ◽

Antonio M. Miranda ◽

Jaime Prat ◽

Luis C. Pons

Keyword(s):

Facial Nerve ◽

Cerebellopontine Angle ◽

Petrous Bone ◽

The Other ◽

Bone Area ◽

Content Type ◽

Fine Print

✓ Three cases of neurinomas of the facial nerve are reported. Two of them originated from the labyrinthine portion of the nerve and the other from the vertical portion. Neurinomas of the first part of the facial nerve can be suspected preoperatively since they seem to give rise to specific clinical and radiological manifestations that can be distinguished from tumors of other portions of the nerve, the petrous bone area, or the cerebellopontine angle. The reported cases of neurinomas of the facial nerve are reviewed and analyzed.

Download Full-text

The child with facial nerve palsy

InnovAiT Education and inspiration for general practice ◽

10.1177/17557380211046283 ◽

2021 ◽

pp. 175573802110462

Author(s):

Tiffanie-Marie Borg ◽

Amy Sarah Warwick ◽

Mas Ahmed

Keyword(s):

Family History ◽

Facial Nerve ◽

Nerve Palsy ◽

Clinical Presentation ◽

Facial Nerve Palsy ◽

Family Members ◽

The Other ◽

Facial Nerve Paralysis ◽

Nerve Paralysis ◽

Diagnosis And Management

In this article we summarise the educational aspects regarding the clinical presentation, diagnosis and management of children presenting with facial nerve paralysis, highlighting the importance of family history. We report two cases of hereditary facial nerve paralysis managed by the authors: one a child with familial facial nerve palsy, and the other a child with Melkersson–Rosenthal syndrome. The history in both cases revealed multiple family members with the same disorder.

Download Full-text

Method of eyelid closure in facial nerve paralysis

Journal of Neurosurgery ◽

10.3171/jns.1982.57.5.0722 ◽

1982 ◽

Vol 57 (5) ◽

pp. 722-723 ◽

Cited By ~ 1

Author(s):

Ephraim I. Zlotnik ◽

Arnold F. Smeyanovich ◽

Eugene P. Tyappo

Keyword(s):

Facial Nerve Paralysis ◽

Total Removal ◽

Nerve Paralysis ◽

Content Type ◽

Eyelid Closure ◽

Prevention And Treatment ◽

Acoustic Neurinomas ◽

Conjunctival Inflammation ◽

Subcutaneous Connective Tissue ◽

Fine Print

✓ The authors present a method of temporary eyelid closure consisting of air inflation of the subcutaneous connective tissue. This method is effective for prevention and treatment of conjunctival inflammation due to facial paralysis developing after total removal of acoustic neurinomas.

Download Full-text

Synovial chondromatosis of the temporomandibular joint with intracranial extension

Journal of Neurosurgery ◽

10.3171/jns.1989.70.1.0121 ◽

1989 ◽

Vol 70 (1) ◽

pp. 121-123 ◽

Cited By ~ 19

Author(s):

C. Phillip Daspit ◽

Robert F. Spetzler

Keyword(s):

Facial Nerve ◽

Temporomandibular Joint ◽

Fine Needle Biopsy ◽

Synovial Chondromatosis ◽

Intracranial Extension ◽

Facial Nerve Paralysis ◽

Nerve Paralysis ◽

Content Type ◽

Nerve Dysfunction ◽

Peripheral Facial Nerve Paralysis

✓ The authors report the unusual presentation of an intracranial extension of synovial chondromatosis of the temporomandibular joint. The patient presented with a peripheral facial nerve paralysis and anacusis. Computerized tomography revealed the lesion, but fine-needle biopsy was inconclusive. Craniotomy with removal of the tumor was performed, and pathological studies confirmed the diagnosis. The facial nerve dysfunction was thought to be secondary to direct neural compression.

Download Full-text

Therapeutic approach and recovery options in traumatic caused intratemporal facial paralysis of children

Romanian Journal of Medical Practice ◽

10.37897/rjmp.2016.3.12 ◽

2016 ◽

Vol 11 (3) ◽

pp. 271-277

Author(s):

Veronica EPURE ◽

◽

D.C. GHEORGHE ◽

Keyword(s):

Facial Nerve ◽

Facial Paralysis ◽

Early Onset ◽

Therapeutic Approach ◽

Nerve Repair ◽

Facial Nerve Paralysis ◽

Nerve Paralysis ◽

Adult Age ◽

Otologic Surgery ◽

Surgical Methods

TFacial nerve paralysis is one of the most feared complications of otologic surgery; the surgeon must always be prepared to recognize and solve such lesions if they occur. The authors present 2 clinical cases of intratemporal lesions of the facial nerve; in one of these we performed early neurografting of the facial nerve, in the second one we performed delayed decompression of the nerve. Facial nerve paralysis with early onset after otologic surgery needs timely exploration (via ENoG) and repair – this is always an emergency, the earlier the exploration the better the outcome; there are a variety of surgical methods for facial nerve repair, according to the type of lesion and its duration. Postoperatively the patient should be carefully monitored both clinically and by electromiography. Generally, posttraumatic facial nerve paralysis evolves better in children, compared to adult age.

Download Full-text

Electrophysiological Study on the Pathology of Synkinesis after Facial Nerve Paralysis

Acta Oto-Laryngologica ◽

10.3109/00016489409128324 ◽

1994 ◽

Vol 114 (sup511) ◽

pp. 161-164 ◽

Cited By ~ 25

Author(s):

Hiroyuki Maeyama ◽

Masaru Aoyagi ◽

Hitoshi Tojima ◽

Hiroo Inamura ◽

Hidehiro Kohsyu ◽

...

Keyword(s):

Facial Nerve ◽

Electrophysiological Study ◽

Facial Nerve Paralysis ◽

Nerve Paralysis

Download Full-text

Repair of facial nerve after removal of cerebellopontine angle tumors: a comparative study

Journal of Neurosurgery ◽

10.3171/jns.1993.78.5.0720 ◽

1993 ◽

Vol 78 (5) ◽

pp. 720-725 ◽

Cited By ~ 19

Author(s):

T. T. King ◽

O. C. Sparrow ◽

J. M. Arias ◽

A. F. O'Connor

Keyword(s):

Facial Nerve ◽

Nerve Repair ◽

Previous Treatment ◽

Kappa Statistic ◽

Complete Agreement ◽

Grading System ◽

Content Type ◽

Nerve Tumor ◽

Facial Nerves ◽

Fine Print

✓ The results of repair of 18 facial nerves were examined by means of a modified House-Brackmann grading system. Six were repaired by end-to-end anastomosis and 12 by nerve graft. The reliability of the simplified House-Brackmann grading system was also assessed, using the kappa statistic to analyze the agreement between pairs of observers who examined the function of 40 nerves in 37 patients. Facial nerves studied had been either preserved, repaired or grafted, or divided and treated by faciohypoglossal nerve anastomosis. One nerve was not treated. The grading system proved to be somewhat unreliable, with complete agreement between observers in only 25% of cases. Facial nerve repair produced a fair return of function in just under two-thirds of the cases. The ability of an examiner ignorant of the patient's history to assess from the end result how the nerve had been managed was also estimated. Observers showed little ability to decide correctly on the previous treatment of the nerve when the patient showed moderate dysfunction postoperatively. The implications of these findings for grading systems and for management of the facial nerve in acoustic nerve tumor surgery are discussed.

Download Full-text