scholarly journals Selective Denervation of the Facial Dermato-Muscular Complex in the Rat: Experimental Model and Anatomical Basis

2021 ◽  
Vol 15 ◽  
Author(s):  
Vlad Tereshenko ◽  
Dominik C. Dotzauer ◽  
Udo Maierhofer ◽  
Christopher Festin ◽  
Matthias Luft ◽  
...  
Keyword(s):  
Trigeminal Nerve ◽  
Cortical Plasticity ◽  
Neuromuscular Junctions ◽  
Cranial Nerves ◽  
Experimental Models ◽  
Infraorbital Nerve ◽  
Immunofluorescent Staining ◽  
Surgical Model ◽  
Anatomical Basis ◽  
The Face

The facial dermato-muscular system consists of highly specialized muscles tightly adhering to the overlaying skin and thus form a complex morphological conglomerate. This is the anatomical and functional basis for versatile facial expressions, which are essential for human social interaction. The neural innervation of the facial skin and muscles occurs via branches of the trigeminal and facial nerves. These are also the most commonly pathologically affected cranial nerves, often requiring surgical treatment. Hence, experimental models for researching these nerves and their pathologies are highly relevant to study pathophysiology and nerve regeneration. Experimental models for the distinctive investigation of the complex afferent and efferent interplay within facial structures are scarce. In this study, we established a robust surgical model for distinctive exploration of facial structures after complete elimination of afferent or efferent innervation in the rat. Animals were allocated into two groups according to the surgical procedure. In the first group, the facial nerve and in the second all distal cutaneous branches of the trigeminal nerve were transected unilaterally. All animals survived and no higher burden was caused by the procedures. Whisker pad movements were documented with video recordings 4 weeks after surgery and showed successful denervation. Whole-mount immunofluorescent staining of facial muscles was performed to visualize the innervation pattern of the neuromuscular junctions. Comprehensive quantitative analysis revealed large differences in afferent axon counts in the cutaneous branches of the trigeminal nerve. Axon number was the highest in the infraorbital nerve (28,625 ± 2,519), followed by the supraorbital nerve (2,131 ± 413), the mental nerve (3,062 ± 341), and the cutaneous branch of the mylohyoid nerve (343 ± 78). Overall, this surgical model is robust and reliable for distinctive surgical deafferentation or deefferentation of the face. It may be used for investigating cortical plasticity, the neurobiological mechanisms behind various clinically relevant conditions like facial paralysis or trigeminal neuralgia as well as local anesthesia in the face and oral cavity.

The Trigeminal Trophic Syndrome: An Unusual Cause of Face Pain, Dysaesthesias, Anaesthesia and Skin/Soft Tissue Lesions

Cephalalgia ◽  
2008 ◽  
Vol 28 (9) ◽  
pp. 980-985 ◽  
Author(s):  
I Garza
Keyword(s):  
Trigeminal Nerve ◽  
Age Of Onset ◽  
Case Series ◽  
Infraorbital Nerve ◽  
Face Pain ◽  
Case Series Report ◽  
The Face ◽  
Trigeminal Trophic Syndrome ◽  
Record Review ◽  
Retrospective Medical Record Review

The trigeminal trophic syndrome is an unusual consequence of trigeminal nerve injury that results in facial anaesthesia, dysaesthesia and skin ulceration. Limited knowledge is available. The aim of this study was to increase the knowledge of this syndrome by performing a retrospective medical record review and case series report. Fourteen cases were identified. The female : male ratio was 6:1. Mean age of onset was 45 years (range 6-82). The cause was iatrogenic in most. Latent period to onset ranged from days to almost one decade. The majority ( n = 12) had bothersome dysaesthesias. Most ( n = 9) self-manipulated the face; a third ( n = 5) did not. Most ulcers affected the second trigeminal division, mainly in the infraorbital nerve distribution. Neuropathic and/or neuralgic facial pain occurred in 50% ( n = 7). Pain intensity was severe in most (n = 6). Gabapentin gave relief in two. To conclude, trigeminal trophic syndrome follows injury to the trigeminal nerve or its nuclei. For unclear reasons, most ulcerations follow infraorbital nerve distribution. Self-manipulation may contribute to ulcer development rather than being required. Gabapentin may help pain.

Trigemino-Bulbar Reflex Pathways

1957 ◽  
Vol 189 (2) ◽  
pp. 384-388 ◽  
Author(s):  
John D. Green ◽  
Jacob De Groot ◽  
Jerome Sutin
Keyword(s):  
Heart Rate ◽  
Dura Mater ◽  
Trigeminal Nerve ◽  
Cranial Nerves ◽  
Nucleus Ambiguus ◽  
Direct Stimulation ◽  
Reflex Pathways ◽  
The Face ◽  
Vagal Reflex ◽  
Stimulation Of

In decerebrate and decerebellate cats stimulation of any division of the trigeminal nerve induces efferent volleys in the VIIth, Xth, XIth and XIIth nerves. Direct stimulation of the face, internal nares and dura mater produces similar volleys. In uncurarized animals similar stimuli cause twitches of face and neck muscles. Slowing of the heart rate may also be induced. Conduction times measured in the brainstem and cranial nerves show that conduction is very rapid in the brainstem to the level of the obex, so that large medullated fibers may be inferred. At the level of the obex a delay of 2–4 msec. occurs, presumably due to synapses and internuncial neurones. Conduction of the volleys in the Xth and XIth nerves is rapid and large fibers must be involved. Removal of the dorsal vagal nuclei does not abolish the vagal reflex which is presumed to relay at the nucleus ambiguus. The vagal responses are very easily fatigued.

scholarly journals Transcutaneous trigeminal nerve stimulation modulates the hand blink reflex

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Beniamina Mercante ◽  
Nicola Loi ◽  
Francesca Ginatempo ◽  
Monica Biggio ◽  
Andrea Manca ◽  
...  
Keyword(s):  
Median Nerve ◽  
Trigeminal Nerve ◽  
Nerve Stimulation ◽  
Blink Reflex ◽  
Infraorbital Nerve ◽  
Hand Position ◽  
Median Nerve Stimulation ◽  
Trigeminal Nerve Stimulation ◽  
Before And After ◽  
The Face

AbstractThe hand-blink reflex (HBR) is a subcortical response, elicited by the electrical stimulation of the median nerve, whose magnitude is specifically modulated according to the spatial properties of the defensive peripersonal space (DPPS) of the face. For these reasons, the HBR is commonly used as a model to assess the DPPS of the face. Little is known on the effects induced by the activation of cutaneous afferents from the face on the DPPS of the face. Therefore, we tested the effect of non-painful transcutaneous trigeminal nerve stimulation (TNS) on the amplitude of the HBR. Fifteen healthy participants underwent HBR recording before and after 20 min of sham- and real-TNS delivered bilaterally to the infraorbital nerve in two separate sessions. The HBR was recorded bilaterally from the orbicularis oculi muscles, following non-painful median nerve stimulation at the wrist. The HBR amplitude was assessed in the “hand‐far” and “hand‐near” conditions, relative to the hand position in respect to the face. The amplitudes of the hand-far and hand-near HBR were measured bilaterally before and after sham- and real-TNS. Real-TNS significantly reduced the magnitude of the HBR, while sham-TNS had no significant effect. The inhibitory effect of TNS was of similar extent on both the hand-far and hand-near components of the HBR, which suggests an action exerted mainly at brainstem level.

A Variation of the Infraorbital Nerve

2010 ◽  
Vol 67 (3) ◽  
pp. onsE315-onsE315 ◽  
Author(s):  
R. Shane Tubbs ◽  
Marios Loukas ◽  
William R. May ◽  
Aaron A. Cohen-Gadol
Keyword(s):  
Trigeminal Nerve ◽  
Clinical Presentation ◽  
Practical Importance ◽  
Pterygopalatine Fossa ◽  
Infraorbital Nerve ◽  
Nerve Branch ◽  
Male Specimen ◽  
Maxillary Nerve ◽  
Pterygoid Plate ◽  
The Face

Abstract OBJECTIVE: We report the case of a seemingly rare variation of a branch of the trigeminal nerve. This unusual finding is of practical importance to the neurosurgeon because ablation of this nerve(s) in such a case would require modification of technique. The existence of a bifurcated infraorbital nerve is also relevant for application of local anesthesia to portions of the face innervated by the maxillary nerve. CLINICAL PRESENTATION: During cadaveric dissection of the face of a male specimen, 2 branches of the infraorbital nerve were identified emanating onto the face. The 2 branches entered separate osseous canals within the orbit to emerge via 2 infraorbital foramina. INTERVENTION: The unusual variation of the trigeminal nerve branch in the reported case necessitates a change in the way in which the nerve is blocked clinically. A common practice involves blocking the infraorbital nerve as it emerges from the infraorbital foramen. The needle is aimed superiorly, posteriorly, and slightly laterally; however, to provide adequate anesthesia to both branches of the infraorbital nerve, as reported here, a needle can be inserted between the zygomatic arch and the notch of the mandible in the pterygopalatine fossa. After the needle contacts the lateral pterygoid plate, it is withdrawn slightly and angled both superiorly and anteriorly to pass into the pterygopalatine fossa. CONCLUSION: Although apparently uncommon, such derangement of the infraorbital nerve should be kept in mind by surgeons during surgical procedures in the region for treatment of various disorders including trigeminal neuralgia.

Acupuncture Points of the Cranial Nerves

1984 ◽  
Vol 12 (01n04) ◽  
pp. 80-92 ◽  
Author(s):  
H.C. Dung
Keyword(s):  
Facial Expression ◽  
Facial Nerve ◽  
Trigeminal Nerve ◽  
Western Medicine ◽  
Cranial Nerves ◽  
Acupuncture Points ◽  
The Face ◽  
Anatomical Sciences ◽  
Basic Medical

An attempt is made to name most of the acupuncture points in the face and forehead region using anatomic nomenclature known to western medicine. All acupuncture points in the face and forehead region are located along terminal or cutaneous branches of the trigeminal nerve and the motor points formed between muscular branches of the facial nerve to the muscles of facial expression. It is believed such nomenclatures will be comprehensible to basic medical scientists and clinical practitioners who have knowledge of anatomical sciences.

TRIGEMINAL PROJECTIONS IN THE RETICULAR FORMATION OF THE PONS IN THE CAT

1962 ◽  
Vol 40 (1) ◽  
pp. 7-12
Author(s):  
J. M. Langlois ◽  
Guy Lamarche
Keyword(s):  
Reticular Formation ◽  
Trigeminal Nerve ◽  
Unit Activity ◽  
Functional Organization ◽  
Pontine Reticular Formation ◽  
Recording Unit ◽  
Spatial Convergence ◽  
The Face ◽  
High Degree ◽  
Stimulation Of

The projections of the trigeminal nerve in the pontine reticular formation of the cat have been investigated by recording unit activity, after physiological stimulation of the face, in 30 "encéphales isolés" preparations. No somatotopical arrangement was found but a high degree of spatial convergence onto pontine reticular units exists and a certain degree of functional organization was observed.

scholarly journals Trigeminal Nerve Schwannoma of the Cerebellopontine Angle

2018 ◽  
Vol 79 (S 05) ◽  
pp. S389-S390
Author(s):  
Maria Peris-Celda ◽  
Christopher Graffeo ◽  
Avital Perry ◽  
Lucas Carlstrom ◽  
Michael Link
Keyword(s):  
Trigeminal Nerve ◽  
Cerebellopontine Angle ◽  
Incidental Finding ◽  
Cranial Nerves ◽  
Internal Auditory Canal ◽  
Clinical History ◽  
Sensory Loss ◽  
Meckel’S Cave ◽  
Neurologic Deficits ◽  
Meckel's Cave

Introduction Large and even moderate sized, extra-axial cerebellopontine angle (CPA) tumors may fill this restricted space and distort the regional anatomy. It may be difficult to determine even with high resolution magnetic resonance imaging (MRI) if the tumor is dural-based, or what the nerve of origin is if a schwannoma. While clinical history and exam are helpful, they are not unequivocal, particularly since many patients present with a myriad of symptoms, or conversely an incidental finding. We present an atypical appearing, asymptomatic CPA tumor, ultimately identified at surgery to be a trigeminal schwannoma. Case History A 40-year-old man presented with new-onset seizure. MRI identified an incidental heterogeneously contrast-enhancing CPA lesion (Fig. 1A–D). The tumor was centered on the internal auditory canal (IAC) with no tumor extension into Meckel's cave, IAC or jugular foramen. Audiometry demonstrated 10db of relative left-sided hearing loss with 100% word recognition. Physical examination was negative for focal neurologic deficits. A retrosigmoid craniotomy was performed and an extra-axial, yellow-hued mass was encountered and resected, which was ultimately confirmed to originate from the trigeminal nerve (Video 1). Gross total resection was achieved, and the patient recovered from surgery with partial ipsilateral trigeminal sensory loss and no other new neurologic deficits. Conclusion Pure CPA trigeminal schwannomas are rare, but should be considered in the differential for enhancing CPA lesions. Although, Meckel's cave involvement is frequently observed, it is not universal, and pure CPA schwannomas of all cranial nerves IV–XII have been reported in the literature.The link to the video can be found at: https://youtu.be/AlodYCu70F8.

Facial Danger Zones: Avoiding Nerve Injury in Facial Plastic Surgery

1994 ◽  
Vol 2 (2) ◽  
pp. 59-66 ◽  
Author(s):  
Brooke R Seckel
Keyword(s):  
Peripheral Nerve ◽  
Plastic Surgery ◽  
Nerve Injury ◽  
Peripheral Nerves ◽  
Cranial Nerves ◽  
Danger Zone ◽  
Facial Plastic Surgery ◽  
Facial Plastic ◽  
The Face ◽  
Anatomic Locations

BR Seckel. Facial danger zones: Avoiding nerve injury in facial plastic surgery. Can J Plast Surg 1994;2(2):59-66. with today's new emphasis on more aggressive and deeper facial dissection during rhytidectomy, the peripheral nerve branches of cranial nerves V and VII in the face are more often exposed closer to the plane of dissection and more likely to be injured in the course of composite, extended sub-submuscular aponeurotic system (sub-SMAS), and subperiosteal rhytidectomy. It is important to have a keen and thorough understanding of the location of these nerves to avoid injury. I divide the face into seven facial danger zones based on known anatomic locations of the branches of the peripheral nerves of the face and the location in which they are most easily injured in the course of facial dissection. A description of the nerve and consequence of injury, the anatomic location of the zone, and the technique for safe surgical dissection for each facial danger zone is presented.

The Extraocular Muscles and Diplopia

2014 ◽  
pp. 124-161
Author(s):  
Shirley H. Wray ◽  
Shirley H. Wray
Keyword(s):  
Eye Movements ◽  
Nerve Palsy ◽  
Neuromuscular Junctions ◽  
Cranial Nerves ◽  
Abducens Nerve ◽  
Extraocular Muscles ◽  
Oblique Muscle ◽  
Oculomotor Nerve Palsy ◽  
Subjective Complaint ◽  
Oculomotor Nuclei

deals with action and innervation of the extraocular muscles. In their intact state, the extraocular muscles and the cranial nerves that innervate them are responsible for every movement of the eyes signaled by the cortex. Diplopia, or double vision, is the commonest subjective complaint associated with a lesion affecting the extraocular muscles, their neuromuscular junctions, the oculomotor nuclei or nerve, or pathways in the brainstem that maintain alignment of the eyes. The diplopia history focuses on distinguishing monocular from binocular diplopia and the diplopia examination pays attention to head position, ocular alignment, and the range of eye movements during monocular and binocular viewing as keys to diagnosis. Diplopia with full eye movements is fully discussed. Four illustrative cases are presented: episodic diplopia due to ocular myasthenia gravis; a case of esotropia (paresis of the lateral rectus with inward deviation of the eye) due to an abducens nerve palsy; a case of exotropia (paresis of the medial rectus with outward deviation of the eye) due to a fascicular oculomotor nerve palsy; and a case of hypertropia (vertical misalignment of the eyes due to paresis of the superior oblique muscle vs. skew deviation) caused by a post-traumatic trochlear nerve palsy.

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