scholarly journals Multidisciplinary Care of Patients with Facial Palsy: Treatment of 1220 Patients in a German Facial Nerve Center

2022 ◽  
Vol 11 (2) ◽  
pp. 427
Author(s):  
Jonathan Steinhäuser ◽  
Gerd Fabian Volk ◽  
Jovanna Thielker ◽  
Maren Geitner ◽  
Anna-Maria Kuttenreich ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Facial Palsy ◽  
Chronic Phase ◽  
Multidisciplinary Care ◽  
Outcome Evaluation ◽  
Biofeedback Training ◽  
Team Approach ◽  
Upper Eyelid ◽  
Surgical Methods ◽  
Face Scale

To determine treatment and outcome in a tertiary multidisciplinary facial nerve center, a retrospective observational study was performed of all patients referred between 2007 and 2018. Facial grading with the Stennert index, the Facial Clinimetric Evaluation (FaCE) scale, and the Facial Disability Index (FDI) were used for outcome evaluation; 1220 patients (58.4% female, median age: 50 years; chronic palsy: 42.8%) were included. Patients with acute and chronic facial palsy were treated in the center for a median of 3.6 months and 10.8 months, respectively. Dominant treatment in the acute phase was glucocorticoids ± acyclovir (47.2%), followed by a significant improvement of all outcome measures (p < 0.001). Facial EMG biofeedback training (21.3%) and botulinum toxin injections (11%) dominated the treatment in the chronic phase, all leading to highly significant improvements according to facial grading, FDI, and FaCE (p < 0.001). Upper eyelid weight (3.8%) and hypoglossal–facial-nerve jump suture (2.5%) were the leading surgical methods, followed by improvement of facial motor function (p < 0.001) and facial-specific quality of life (FDI, FaCE; p < 0.05). A standardized multidisciplinary team approach in a facial nerve center leads to improved facial and emotional function in patients with acute or chronic facial palsy.

Early Outcomes in an Emerging Facial Nerve Center: The Oregon Health and Science University (OHSU) Experience

2020 ◽  
pp. 000348942095737
Author(s):  
Natalie A. Krane ◽  
Jimmy S. Chen ◽  
Haley Hanseler ◽  
Wenelia Baghoomian ◽  
John Ng ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Facial Palsy ◽  
Head And Neck Carcinoma ◽  
Nerve Transfer ◽  
Life Outcomes ◽  
Subjective Quality Of Life ◽  
Neck Carcinoma ◽  
Face Scale ◽  
Measuring Outcomes ◽  
Oral Commissure

Objectives: Nerve transfer (NT) and free gracilis muscle transfer (FGMT) are procedures for reanimation of the paralyzed face. Assessing the surgical outcomes of these procedures is imperative when evaluating the effectiveness of these interventions, especially when establishing a new center focused on the treatment of patients with facial paralysis. We desired to discuss the factors to consider when implementing a facial nerve center and the means by which the specialist can assess and analyze outcomes. Methods: Patients with facial palsy secondary to multiple etiologies, including cerebellopontine angle tumors, head and neck carcinoma, and trauma, who underwent NT or FGMT between 2014 and 2019 were included. Primary outcomes were facial symmetry and smile excursion, calculated using FACE-gram and Emotrics software. Subjective quality of life outcomes, including the Facial Clinimetric Evaluation (FaCE) Scale and Synkinesis Assessment Questionnaire (SAQ), were also assessed. Results: 14/22 NT and 6/6 FGMT patients met inclusion criteria having both pre-and postoperative photo documentation. NT increased oral commissure excursion from 0.4 mm (SD 5.3) to 2.9 mm (SD 6.8) ( P = 0.05), and improved symmetry of excursion ( P < 0.001) and angle ( P < 0.001). FGMT increased oral commissure excursion from −1.4 mm (SD 3.9) to 2.1 mm (SD 3.7), ( P = 0.02), and improved symmetry of excursion ( P < 0.001). FaCE scores improved in NT patients postoperatively ( P < 0.001). Conclusions: Measuring outcomes, critical analyses, and a multidisciplinary approach are necessary components when building a facial nerve center. At our emerging facial nerve center, we found NT and FGMT procedures improved smile excursion and symmetry, and improved QOL following NT in patients with facial palsy secondary to multiple etiologies.

scholarly journals Predicting Factors Influencing Visual Function of the Eye in Patients with Unresolved Facial Nerve Palsy after Upper Eyelid Gold Weight Loading

2021 ◽  
Vol 10 (4) ◽  
pp. 578
Author(s):  
Izabela Nowak-Gospodarowicz ◽  
Marek Rękas
Keyword(s):  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Upper Eyelid ◽  
Patient Age ◽  
Corneal Sensation ◽  
History Of ◽  
Gold Weights ◽  
Bell's Phenomenon ◽  
Bell’S Phenomenon

Implantation of gold weights into the upper eyelid is a proven method of treating lagophthalmos and exposure keratopathy in patients with unresolved facial nerve palsy. The aim of this study was to evaluate the factors affecting visual acuity and corneal complications in patients after upper eyelid gold weight lid loading. Material and methods: This prospective consecutive clinical study was conducted in years 2012–2018. In total, 59 people (40 women, 19 men aged 55.5 ± 17.4 years) meeting the inclusion criteria were treated with gold weights. The ordered multinomial logit model was used to analyze the factors affecting best-corrected visual acuity (BCVA) and degree of exposure keratopathy after surgery. The influence of the following variables was analyzed: patient age, etiology and duration of the facial nerve palsy, history of the previous eyelid surgery, degree of lagophthalmos in mm, presence of Bell’s phenomenon, and corneal sensation, Schirmer test results. Results: Implantation of gold weights into the upper eyelid effectively reduced lagophthalmos and exposure keratopathy in the study group (p < 0.001). BCVA was maintained or better in 95% of patients after surgery. Patient age, presence of the Bell’s phenomenon, and corneal sensation significantly affected the final BCVA (p < 0.1). The presence of Bell’s phenomenon and corneal sensation had a positive effect on the degree of keratopathy after surgery (p < 0.1). In turn, patient age and history of tarsorrhaphy were significant negative prognostic factors of exposure keratopathy and BCVA after surgery (p < 0.05). Etiology and duration of facial nerve palsy, degree of corneal exposure in mm, and results of the Schirmer test did not have a significant impact on the outcome after surgery (p > 0.1). Conclusions: The results of our study may help to answer the question of how to direct ophthalmologists and other specialists who refer to ophthalmologists for management advice in patients with facial nerve palsy. Elderly patients with a history of tarsorrhaphy who present with poor Bell’s phenomenon and/or a lack of corneal sensation should be the first candidates for immediate correction of lagophthalmos.

scholarly journals Congenital unilateral facial palsy revealing a facial nerve agenesis: a case report and review of the literature

2019 ◽  
Vol 5 (1) ◽  
pp. 20180029
Author(s):  
Yaotse Elikplim Nordjoe ◽  
Ouidad Azdad ◽  
Mohamed Lahkim ◽  
Laila Jroundi ◽  
Fatima Zahrae Laamrani
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Temporal Bone ◽  
Facial Paralysis ◽  
Facial Palsy ◽  
Rare Condition ◽  
Review Of The Literature ◽  
Moebius Syndrome ◽  
Temporal Bone Ct

Facial nerve aplasia is an extremely rare condition that is usually syndromic, namely, in Moebius syndrome. The occurrence of isolated agenesis of facial nerve is even rarer, with only few cases reported in the literature. We report a case of congenital facial paralysis due to facial nerve aplasia diagnosed on MRI, while no noticeable abnormality was detected on the temporal bone CT.

Interdisciplinary Teams in Endometriosis Care

2020 ◽  
Vol 38 (02/03) ◽  
pp. 227-234
Author(s):  
Catherine Allaire ◽  
Alicia Jean Long ◽  
Mohamed A. Bedaiwy ◽  
Paul J. Yong
Keyword(s):  
Chronic Pain ◽  
Interdisciplinary Team ◽  
Multidisciplinary Care ◽  
Complex Problem ◽  
Interdisciplinary Teams ◽  
Team Approach ◽  
Team Care ◽  
Psychological Therapies ◽  
Published Evidence ◽  
Chronic Pain Conditions

AbstractEndometriosis-associated chronic pelvic pain can at times be a complex problem that is resistant to standard medical and surgical therapies. Multiple comorbidities and central sensitization may be at play and must be recognized with the help of a thorough history and physical examination. If a complex pain problem is identified, most endometriosis expert reviews and guidelines recommend multidisciplinary care. However, there are no specific recommendations about what should be the components of this approach and how that type of team care should be delivered. There is evidence showing the effectiveness of specific interventions such as pain education, physical therapy, psychological therapies, and pharmacotherapies for the treatment of chronic pain. Interdisciplinary team models have been well studied and validated in other chronic pain conditions such as low back pain. The published evidence in support of interdisciplinary teams for endometriosis-associated chronic pain is more limited but appears promising. Based on the available evidence, a model for an interdisciplinary team approach for endometriosis care is outlined.

Recurrent bilateral peripheral facial palsy

1989 ◽  
Vol 103 (1) ◽  
pp. 117-119 ◽  
Author(s):  
N. Stahl ◽  
T. Ferit
Keyword(s):  
Facial Nerve ◽  
Facial Palsy ◽  
Common Finding ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Peripheral Facial Palsy ◽  
Local Disease ◽  
Idiopathic Facial Palsy

AbstractFacial nerve paralysis is a common otolaryngological diagnosis. Recurrent unilateral peripheral facial palsy is found in about 7 per cent of the cases. Simultaneous bilateral facial palsy is relatively uncommon and occurs in 0.3–2.0 per cent of cases of facial palsy. Recurrent. simultaneous, bilateral, idiopathic facial palsy to the best of our knowledge has never been reported. A case of recurrent, simultaneous, bilateral, idiopathic facial palsy is presented. No evidence of systemic or local disease was found in both attacks of peripheral facial palsies. The association with states of stress is the only common finding between the two attacks.

scholarly journals Hypoglossal-facial ‘side’-to-side neurorrhaphy combined with electrical myostimulation for facial palsy in rats

2018 ◽  
Vol 9 (1) ◽  
pp. 167-174
Author(s):  
Binbin Wang ◽  
Shiwei Wang ◽  
Song Liu ◽  
Shaodong Zhang ◽  
Dezhi Li ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Motor Neurons ◽  
Functional Recovery ◽  
Rat Model ◽  
Facial Palsy ◽  
Crush Injury ◽  
Nerve Crush ◽  
Retrograde Labeling ◽  
Electrophysiological Examination ◽  
Nerve Crush Injury

Abstract Introduction This study investigated the effect of combining hypoglossal-facial nerve “side”-to-side neurorrhaphy and electrical myostimulation in a rat model of facial palsy. Methods Rats with facial nerve crush injury were subjected to control condition, monotherapy of either neurorrhaphy or electrical myostimulation, or bitherapy of the two treatments. After 1, 3, and 6 months, rats were performed the facial symmetry evaluation, electrophysiological examination and the retrograde labeling of motor neurons. Results As early as 3 months after injury, face symmetry significantly improved in rats of the bitherapy group. At 3 or 6 months after injury, either the parameters of electrophysiological examination or the number of labeled motor neurons were significantly increased in the bitherapy group than in any other group. Discussion The combination of neurorrhaphy and electrical myostimulation effectively promoted the functional recovery after facial nerve crush injury.

MRI of the facial nerve in idiopathic facial palsy

1996 ◽  
Vol 6 (5) ◽  
pp. 631-636 ◽  
Author(s):  
I. Saatçi ◽  
F. Şahintürk ◽  
L. Sennaroğlu ◽  
F. Boyvat ◽  
B. Gürsel ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Facial Palsy ◽  
Idiopathic Facial Palsy
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