1/5. Cancer of the parotid gland: role of 7th nerve preservation.Most neoplasms arising in the parotid gland are benign. patients with cancer of the parotid gland usually present with normal facial nerve function. In these patients, findings at the time of surgery will guide the management of the facial nerve, with most surgeons preserving the nerve unless it is adherent to, or imbedded in, a malignant tumor. In cases where the margins of resection are close to the facial nerve, adjuvant radiotherapy administered postoperatively has significantly improved local control of disease. The minority of patients with parotid cancer who present with facial nerve palsy has a poor prognosis despite extensive surgical resection including the facial nerve.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/5. Primary post-traumatic mandibular reconstruction in infancy: a 10-year follow-up.Ballistic trauma to the craniofacial skeleton combines the challenges of complex bone injury and loss with severe soft tissue injury and violation of the naso-orbital or oropharyngeal cavities. The authors report a patient who experienced a unique ballistic injury at 28 months of age that resulted in loss of the mandibular ramus and condyle. A segmental injury to the facial nerve was also identified. Primary costochondral grafting and delayed interpositional nerve grafting was undertaken. After 10 years, the patient has nearly 40 mm of opening, with only slight deviation to the injured side. Her facial nerve regeneration provides complete orbicularis oculi function, oral competence, and only slight facial asymmetry. This traumatic reconstruction differs from that of patients with hemifacial microsomia or post-traumatic/arthritic ankylosis in that the joint space itself was spared. Thus, the costochondral graft benefits from the remaining articular disk and upper disk space and is able to rotate and translate. Function and growth are adequately re-established, even in this young pediatric patient.- - - - - - - - - - ranking = 0.18403844390163keywords = complex (Clic here for more details about this article) |
3/5. An unusual case of facial nerve palsy following soccer related minor head injury.A 16 year old amateur soccer player sustained a minor head injury while contesting a ball in the air. He was unconscious for two minutes and remained "dizzy" for about an hour. After two days he developed a profound left lower motor neurone facial nerve palsy. He was found to have a complex fracture of the left petrous temporal bone, with fluid in the left middle ear and left mastoid. Treatment was conservative with oral steroids and oral co-amoxiclav and a left myringotomy to decompress his middle ear. The spectrum of aetiology, presentation, and prognosis for facial nerve injuries is discussed.- - - - - - - - - - ranking = 0.18403844390163keywords = complex (Clic here for more details about this article) |
4/5. facial paralysis: traumatic neuromas vs. facial nerve neoplasms.Traumatic neuromas (TN) are benign proliferations of neural tissue that may occur without disruption of the facial nerve. The clinical presentation, as well as the radiographic appearance, may suggest neoplastic involvement of the facial nerve. Histologically, they may closely resemble neurilemomas (Schwannomas) or neurofibromas. Three cases of TN of the facial nerve associated with facial paralysis are presented here. Unlike previously reported cases, these tumors were not associated with chronic inflammatory middle ear disease. TN must be considered in the differential diagnosis and treatment of facial paralysis.- - - - - - - - - - ranking = 4keywords = neoplasm (Clic here for more details about this article) |
5/5. Syndromes of a complex lesion of greater and lesser superficial petrosal nerves (paradoxical facial hyperaemia, salivation, lacrimation and mucus excretion).After closed cranial trauma with paralysis of the facial nerve, a patient had a fracture into the petrosus apex with a bony bridge over the nerve, and a subdural haematoma, which were dealt with during an operation for nerve decompression. Examination of the patient 2.5 years later revealed the presence of the crocodile tears syndrome, mucus secretion and the salivary atropine paradox, i.e. severe hyperaemia of the paretic half of the face during intense salivation in response to atropine. Other patients who suffered similar trauma but had no operation demonstrated the same syndrome. The crocodile tears syndrome is considered to be a result of an ephaptic union of the central portion of the damaged lesser superficial petrosal nerve (SPN) with the peripheral portion of the greater SPN. The salivary atropine paradox is then due to the loss of the peripheral portion of the former nerve combined with denervation of the salivary parotid gland. Facial hyperaemia during intense salivation after atropine administration is explained as a result of the intensified release of vasoactive intestinal polypeptide from the gland, stimulated by atropine, into the blood circulation.- - - - - - - - - - ranking = 0.7361537756065keywords = complex (Clic here for more details about this article) |