1/18. Facial nerve injury following superficial temporal artery biopsy.BACKGROUND: With proper training, superficial temporal artery biopsy is a safe office procedure with few complications. Surgeons from different disciplines, including ophthalmologists, dermatologists, general surgeons, and plastic surgeons may be called upon to perform this common procedure to confirm giant cell arteritis. OBJECTIVE: To emphasize the surgical anatomy of the scalp as it pertains to superficial temporal artery biopsy and to raise awareness that significant complications can occur after superficial temporal artery biopsy. METHOD: Case report. RESULTS: A 75-year-old woman with presumed giant cell arteritis developed frontalis muscle paralysis following a superficial temporal artery biopsy. biopsy selection site within the danger zone combined with deep dissection carries the greatest risk of injury to the temporal branches of the facial nerve. CONCLUSION: Any surgeon involved in the practice of performing superficial temporal artery biopsies should have a thorough understanding of proper surgical techniques and regional anatomy to avoid potential devastating complications.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
2/18. Injury to the facial nerve associated with the use of a disposable nerve stimulator.Clinical observations and experimental data from this study support the thesis that the disposable Weck nerve locator/stimulator may induce neural damage. This potential damage may cause at least a temporary paresis. Although more study is required to better document the method, degree, and factors influencing injury, we believe that enough evidence is present to induce caution and warrant further study. We recommend that the stimulators be used with caution on the lowest setting possible and with as little contact with the nerve as possible.- - - - - - - - - - ranking = 46.853131623277keywords = paresis (Clic here for more details about this article) |
3/18. Traumatic facial nerve injuries: review of diagnosis and treatment.Both blunt and penetrating craniofacial trauma may lead to severe facial nerve injury and sequelae of facial paralysis. Initial evaluation involves quantitation of motor deficits using a clinical grading system, such as the House-Brackmann scale. High resolution computed tomography is used for localization of nerve injury in suspected cases of temporal bone trauma. In the absence of gross radiographic abnormalities, electrophysiologic testing helps predict the likelihood of spontaneous recovery. In patients with deteriorating facial nerve injuries by electroneuronography, surgical exploration is the preferred management. Primary end-to-end neurorrhaphy is the preferred management for transection injuries, while facial nerve decompression may benefit other forms of high-grade nerve trauma. Secondary facial reanimation procedures, such as cranial nerve crossovers, dynamic muscle slings or various static procedures, are useful adjuncts when initial facial nerve repair is unsuccessful or impossible. A review of facial nerve trauma management and case illustrations are presented.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
4/18. incidence of cervical branch injury with "marginal mandibular nerve pseudo-paralysis" in patients undergoing face lift.The anatomy of the cervical and marginal mandibular branches of the facial nerve is reviewed. In the senior author's practice, "pseudoparalysis of the marginal mandibular nerve" due to cervical branch injury occurred in 34 of 2002 superficial musculoaponeurotic system-platysma face lifts (1.7 percent) and was associated with a full recovery in 100 percent of cases within a time period ranging from 3 weeks to 6 months. Cervical branch injury can be distinguished from marginal mandibular nerve injury by the fact that the patient will be able to evert the lower lip because of a functioning mentalis muscle.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
5/18. Secondary end-to-end repair of extensive facial nerve defects: surgical technique and postoperative functional results.BACKGROUND: Repair of the transected facial nerve is imperative for restoration of muscle function, including the ability to produce appropriate facial expressions. Injury might involve the main trunk and its several branches. Restoration of function presupposes meticulous repair of all injured nerve branches. methods: Here we report three cases of secondary tension-free end-to-end coaptation of a transected trunk and branches of the facial nerve by removal of the superficial part of the parotid gland. RESULTS: Facial tone and symmetry at rest and motion were achieved. In two patients, a slight residual synkinesis is observed under stress. CONCLUSIONS: Direct end-to-end coaptation of the facial nerve and its branches by the technique described should be considered before deciding on grafts or rerouting procedures to deal with gaps of up to 15 mm. This technique is not recommended in the presence of infection and nerve defects. Intensive postoperative physiotherapy is required for optimal results.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
6/18. hemifacial spasm due to peripheral injury of facial nerve: a nuclear syndrome?Four cases of hemifacial spasm (HFS) are reported. The spasm followed a few months after injury to a peripheral branch of the seventh nerve. An EMG examination of facial muscles disclosed the typical finding of HFS: spontaneous activity, paradoxical cocontraction, and diffusion of spontaneous or provoked blinking. A nuclear involvement, secondary to the nerve lesion, is the most likely pathophysiological explanation for similar cases in HFS.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
7/18. Neurotube for facial nerve repair.Facial nerve reconstruction for lesions with nerve gaps frequently require autologous or tubulized grafts of biological or synthetic origin. Neurotube, a bioabsorbable polyglycolic acid tube, represents a valid solution for this kind of defect in emergency and planned surgery. Seven posttraumatic lesions of terminal branches of the facial nerve were repaired by means of Neurotube from September 1999-September 2001. The nerve gap size ranged between 1-3 cm. nerve regeneration was evaluated at 7-12 months of follow-up when muscle recovery function was examined. Muscle function was very good in 1 case, good in 4, and fair in 2 (71% positive results). No intolerance or discomfort was reported or observed. Neurotube is useful for the reconstruction of facial nerve lesions with a small nerve gap (less then 3 cm) when a direct anastomosis of the two stumps is not possible, or when the suture appears to be in tension. It is a valid alternative to autologous and biological tubulized grafts. The limits of this method are: 1) it can only be used with gaps of less than 3 cm; 2) it is quite costly; 3) there are reports of possible intolerance; and 4) it is not suitable for lesions of the proximal part of the facial nerve.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
8/18. Neurovascular musculocutaneous latissimus dorsi free-flap transfer for reconstruction of a major cheek defect with facial palsy in a 14-month-old child.This report deals with a female infant 14 months old at time of surgery. Three weeks before admission, she suffered a direct blow to the left cheek by hitting a table. Within 24 h, she developed a hematoma involving the whole cheek. Ten days later, she developed an eschar on the cheek and was referred to us. Three weeks after the initial trauma, the damaged tissues were debrided, including the skin, subcutaneous tissue, and muscle. The buccal mucosa remained intact. Facial palsy involving the territory of the buccal and mandibular branches was already evident at 3 weeks, as well as facial asymmetry. Consequently, a free musculocutaneous neurovascular latissimus dorsi free flap was proposed to restore the volume, shape, and function of the left half of the face. We present the surgical technique and the results 3.5 years later.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
9/18. End-to-side intrapetrous hypoglossal-facialanastomosis for reanimation of the face. Technical note.The aim of this paper was to report on further experience with a new technique for reanimation of the facial nerve. This procedure allows a straight end-to-side hypoglossal-facial anastomosis without interruption of the 12th cranial nerve or the need for graft interposition. It is technically demanding and time consuming but offers an effective, reliable, and extraordinarily quick means of reinnervating the facial muscles, including the orbicularis oculi muscle, thus avoiding the need for a gold weight in the eyelid or a fascial sling.- - - - - - - - - - ranking = 2keywords = muscle (Clic here for more details about this article) |
10/18. Revision facial nerve surgery.Transection of the facial nerve can result from blunt or penetrating trauma to the face or temporal bone. It can also occur accidentally during surgery, or as a planned surgical procedure carried out in the interest of eradicating disease. If transection is recognized at surgery, direct anastomosis or cable grafting is the procedure of choice. This article presents two cases with neither clinical nor electrical evidence of recovery. The authors review current understanding of the changes that occur in the neuron, axon, and muscle after injury to the nerve and the underlying pathology that led to graft failure in these cases. They also evaluate surgical options and diagnostic test results that help in selecting appropriate surgical procedures.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
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