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Bell's Palsy
Published in Charles Theisler, Adjuvant Medical Care, 2023
Bell’s palsy is a lower motor neuron disease of the facial nerve characterized by a transient paralysis. The disorder affects men and women equally and can occur at any age. Bell’s palsy is associated with significant edema (swelling) and ischemia (restricted blood supply) of the facial nerve as it passes through its bony canal.1 The primary cause is often exposure to a viral infection. The main symptom is muscle weakness on one side of the face, causing that side of the face to droop and appear distorted. Additional symptoms which may include pain behind the ear, loss of taste in half the tongue, sensitivity to sound in one ear, or excessive lacrimation in one eye, can be mild to severe.
Salivary Gland Tumours
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Facial weakness: Facial nerve injury is a significant morbidity. Risk of facial nerve damage is related to the extent of the disease, type of resection, and surgical experience. Neuropraxia usually recovers within 4–6 weeks, and more severe injuries, in 6–12 months. Risk of permanent facial palsy is 1–2%.
7th Cranial Nerve (Facial) Palsy
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
The facial nerve (7th cranial nerve) supplies the muscles of facial expression, the stapedius muscle, and is responsible for the taste sensation from the anterior two-thirds of the tongue. Parasympathetic motor fibres to the salivary glands and chorda tympani are also carried with the facial nerve. Since a minor degree of facial asymmetry is not uncommon, one should not jump into making a diagnosis of facial nerve palsy without a thorough examination revealing the presence of definitive physical signs. The most common cause for an upper motor neurone lesion is a stroke that is characterized by weakness of the lower face contralateral to the lesion. The upper face is spared because of the bilateral innervation.
Objective assessment of eyelid position and tear meniscus in facial nerve palsy
Published in Orbit, 2022
Alicia Galindo-Ferreiro, Victoria Marqués-Fernández, Hortensia Sanchez-Tocino, Silvana A. Schellini
The seventh cranial nerve, called the facial nerve, controls the muscles for facial expression. Bell’s palsy (BP) is an idiopathic, unilateral, acute weakness of the facial muscles in a pattern consistent with peripheral facial nerve dysfunction resulting in blink dysfunction, malposition of the eyelids such as lower lid ectropion, upper lid retraction, decreased tear production, and a defective tear pump lacrimal drainage mechanism.1Concurring with facial nerve palsy (FNP), the altered position of the lids associated with lower lid laxity can commonly lead to exposure keratopathy, dry eye, and tearing.2 However, there are few studies that objectively evaluate eyelid malposition, with quantitative measurements of margin reflex distance to the upper (MRD1) or to the lower (MRD2) lid in patients with FNP.2,3 Additionally, there are no studies that measure these changes over time.
Supporting the use of adjuvant radiotherapy in recurrent pleomorphic adenoma of the parotid
Published in Acta Oto-Laryngologica, 2021
Justin M. Hintze, Fergal O’Duffy, Ailbhe White-Gibson, Paul O’Neill, John Kinsella, Conrad Timon, Paul Lennon
Injury to the facial nerve is discussed in many of the articles reviewed but there was no systematic approach to the reporting of these complications and therefore it is difficult to draw substantial conclusions. Some describe high rates of post-operative temporary facial nerve weakness (67%), the majority of which resolve, leaving only few with permanent injuries (8%). When compared against rates of nerve palsies post primary parotidectomies, Renehan et al. found the rates of facial palsy to be 6 times greater in recurrent cases [7]. Rates of facial nerve injury were higher in patients that had previous parotidectomy than in those that had an enucleation (29 versus 10%). In general, most agree that there is an increased risk with increase number of surgeries. With regards to RT, it has been suggested that the chance of fibrosis and forming of scar tissues increases, with relatively higher risk of injuring the facial nerve in any subsequent reoperation [13].
Intraparotid facial nerve schwannoma: a 17-year, single-institution experience of diagnosis and management
Published in Acta Oto-Laryngologica, 2019
Shijun Li, Xuguang Lu, Shang Xie, Zimeng Li, Xiaofeng Shan, Zhigang Cai
Theoretically, flexible application of both stripping surgery and intracapsular enucleation could help to preserve facial nerve integrity. While in practice, surgical resection may lead to injury of fasciculus or even axons due to negligence, or nerve degeneration in extreme cases wherein the fasciculus would become fragile. In any such case of severe damage, the facial nerve should be reconstructed. Several studies have suggested gross tumor resection with primary nerve grafting for patients with a preoperative facial function of HB grade IV or worse because functional recovery after nerve preservation is not better than that after reconstruction in such cases [5,7]. But, in our study, patients with preoperative facial function HB Grade V recovered to Grade II or III after nerve sparing surgery; this might because the environment in the parotid gland differs from that in the temporal bone wherein the facial nerve has better conditions for reanimation. Thus, reconstructive surgery should be performed only after an attempt at nerve preservation has failed.