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Facial anatomy
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
The facial nerve exits the pons at the level of the pontomedullary junction and projects through the cerebellopontine angle via the cerebellopontine cistern towards the internal auditory meatus within the petrous temporal bone. The internal auditory canal runs laterally through this bone for approximately 1 cm whilst it gradually narrows until it creates a fundus at its lateral boundary. The facial nerve enters the internal auditory canal via the anterosuperior quadrant and runs along this canal to the fundus, where it enters the facial canal. The facial canal is approximately 3 cm long and “Z”-shaped. Despite being small, it is divided into three sections, the labrynthine, tympanic and mastoidal segments. The facial nerve traverses the facial canal, giving off branches as it does so, such as the chorda tympani and the nerve to stapedius.
Facial nerve—a clinical and anatomical review
Published in J. Belinha, R.M. Natal Jorge, J.C. Reis Campos, Mário A.P. Vaz, João Manuel, R.S. Tavares, Biodental Engineering V, 2019
Fernand Gentil, J.C. Reis Campos, Marco Parente, C.F. Santos, Bruno Areias, R.M. Natal Jorge
The patient with peripheral facial paralysis cannot wrinkle forehead, does not close the eye, does not open the nostrils and mouth strayed to the side. All muscles of facial expression are paralyzed. The face is sad, inexpressive and the twisted smile. The most common causes are: Bell’palsy, facial trauma, trauma by otologic surgery or of the parotid gland, Ramsay Hunt syndrome (Worme et al. 2013), acute or chronic otitis media, Lyme disease, tumors, Melkerson-Rosenthal syndrome, bilateral paralysis and congenital facial paralysis (Jain et al. 2006). Injury to the geniculate ganglion and proximal to this region can lead to decreased lacrimation. If the damage is proximal to the nerve of stapedius can result in hyperacusis in the affected ear (Gordin et al. 2015).
Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
Although the stapedius is a middle ear muscle in mammals, including humans, it keeps its original attachment to structures of the 2nd (hyoid) arch because, as its name indicates, the stapedius attaches onto the neck of the stapes, a bone derived from the 2nd arch (the stapedius originates from the pyramidal eminence of the middle ear cavity) (Plate 3.45a and Plate 3.45c). The stapedius is innervated by a branch of the facial nerve, the nerve to stapedius, and controls the amplitude of sound waves to the inner ear.
Taste and acoustic reflex after recovery from facial muscle paralysis in patients with facial nerve palsy
Published in Acta Oto-Laryngologica, 2021
Teruyuki Sato, Nobuo Ohta, Youji Tareishi, Takechiyo Yamada
At 6 months after treatment, the number of subjects with normal AR was significantly smaller than the number of subjects with a normal taste. This demonstrates that it is more difficult for AR to recover than it is for taste. The reason for this surmised to lie in the thinness of the nerves in the ear: thin nerve fibers are said to be more resistant to compression and pathological invasion than thick nerve fibers [6,13]. In addition, recovery of nerve damage usually begins in thick nerves [13]. Because the nerve thickness is in the order of facial nerve main trunk > chorda tympani > nerve to stapedius [14], there is the possibility that recovery of the nerve to the stapedius is delayed. Since the stapedius muscle is a striated muscle, the possibility of muscle disuse with prolonged nerve palsy should also be considered. Therefore, since the disuse of the stapedius muscle has a small effect in the early stage of onset, the AR can be used as a prognostic factor for FMP, in which AR appears if nerve damage is weak. However, it is also affected by the disuse of the stapedius muscle in the late stage of onset. It also suggests that AR may not be expressed even if the FNP is restored. These will need to be considered more thoroughly in the future.
Remifentanil versus labetalol for deliberate hypotensive anesthesia in children undergoing cochlear implantation: A randomized clinical trial
Published in Egyptian Journal of Anaesthesia, 2021
Taysser M. Abdelraheem, Amira M. Elkeblawy
Anesthetic aims in cochlear implantation are to keep hemodynamics stable, offer a dry surgical field, adjust anesthetic technique to enable the facial nerve and stapedius reflex monitoring and testing [14]. DHA leads to decrease blood loss that can help surgical exposure, reduce tissue damage, and enhance postoperative healing. Various medications and techniques were used in the past, but none was completely effective and safe [15].