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Common otology viva topics
Published in Joseph Manjaly, Peter Kullar, Advanced ENT Training, 2019
Necrotising otitis externa (NOE) causes facial palsy by compression of the stylomastoid segment. Facial schwanommas are benign and are only considered for treatment if the House–Brackmann score is 4 or more, since treatments rarely give House–Brackmann scores better than 3. Melkersson-Rosenthal syndrome is an inflammatory condition that presents with recurring facial swellings and fissured tongues.
Management of facial soft-tissue injuries
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
Siavash Siv Eftekhari, R. Bryan Bell
During final examination, it is imperative to assess cranial nerve function and to document injury to vital structures, such as the eye and brain. Various nerve function grading systems have been described, most notably the House–Brackmann score for facial nerve function. A nerve stimulator may be helpful in assessing the integrity of nerve branches. Consultation with subspecialists in ophthalmology and/or neurosurgery should be obtained as indicated.
Therapists’ perceptions and attitudes in facial palsy rehabilitation therapy: A mixed methods study
Published in Physiotherapy Theory and Practice, 2022
Martinus M. van Veen, Britt W.T ten Hoope, Tessa E. Bruins, Roy E. Stewart, Paul M.N. Werker, Pieter U. Dijkstra
All therapists stated they use some kind of measurement tool to assess changes in facial function; however, the tools themselves and the frequency with which they were used differed considerably. The Sunnybrook Facial Grading System (SFGS) (Ross, Fradet, and Nedzelski, 1996) was used by all therapists. An advantage of this tool over the widely known House-Brackmann score (House and Brackmann, 1985), which was only used by a few therapists, was said to be that it provides detailed regional information on facial function and has a dedicated section on synkinesis, making a more detailed longitudinal assessment possible. Patient-reported outcome measures (PROM) were used less frequently and were not uniformly stated to be important. The most widely used PROM was the Facial Disability Index (VanSwearingen and Brach, 1996).
Facial nerve stimulation in cochlear implant users – a matter of stimulus parameters?
Published in Cochlear Implants International, 2022
Lutz Gärtner, Thomas Lenarz, Jurgita Ivanauskaite, Andreas Büchner
The female patient suffered from progressive bilateral hearing impairment since the age of 6.5 years without origin of middle ear affection or otosclerosis. Due to profound hearing loss on the right side and severe hearing loss in the high-frequency region on the left side, she was provided with a hearing aid on the left side only. At the age of 20 years, she was sequentially implanted on the right side first and 4 years later on the left side. The left side never showed any complications. On the right side, she was re-implanted because of a technical defect twice and once with a delay of 6 months between explantation and re-implantation because of suspicious subacute infection with complaints of cephalgia around the implant and local swelling. After delayed implantation on the right side, she reported subjective FNS and nonspecific vertigo, as well as noisy sound perceptions. Imaging of the CI (SYNCHRONY FLEX28, MED-EL, Innsbruck, Austria) is shown in Figure 4(A). The House–Brackmann score showed a normal facial nerve function (grade I). Digital volume tomography of the temporal bone revealed a questionable thin bony lamella that separated the facial nerve from the cochlea on the right side (Figure 4B).
Recurrent Bell's palsy following ventriculoperitoneal shunt insertion: an unusual case to face
Published in British Journal of Neurosurgery, 2018
Ashwin Kumaria, Tim C. Hammett, Murugan Sitaraman, Dan A. D'Aquino, Donald C. Macarthur
A 15 year old boy with a history of hydrocephalus secondary to tectal plate glioma with VP shunt in situ (inserted 1 year ago) presented with a one day history of headache and lethargy but no infective features. Examination was unremarkable although CT head scan showed ventriculomegaly and shunt failure was diagnosed. His existing right parietal VP shunt was removed and a new left VP shunt was inserted in an uncomplicated operation. Initial post-operative recovery was normal but at day 2 post-op he was noted to have left sided facial droop. On review by the ENT team he was diagnosed with Bell’s palsy with facial weakness of House-Brackmann score 3.