Facial Nerve Injuries ; rehabilitation ; surgery ; Humans

Surgery of the parotid gland is usually indicated for the relief of an inflammatory disorder or for control of neoplasia. In all these procedures, the overriding critical factor is the management of the facial nerve. The facial nerve is embedded within the substance of the gland and is at risk of injury during any parotid gland operation. The various surgical approaches described in our study comprised a common thread, the surgeon’s awareness of facial nerve anatomy and efforts to protect the nerve from an inadvertent injury.
Parotid Gland ; Facial Nerve ; surgery ; Wounds and Injuries

The paper summarizes the academic thought and clinical experience of professor LI De-hua in treatment of facial nerve injury after total parotidectomy with blade needle based on jingjin (muscle region of meridian, sinew/fascia) theory. This disease is located at muscle regions of hand-/foot-three yang meridians; and the sinew/fascia adhesion is its basic pathogenesis, manifested by "transversely-distributed collaterals" and "knotted tendons". In treatment, the knotted tendons are taken as the points. Using the relaxation technique of blade needle, the lesions of sinews/fascia are dissected and removed to release the stimulation or compression to the nerves and vessels so that the normal function of sinews/fascia can be restored.
Humans ; Facial Nerve Injuries/surgery* ; Fascia ; Foot ; Hand ; Lower Extremity

OBJECTIVETo investigate the morphological changes after chemically extracted acellular nerve allografts transplant.

METHODSSeventy-two rabbits were divided into four groups. Acellular allografts of facial nerve were used in experimental group, and facial nerve autografts, acellular peroneal nerve allografts and peroneal nerve autografts respectively used in three control groups. The morphological changes after transplant were evaluated by modified trichrome staining, immunohistological staining and transmission electron microscope.

RESULTSThe two facial nerve grafts showed numerous regenerated nerve fibers, vessels and as well as a spindle schwann cells arranged longitudinally. No significant difference was observed in the fiber number and myelin thickness between the two groups,while the two peroneal nerve groups showed poor regeneration 6 months after operation.

CONCLUSIONSThe facial nerve allografts showed more neurite regeneration six months after transplant, and the regenerated axons passed through the distal stoma and there were well revascularized and proliferated schwann cells in the grafts.

Animals ; Disease Models, Animal ; Facial Nerve ; pathology ; transplantation ; Facial Nerve Injuries ; pathology ; surgery ; Nerve Regeneration ; Rabbits ; Transplantation, Homologous

OBJECTIVE: To observe the recovery process of facial behavior and function in rat, and then to supply reliable functional parameters for the researches in such fields. METHOD: Rat models of facial nerve paralysis were set up by sectioning and anastomosis of facial nerve. The behavioral change included whisker movement and blink reflex were observed weekly. Electroneurography (ENoG) and blink reflex (BR) were examined dynamically and all data were analyzed by statistic soft ware. RESULT: Postoperatively, the whisker movement ceased, blink reflex was lost or sluggish but the fibrillation of vibrissae appeared. Whisker movement and evoke blink reflex were seen 1-2 months following operation gradually, which subsequently increased in intensity and frequency. Mass contraction of the periauricular muscles were observed at the same time as eye closure 2 month following operation. The latency of compound muscle action potential (CMAP) at experimental side began to prolong at 21 day, reached climax at 1 month and was stabilized at 3-4 month postoperatively, but it could not get full recovery. The latencies of 28-63 day were longer than other time points (P<0.05). The amplitude and intensity didn't change characteristically. The R1 can be observed repetitively, which disappeared at 7-14 day and gradually recovered 1 month following operation. At experimental side, the R1-type wave (R1oris) in orbicularis oris could be observed at the same time as R1 recorded 2 month following operation, which indicated the facial synkinesis, one hyperkinetic post-paralytic sequela happened. Then the latency of both R1 and R1oris decreased concomitantly. There were correlations between them, but only the significant difference of R1oris latency presented between 2 month and other time points (P<0.05). CONCLUSION It is concluded that the methods of ENoG and BR could examine the recovery process of facial movement, which would help studying the pathophysiological mechanism of facial nerve injury and regeneration after being revised.
Anastomosis, Surgical ; Animals ; Blinking ; Facial Nerve ; surgery ; Facial Nerve Injuries ; physiopathology ; surgery ; Facial Paralysis ; physiopathology ; surgery ; Male ; Rats ; Rats, Sprague-Dawley ; Recovery of Function

PURPOSE: Corrugator supercilii muscle pulls eyebrow to inferomedial direction and produces the vertical component of the glabellar line formation. Current techniques for eliminating of glabellar frown include direct resection of corrugators and botulinum toxin injection. Muscle resection in endoscopic face lift procedure is relatively complex and has many disadvantages such as possible nerve injury, postoperative edema, pain and a long recovery period. The Botox treatment on the other hand is much more simple in technique but has a short duration of action. The authors have attempted new ways of finding improved treatment of the glabellar frown by selectively blocking of motor nerves innervating the corrugator supercili muscle by using radiofrequency ablation technique. METHODS: A total of 80 patients were recruited in our study during the period from Feb. 2007 to June 2008. A probe was introduced from the supraorbital ridge and advanced to the corrugator supercilii muscle. Nerve stimulator was then used to locate the nerve innervating the corrugator and radiofrequency ablation of the nerve was done. RESULTS: In all patients, there were marked improvement in glabellar frown after treatment. There were no reported cases of any relapses during the follow up period. No complication was noted such as facial nerve injury. No patient complained of any adverse symptoms other than slight discomfort due to swelling of the operation site. CONCLUSION: The treatment of glabellar frown lines using selective nerve block with radiofrequency ablation was not only less invasive but also excellent in surgical outcomes.
Botulinum Toxins ; Botulinum Toxins, Type A ; Edema ; Eyebrows ; Facial Muscles ; Facial Nerve ; Facial Nerve Injuries ; Follow-Up Studies ; Hand ; Humans ; Muscles ; Nerve Block ; Recurrence ; Rhytidoplasty ; Surgery, Plastic

OBJECTIVETo evaluate autogenous vein grafts and inside-out vein grafts as conduits for the defects repair in the rabbit facial nerves.

METHODSThe 10 mm segments of buccal division of facial nerve were transected for 48 rabbits in this study. Then the gaps were immediately repaired by autogenous vein grafts or inside-out vein grafts in different groups. All the animals underwent the whisker movement test and electrophysiologic test during the following 16 weeks at different time points postoperatively. Subsequently, the histological examination was performed to observe the facial nerve regeneration morphologically.

RESULTSAt 8 weeks after operation, the facial nerve regeneration has significant difference between the experimental group and the control group in electrophysiologic test and histological observation. However, at the end of this study, 16 weeks after operation, there was no significant difference between inside-out vein grafts and standard vein grafts in enhancing peripheral nerve regeneration.

CONCLUSIONThis study suggest that both kinds of vein grafts play positive roles in facial nerve regeneration after being repaired immediately, but the autogenous inside-out vein grafts might accelerate and facilitate axonal regeneration as compared with control.

Animals ; Axons ; physiology ; Facial Nerve ; physiology ; surgery ; Facial Nerve Injuries ; surgery ; Male ; Nerve Regeneration ; physiology ; Rabbits ; Transplantation, Autologous ; methods ; Veins ; transplantation

OBJECTIVETo investigate the optimal timing for the repair of persistent incomplete facial paralysis by hypoglossal-facial 'side'-to-side neurorrhaphy in rats.

METHODSA total of 30 adult rats with crushed and bulldog-clamped facial nerve injury were randomly divided into 5 groups (n = 6 each) that were subjected to injury without nerve repair or with immediate repair, 2-week-delayed repair, 4-week-delayed repair, or 8-week-delayed repair. Three months later, the effects of repair in each rat were evaluated by facial symmetry assessment, electrophysiological examination, retrograde labeling, and axon regeneration measurement.

RESULTSAt 3 months after injury, the alpha angle significantly increased in the group of rats with 4-week-delayed repair compared with the other four groups. Upon stimulation of the facial nerve or Pre degenerated nerve, the muscle action potentials MAPs were recorded in the whisker pad muscle, and the MAP amplitude and area under the curve in the 4-week-delayed repair group were significantly augmented at 3 months post-injury. Similarly, the number of retrograde-labeled motor neurons in the facial and hypoglossal nuclei was quantified to be significantly greater in the 4-week-delayed repair group than in the other groups, and a large number of regenerated axons was also observed.

CONCLUSIONThe results of this study demonstrated that hemiHN-FN neurorrhaphy performed 4 weeks after facial nerve injury was most effective in terms of the functional recovery of axonal regeneration and activation of facial muscles.

Animals ; Disease Models, Animal ; Facial Nerve ; surgery ; Facial Nerve Injuries ; complications ; surgery ; Facial Paralysis ; etiology ; surgery ; Hypoglossal Nerve ; surgery ; Nerve Regeneration ; Neurosurgical Procedures ; methods ; Rats, Sprague-Dawley ; Treatment Outcome

Fine needle aspiration (FNA) is a highly accurate and safe procedure for the evaluation of salivary gland lesions. Although complications are extremely rare, salivary gland FNA may cause hemorrhage, facial nerve injury, or cellulitis at the entry point. The risk of these complications increases in tumors of high vascularity. We report a case of unexpected facial nerve palsy following a fine needle aspiration in a patient with lymphangioma. The patient received a total parotidectomy with preservation of the facial nerve function, and recovered without developing complications after the surgery.
Biopsy, Fine-Needle* ; Cell Biology* ; Cellulitis ; Facial Nerve ; Facial Nerve Injuries ; Facial Paralysis* ; General Surgery ; Hemorrhage ; Humans ; Lymphangioma* ; Paralysis ; Parotid Gland ; Salivary Glands

Posterior tympanotomy is a procedure performed to access the posterior mesotympanum through a mastoid exposure while preserving the posterior external auditory canal wall. It is dangereous to drill the the site of procedure, as it is surrounded by incuidal fossa superiorly, facial nerve posteriomedially, and chorda tympani nerve anterolaterally, and forms a very narrow pathway. There is always a risk of surgical trauma involving important surgical structures, especially facial nerve and chorda tympani nerve. The development of image-guided surgery (IGS) has significantly improved the performance of many surgical procedures by aiding the identification of surgical landmarks, improving surgical outcomes, rendering the procedure safer and more efficient, especially for beginner otologic surgery, in revision operations, in cases of massive bleeding and tumor of complex anatomy. To see how IGS could help otologic surgeons to identify fine, important structures during posterior tympanotomy, we report a case of posterior tympanotomy in chronic otitis media, which was done using the image-guided surgical technique.
Chorda Tympani Nerve ; Ear Canal ; Facial Nerve ; General Surgery ; Hemorrhage ; Mastoid ; Otitis Media* ; Otitis* ; Surgery, Computer-Assisted ; Wounds and Injuries