Facial nerve palsy following SSRO is a rare but serious problem. In the event of post-operative facial palsy, careful clinical and neurophysiological investigations such as a nerve condunction test for facial function is mandatory. The authors examined patients with facial palsy following SSRO. Patients recovered after 3~4 months and we had performed clinical examinations with electromyography and nerve conduction tests during follow-up period.]]>
Electromyography ; Facial Nerve ; Facial Paralysis ; Follow-Up Studies ; Humans ; Neural Conduction ; Orthognathic Surgery ; Osteotomy, Sagittal Split Ramus ; Paralysis ; Prognathism

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

Pus overflow from patent's fistula belew the left face near mandibular angle 2 years agowith a little pain. Symptoms relieved after oral antibiotics. This symptom frequently occurred in the past six months. Postoperative facial paralysis occurred after surgery, and recovered after treatment. It was diagnosed as the postoperative facial paralysis after first branchial fistula surgery.
Branchial Region ; pathology ; surgery ; Face ; Facial Paralysis ; etiology ; Fistula ; pathology ; surgery ; Humans ; Mandible ; Pain

PURPOSE: Facial paralysis is an uncommon but significant complication of chronic otitis media (COM). Surgical eradication of the disease is the most viable way to overcome facial paralysis therefrom. In an effort to guide treatment of this rare complication, we analyzed the prognosis of facial function after surgical treatment. MATERIALS AND METHODS: A total of 3435 patients with COM, who underwent various otologic surgeries throughout a period of 20 years, were analyzed retrospectively. Forty six patients (1.33%) had facial nerve paralysis caused by COM. We analyzed prognostic factors including delay of surgery, the extent of disease, presence or absence of cholesteatoma and the type of surgery affecting surgical outcomes. RESULTS: Surgical intervention had a good effect on the restoration of facial function in cases of shorter duration of onset of facial paralysis to surgery and cases of sudden onset, without cholesteatoma. No previous ear surgery and healthy bony labyrinth indicated a good postoperative prognosis. CONCLUSION: COM causing facial paralysis is most frequently due to cholesteatoma and the presence of cholesteatoma decreased the effectiveness of surgical treatment and indicated a poor prognosis after surgery. In our experience, early surgical intervention can be crucial to recovery of facial function. To prevent recurrent cholesteatoma, which leads to local destruction of the facial nerve, complete eradication of the disease in one procedure cannot be overemphasized for the treatment of patients with COM.
Adult ; Aged ; Chronic Disease ; Facial Nerve/surgery ; Facial Nerve Diseases/*etiology/*surgery ; Facial Paralysis/*etiology/*surgery ; Female ; Humans ; Male ; Middle Aged ; Otitis Media/*complications ; Retrospective Studies ; Young Adult

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

OBJECTIVETo study the course and distribution of buccal and marginal mandibular branches of facial nerve, and its relevance to the treatment of facial paralysis and the protection of facial nerve during surgery.

METHODS12 cadaver heads were dissected (24 specimens). The course of the buccal and marginal mandibular branch and the interconnections between them were observed. The relationship of buccal branch to parotid duct, marginal mandibular branch to the inferior border of mandible were studied. With modified Sihler's staining technique, the distribution of facial nerve branches in innervated mimetic muscles was displayed. These anatomic relationships mentioned above were further confirmed during the operation of 40 patients with facial paralysis.

RESULTSParotid duct had a constant surface landmark. Buccal branch mainly consisted of 2-3 ramifications in 87.5% of the specimens, while marginal mandibular branch was double or single in 95.9% of the specimens. The buccal branch coursed within the distance between 10.7 mm above and 9.3 mm below the parotid duct, and innervated mimetic muscles of midface. The marginal mandibular branch coursed within the distance between 13.4 mm above and 4.8 mm below the lower border of mandible, crossed superiorly the facial artery and innervated mimetic muscles of lower lip.

CONCLUSIONSThere is a close relationship of buccal branch to parotid duct and marginal mandibular branch to facial artery and lower border of mandible. With modified Sihler's staining technique, the original 3-dimensional picture of the intramuscular nerve distribution in human mimetic muscles.

Adult ; Facial Nerve ; anatomy & histology ; Facial Paralysis ; surgery ; Female ; Humans ; In Vitro Techniques ; Male ; Mandible ; anatomy & histology ; innervation

BACKGROUND AND PURPOSE: Hemifacial spasm (HFS) is mostly caused by the compression of the facial nerve by cerebral vessels, but the significance of spasm severity remains unclear. We investigated the clinical significance of spasm severity in patients with HFS who underwent microvascular decompression (MVD). METHODS: We enrolled 636 patients with HFS who underwent MVD between May 2010 and December 2013 at Samsung Medical Center (SMC), Seoul, Korea. Subjects were divided into two groups based on spasm severity: severe (SMC grade 3 or 4) and mild (SMC grade 1 or 2). We compared demographic, clinical, and surgical data between these two groups. RESULTS: The severe-spasm group was older and had a longer disease duration at the time of MVD compared to the mild-spasm group. Additionally, hypertension and diabetes mellitus were more common in the severe-spasm group than in the mild-spasm group. Regarding surgical findings, there were more patients with multiple offending vessels and more-severe indentations in the severe-spasm group than in the mild-spasm group. Even though the surgical outcomes did not differ, the incidence of delayed facial palsy after MVD was higher in the severe-spasm group than in the mild-spasm group. Logistic regression analysis showed that severe-spasm was correlated with longer disease duration, hypertension, severe indentation, multiple offending vessels, and delayed facial palsy after MVD. CONCLUSIONS: Spasm severity does not predict surgical outcomes, but it can be used as a marker of pathologic compression in MVD for HFS, and be considered as a predictor of delayed facial palsy after MVD.
Diabetes Mellitus ; Facial Nerve ; Facial Paralysis* ; Hemifacial Spasm* ; Humans ; Hypertension ; Incidence ; Korea ; Logistic Models ; Microvascular Decompression Surgery ; Seoul ; Spasm

OBJECTIVE: To investigate into the surgical approaches and clinical curative effect of peripheral facial nerve paralysis in different causes and injury location. METHOD: Thirty-two cases of peripheral facial paralysis were treated with selective facial nerve decompression via different surgical approaches. After 0.5 year to 2 years follow up, the recovered functions of facial nerve were judged by House and Brackmann grading system. RESULT: In all patients, 17 cases of peripheral facial paralysis caused by trauma were underwent facial nerve decompression in two weeks, 11 cases reached degree I (84.6%) according to House-Brackmann (H-B) facial nerve function scores, 3 cases were treated in the third week, 2 cases reached degree II and other 1 cases reached degree III. One patient was treated after 8 weeks and facial nerve function scores only reached degree VI. Thirteen cases of otomastoiditis in middle ear were underwent facial nerve decompression in one week, postoperative House-Brackmann grade was I in 8 cases, II in 2, and III in 4. CONCLUSION Majority of patients with peripheral facial paralysis were treated with facial nerve decompression have better clinical curative effect by suitable operation and juncture due to trauma or cholesteatoma otitis media, but operation for traumatic peripheral facial paralysis should be undertaken in two weeks.
Adolescent ; Adult ; Cholesteatoma, Middle Ear ; surgery ; Decompression, Surgical ; methods ; Facial Nerve ; surgery ; Facial Paralysis ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Temporal Bone ; surgery ; Young Adult

OBJECTIVE: This study is to investigate time course of symptom disappearance in patients whose spasm relieved completely after microvascular decompression (MVD). METHODS: Of 115 patients with hemifacial spasm (HFS) who underwent MVD from April 2003 to December 2006, 89 patients who had no facial paralysis after operation and showed no spasm at last follow-up more than 1.5 years after operation were selected. Symptom disappearance with time after MVD was classified into type 1 (symptom disappearance right after operation), type 2 (delayed symptom disappearance) and type 3 (unusual symptom disappearance). Type 2 was classified into type 2a (with postoperative silent period) and type 2b (without silent period). RESULTS: Type 1, type 2a, type 2b and type 3 were 38.2%, 48.37%, 12.4% and 1.1%, respectively. Delayed disappearance group (type 2) was 60.7%. Post-operative symptom duration in all cases ranged from 0 to 900 days, average was 74.6 days and median was 14 days. In case of type 2, average post-operative symptom duration was 115.1 days and median was 42 days. Five and 3 patients required more than 1 year and 2 years, respectively, until complete disappearance of spasm. In type 2a, postoperative silent period ranged from 1 to 10 days, with an average of 2.4 days. CONCLUSION: Surgeons should be aware that delayed symptom disappearance after MVD for HFS is more common than it has been reported, silent period can be as long as 10 days and time course of symptom disappearance is various as well as unpredictable.
Facial Paralysis ; Follow-Up Studies ; Hemifacial Spasm ; Humans ; Microvascular Decompression Surgery ; Spasm

facial esthetics, masticatory function and others. But several complications associated with BSSRO may appear. Especially among them, facial nerve palsy following BSSRO is rare but serious problem. We treated for facial nerve palsy following BSSRO by physical therapy, steroid therapy and surgical intervention and then the result was favorable. Therefore we would like to report a case about a patient with facial nerve palsy after BSSRO with a review of the literatures.]]>
Esthetics ; Facial Nerve ; Humans ; Mandible ; Orthognathic Surgery ; Osteotomy, Sagittal Split Ramus ; Paralysis ; Prognathism ; Retrognathia