PURPOSE: Mobius syndrome is a rare congenital disorder characterized by facial diplegia and bilateral abducens palsy, which occasionally combines with other cranial nerve dysfunction. The inability to show happiness, sadness or anger by facial expression frequently results in social dysfunction. The classic concept of cross facial nerve grafting and free muscle transplantation, which is standard in unilateral developmental facial palsy, cannot be used in these patients without special consideration. Our experience in the treatment of three patients with this syndrome using transfer of muscles innervated by trigeminal nerve showed rewarding results. METHODS: We used bilateral temporalis muscle elevated from the bony temporal fossa. Muscles and their attached fascia were folded down over the anterior surface of the zygomatic arch. The divided strips from the attached fascia were passed subcutaneously and anchored to the medial canthus and the nasolabial crease for smiling and competence of mouth and eyelids. For the recent 13 years the authors applied this method in 3 Mobius syndrome cases- 45 year-old man and 13 year-old boy, 8 year-old girl. RESULTS: One month after the surgery the patients had good support and already showed voluntary movement at the corner of their mouth. They showed full closure of both eyelids. There was no scleral showing during eyelid closure. Also full closure of the mouth was achieved. After six months, the reconstructed movements of face were maintained. CONCLUSION: Temporalis muscle transfer for Mobius syndrome is an excellent method for bilateral reconstruction at one stage, is easy to perform, and has a wide range of reconstruction and reproducibility.
Adolescent ; Anger ; Child ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Cranial Nerves ; Eyelids ; Facial Expression ; Facial Nerve ; Facial Paralysis ; Fascia ; Female ; Happiness ; Humans ; Male ; Mental Competency ; Middle Aged ; Mobius Syndrome* ; Mouth ; Muscles ; Paralysis ; Reward ; Smiling ; Transplants ; Trigeminal Nerve ; Zygoma

There are many theonies regarding the etiology of idiopathic facial paralysis(Bell's palsy), but none will bear close examination at the present time. Quite possibly a proportion of causes should be classified as due to the herpes virtus. Herpes zoster is commonly known as a benign viral disease affecting the sensory nerves, but less well known is that this viral infection also caused muscle paralysis, in a not significant number of patients. There is increasing evidence that sympathetic blocks performed during the acute stage of herpes zoster infection shorten the eruptive phase of the disease and decreases the incidence of post herpetic neuralgia. Early treatment is particularly important in elderly patients in whom the incidence of long standing postherpetic pain is extremely high. The aim of treatment of Bell's palsy is to reduce edema and improve circulation to be facial nerve. Stellate ganglion block resulted in abolishing cerebral vascular spasm and in increasing cerebral blood flow. Thus stellate ganglion block is effective in treatment of Bell's palsy. This patient with herpes zoster associated with idopathic complete Bell's palsy was treated by repeat stellate ganglion block with 1% lidocaine and excellent result were noted.
Aged ; Bell Palsy ; Edema ; Facial Nerve ; Facial Paralysis* ; Herpes Zoster* ; Humans ; Incidence ; Lidocaine ; Neuralgia ; Paralysis ; Spasm ; Stellate Ganglion* ; Virus Diseases

No abstract available.
Duane Retraction Syndrome* ; Facial Paralysis ; Mobius Syndrome*

The Onyx liquid embolic system is a relatively safe and commonly used treatment for vascular malformations, such as arteriovenous fistulas and arteriovenous malformations. However, studies on possible complications after Onyx embolization in patients with vascular malformations are limited, and the occurrence of cranial nerve palsy is occasionally reported. Here we report the progress of two different types of cranial nerve palsy that can occur after embolization. In both cases, Onyx embolization was performed to treat vascular malformations and ipsilateral oculomotor and facial nerve palsies were observed. Both patients were treated with steroids and exhibited symptom improvement after several months. The most common types of neuropathy that can occur after Onyx embolization are facial nerve palsy and trigeminal neuralgia. Although the mechanisms underlying these neuropathies are not clear, they may involve traction injuries sustained while extracting the microcatheter, mass effects resulting from thrombi and edema, or Onyx reflux into the vasa nervorum. In most cases, the neuropathy spontaneously resolves several months following the procedure.
Arteriovenous Fistula ; Arteriovenous Malformations ; Cranial Nerve Diseases* ; Cranial Nerves* ; Edema ; Facial Nerve ; Humans ; Paralysis ; Steroids ; Traction ; Trigeminal Neuralgia ; Vasa Nervorum ; Vascular Malformations*

Facial Nerve ; Facial Nerve Diseases ; Facial Nerve Injuries ; Facial Paralysis ; Neurology ; trends

It is uncommon for a palatal fistula to be detected in individuals who have not undergone surgery, and only sporadic cases have been reported. It is even more difficult to find cases of acquired palatal fistula in patients with submucous or incomplete cleft palate. Herein, we present 2 rare cases of this phenomenon. Case 1 was a patient with submucous cleft palate who acquired a palatal fistula after suffering from oral candidiasis at the age of 5 months. Case 2 was a patient with incomplete cleft palate who spontaneously, without trauma or infection, presented with a palatal fistula at the age of 9 months.
Candidiasis, Oral ; Cleft Palate* ; Fistula* ; Humans ; Oral Fistula

Alveolar synechia or syngnathia is a rare anomaly showing soft tissue or bony adhesions between the alveolar ridges of maxilla and mandible. In our review of the world literature, we have identified 68 reports of alvelolar synechia. Most cases describe cleft palate and the term cleft palate and congenital alveolar synechia syndrome was coined by Verdi and 0'neal(1983). Additional anomalies such as cleft lip, micrognathia, microglossia, lower lip pits, ankyloblepharon, and limb anomalies are associated. Related syndromes may include popliteal pterygium syndrome, van der Woude syndrome, and orofaciodigital syndrome. We present a child with congenital alveolar synechia and left unilateral complete cleft lip and palate. The child had difficulty in mouth opening with a maximal anterior jaw opening of 4 mm. The fibrous synechia was resected at the age of 4 months. On dividing the fibrous band, the jaws were distracted to an opening of only 7 mm using finger dilatation. However, the maximal anterior jaw opening by passive dilatation had increased to 19.0 mm after 2 months and up to 23.1 mm after 6 months by stretching exercise of the mandible, so the child could open his mouth successfully.
Child ; Cleft Lip ; Cleft Palate* ; Dilatation ; Extremities ; Fingers ; Humans ; Jaw ; Lip ; Mandible ; Maxilla ; Mouth ; Numismatics ; Orofaciodigital Syndromes ; Palate ; Pterygium ; Tongue Diseases

Alveolar synechia or syngnathia is a rare anomaly showing soft tissue or bony adhesions between the alveolar ridges of maxilla and mandible. In our review of the world literature, we have identified 68 reports of alvelolar synechia. Most cases describe cleft palate and the term cleft palate and congenital alveolar synechia syndrome was coined by Verdi and 0'neal(1983). Additional anomalies such as cleft lip, micrognathia, microglossia, lower lip pits, ankyloblepharon, and limb anomalies are associated. Related syndromes may include popliteal pterygium syndrome, van der Woude syndrome, and orofaciodigital syndrome. We present a child with congenital alveolar synechia and left unilateral complete cleft lip and palate. The child had difficulty in mouth opening with a maximal anterior jaw opening of 4 mm. The fibrous synechia was resected at the age of 4 months. On dividing the fibrous band, the jaws were distracted to an opening of only 7 mm using finger dilatation. However, the maximal anterior jaw opening by passive dilatation had increased to 19.0 mm after 2 months and up to 23.1 mm after 6 months by stretching exercise of the mandible, so the child could open his mouth successfully.
Child ; Cleft Lip ; Cleft Palate* ; Dilatation ; Extremities ; Fingers ; Humans ; Jaw ; Lip ; Mandible ; Maxilla ; Mouth ; Numismatics ; Orofaciodigital Syndromes ; Palate ; Pterygium ; Tongue Diseases

In recent years our research team introduced many foreign patterns to our clinics, kept innovating and exploiting more reasonable modes and methods to cure the cleft patients in the situation of a developing country. Now we concluded the treatment principles, patterns and techniques of the sequential therapy according to the different temporal stages of cleft, from its arising to the evolution, evaluated our therapy results and induced a preliminary guide line of our treating clefts. We sincerely hope this rule could promote the general progress in both clinical treatment and researching.
Cleft Lip ; Cleft Palate ; Humans

OBJECTIVETo explore the secondary correction demand rule for unilateral cleft lip patients.

METHODSThe population in parts of Henan province were investigated by census method. The unilateral cleft lip patients underwent the primary correction were selected and be photographed, and 100 patients were selected randomly into study. The subjective satisfaction for the patients' facial appearance was evaluated by three groups: Professional group(cleft lip and palate specialist), non-professional group (the hospital administrative staff), and family members of patients group. The facial symmetry rate was measured for the patients with consistent subjective evaluation.

RESULTSThe rate of facial symmetry and subjective evaluation was not convergence. The subjective evaluation disaffect rates of profes-sional and non-professional groups were higher than that in family members of patients group (P<0.05).

CONCLUSIONThe rate of facial symmetry is not the most suitable method to evaluate the demand of the secondary correction for unilateral cleft lip patients.