[Facial palsy rehabilitation: Assessment before surgery]. / Réhabilitation de la face paralysée. Bilan préthérapeutique du patient.

A patient who needs a surgery for facial rehabilitation must have a complete assessment. The etiology of the facial palsy must be clear. It is necessary to have a MRI of the facial nerve for the statement of the initial pathology or to search a lesion on the nerve. The facial palsy must be definite which is depending of the delay of the palsy and the etiology. An electromyography must be done. The choice of the procedure depends on the delay of the palsy, the site on the nerve, the associated diseases and the opinion of the patient after a good explanation.

[Hypoglossofacial anastomosis for facial palsy treatment: Indications and results]. / Réhabilitation de la face paralysée par anastomose hypoglosso-faciale. Indications et résultats.

UNLABELLED: Hypoglossofacial anastomosis is a classical surgical procedure for the treatment of facial paralysis when the trunk of the facial nerve cannot be repaired and its peripheral branches are normal. PATIENTS AND METHODS: Between 2004 and 2015, 77 patients were able to benefit from an hypoglossofacial anastomosis. The etiology of the paralysis was mainly the surgery of vestibular schwannoma, tumors of the facial nerve and diseases of the brainstem. A specific and premature speech therapy remediation was realized for all patients in order to preserve the tongue function and to upgrade the facial motricity. RESULTS: Sixty-nine patients could be studied. The House Brackmann grading scale was used to appreciate the result. Thirty-one patients are grade III, 34 grade IV and in only one case the result is a grade V despite the anastomosis works. The main predictive factor for a good result is a small delay between the onset of the paralysis and the surgery for the rehabilitation. The specific physiotherapy upgrades the result with less side effects of the anastomosis. CONCLUSION: Hypoglossofacial anastomosis is a simple and reliable surgical procedure for rehabilitation of paralysed face. The quality of the result is linked with an early surgery and a specific physiotherapy.

Pulmonary sequestration of the left upper lobe associated with a bronchogenic cyst: case report of an exceptional association.

Intralobar pulmonary sequestration (ILPS) and bronchogenic cyst are rare congenital diseases. We present the first case of the association between an ILPS located in the upper lobe and a bronchogenic cyst. This association has been discovered antenatally in a girl. The cystic lesion has been shown by a fetal MRI and confirmed by a CT scan at 3 weeks of life. She underwent a left upper lobectomy by thoracoscopy at the age of 5 months. Postoperative course was uneventfull. This case confirms the congenital origin of pulmonary sequestration and shows the interest of an early surgery.