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1.
Medicine (Baltimore) ; 102(51): e36751, 2023 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-38134097

RESUMO

Facial neuritis is a common clinical disease with high incidence, also known as Bell palsy or idiopathic facial nerve paralysis, which is an acute onset of peripheral facial neuropathy. In modern medicine, there have been obstacles to the effective treatment of facial neuritis. At present, the clinical use of Western medicine treatment is also a summary of clinical experience, the reason is that the cause of facial neuritis is unknown. Facial neuritis belongs to the category of "facial paralysis" in traditional Chinese medicine. For thousands of years, Chinese medicine has accumulated a lot of relevant treatment experience in the process of diagnosis and treatment. At the same time, traditional Chinese medicine, acupuncture and the combination of acupuncture and medicine play an important role in the treatment of facial neuritis. This article discusses the treatment of facial neuritis with acupuncture combined with Chinese medicine, based on the research progress of modern medicine. In this review, we provide an overview of the effectiveness of acupuncture and medication combinations and facial neuritis with current studies investigating acupuncture and medication combinations in the treatment of facial neuritis.


Assuntos
Terapia por Acupuntura , Paralisia de Bell , Doenças do Nervo Facial , Paralisia Facial , Humanos , Doenças do Nervo Facial/terapia , Paralisia de Bell/terapia , Paralisia Facial/terapia , Medicina Tradicional Chinesa
2.
Prensa méd. argent ; 108(2): 94-100, 20220000. fig, tab
Artigo em Espanhol | LILACS | ID: biblio-1368454

RESUMO

El schwannoma es una patología rara del nervio facial. Su diagnóstico preoperatorio es dificultoso dado que no tiene síntomas ni signos patognomónico de la enfermedad. La disección del nervio facial en su tronco y sus ramas con electroestimulacion es la forma de quirúrgica de sospecharlo intraoperatoriamente. La descompresión parcial o exeresis completa deberá ser considerado de acuerdo a la experiencia del equipo quirúrgico en reconstrucción nerviosa. La reparación del nervio facial como primera opción debe el injerto inmediato o sutura termino terminal. La neurotización es un procedimiento quirúrgico que le provoca al paciente simetría facial con manejo de oclusión ocular y manejo de comisura bucal, debe ser realizado antes del año de la injuria nerviosa. La rehabilitación del nervio facial necesita de un equipo multidisciplinario y la colaboración permanente del paciente para conseguir los objetivos propuestos.


Schwannoma is a rare pathology of the facial nerve. Its preoperative diagnosis is difficult since it has no symptoms or pathognomonic signs of the disease. The dissection of the facial nerve in its trunk and its branches with electrostimulation is the surgical way to suspect it intraoperatively. Partial decompression or complete exeresis should be considered according to the experience of the surgical team in nerve reconstruction. The repair of the facial nerve as a first option should be the immediate graft or end-to-end suture. Neurotization is a surgical procedure that causes the patient facial symmetry with management of ocular occlusion and management of the corner of the mouth, it must be performed within a year of the nerve injury. The rehabilitation of the facial nerve requires a multidisciplinary team and the permanent collaboration of the patient to achieve the proposed objectives.


Assuntos
Humanos , Feminino , Adulto , Anastomose Cirúrgica/métodos , Transferência de Nervo/reabilitação , Doenças do Nervo Hipoglosso/cirurgia , Doenças do Nervo Facial/patologia , Período Pré-Operatório , Neurilemoma/patologia
3.
Rinsho Shinkeigaku ; 61(2): 115-119, 2021 Feb 23.
Artigo em Japonês | MEDLINE | ID: mdl-33504750

RESUMO

A 59-year-old woman presented with a 7-year history of facial numbness on the left side, and gradual worsening of symptoms. Over several years, facial muscle weakness, dysarthria, tongue atrophy and fasciculation had progressed. Then, she developed cerebellar ataxia affecting the left extremities, in addition to earlier symptoms. Brain MRI revealed cerebellar atrophy, and 99mTc-SPECT depicted cerebellar hypoperfusion. A repetitive nerve stimulation test (RNS) indicated abnormal decrement in the nasalis and trapezius muscles on the left side. Facial-onset sensory and motor neuronopathy (FOSMN) was diagnosed. Administration of intravenous immunoglobulin resulted in improvement of some symptoms. Although cerebellar ataxia is not a common symptom of FOSMN, a case showing TDP-43-positive glial cytoplasmic inclusions in cerebellar white matter has been reported. Therefore, it is possible that FOSMN may cause cerebellum impairment in some patients. Furthermore, RNS positive rate in the trapezius muscle is known to be high in amyotrophic lateral sclerosis (ALS) patients. It is speculated that RNS of the affected muscles in FOSMN may show abnormal decrement by the same mechanisms as ALS.


Assuntos
Ataxia Cerebelar/etiologia , Técnicas de Diagnóstico Neurológico , Doenças do Nervo Facial/complicações , Doenças do Nervo Facial/diagnóstico , Neurônios Motores , Células Receptoras Sensoriais , Estimulação Elétrica Nervosa Transcutânea , Proteínas de Ligação a DNA/metabolismo , Doenças do Nervo Facial/tratamento farmacológico , Feminino , Humanos , Imunoglobulinas Intravenosas/administração & dosagem , Pessoa de Meia-Idade , Músculos Superficiais do Dorso/inervação , Substância Branca/metabolismo
4.
Sci Rep ; 10(1): 17795, 2020 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-33082370

RESUMO

Following facial nerve axotomy, nerve function is not fully restored even after reconstruction. This may be attributed to axon degeneration/neuronal death and sustained neuroinflammation. CD38 is an enzyme that catalyses the hydrolysis of nicotinamide adenine dinucleotide (NAD+) and is a candidate molecule for regulating neurodegeneration and neuroinflammation. In this study, we analyzed the effect of CD38 deletion and NAD+ supplementation on neuronal death and glial activation in the facial nucleus in the brain stem, and on axon degeneration and immune cell infiltration in the distal portion of the facial nerve after axotomy in mice. Compared with wild-type mice, CD38 knockout (KO) mice showed reduced microglial activation in the facial nucleus, whereas the levels of neuronal death were not significantly different. In contrast, the axon degeneration and demyelination were delayed, and macrophage accumulation was reduced in the facial nerve of CD38 KO mice after axotomy. Supplementation of NAD+ with nicotinamide riboside slowed the axon degeneration and demyelination, although it did not alter the level of macrophage infiltration after axotomy. These results suggest that CD38 deletion and supplementation of NAD+ may protect transected axon cell-autonomously after facial nerve axotomy.


Assuntos
ADP-Ribosil Ciclase 1/metabolismo , Axônios/fisiologia , Axotomia/métodos , Doenças do Nervo Facial/metabolismo , Nervo Facial/patologia , NAD/metabolismo , ADP-Ribosil Ciclase 1/genética , Animais , Contagem de Células , Células Cultivadas , Suplementos Nutricionais , Modelos Animais de Doenças , Doenças do Nervo Facial/genética , Doenças do Nervo Facial/terapia , Humanos , Camundongos , Camundongos Endogâmicos ICR , Camundongos Knockout , Degeneração Neural
5.
Zhongguo Zhong Yao Za Zhi ; 45(12): 2735-2751, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-32627446

RESUMO

Xiaoxuming Decoction is an ancient classic herbal formula for the treatment of stroke. In ancient times, the connotation of stroke was very extensive, including facial neuritis, acute cerebral infarction, acute cerebral hemorrhage, sequelae of cerebral hemorrhage, unexplained weakness of limbs, cervical spondylosis, acute myelitis, acute radiculitis, Guillain Barre syndrome, multiple sclerosis, myasthenia gravis, motor neuron disease, dermatomyositis, hypokalemic paralysis peripheral neuritis. It has been identified that: ①Xiaoxuming Decoction is very common in the treatment of cerebrovascular diseases, such as cerebral infarction, cerebral hemorrhage and other cerebrovascular diseases, facial neuritis, acute myelitis, acute radiculitis, Guillain Barre syndrome, unexplained limb weakness, multiple sclerosis, motor neuron disease, myasthenia gravis, and rheumatic and immune system diseases, such as dermatomyositis, and can not only alleviate symptoms, but also improve prognosis and the long-term survival rate. ②Sudden limb failure, facial paralysis, and hypoalgesia without heat syndrome are the key indications of Xiaoxuming Decoction. ③This is a special prescription for the treatment of acute facial neuritis, and can cure in one week in the combination with moxibustion. ④In the treatment of facial neuritis complicated with hypertension or acute cerebrovascular disease, Xiaoxuming Decoction generally has a certain antihypertensive effect, without any hypertensive effect, which reflected its two-way regulatory effect for blood pressure. ⑤In the treatment of unknown limb weakness, acute myelitis, acute radiculitis, Guillain Barre syndrome, Xiaoxuming Decoction can rapidly alleviate the symptoms. ⑥This is the basic formula for multiple sclerosis and motor neuron disease. Long term use of Xiaoxuming Decoction can alleviate the symptom of limb weakness, reduce the occurrence of complications and delay the progress of the disease, but with a poor long-term prognosis. ⑦In the treatment of myasthenia gravis, Xiaoxuming Decoction can significantly improve muscle strength, and gradually help stop hormone reduction. After thymoma surgery, Xiaoxuming Decoction is also applicable to some patients with recurrent myasthenia gravis. ⑧Xiaoxuming Decoction also plays a role in the treatment of dermatomyositis and cervical spondylopathy. ⑨Raw ephedra is the monarch drug of Xiaoxuming Decoction, which is the key to the effect. The dosage starts with 6 g is titrated in a small dose and increases gradually. In addition, this formula is forbidden for those with red face, fast heart rate, high blood pressure, blocked stool, red tongue, yellow fur, wiry and rapid pulse or powerful pulse, and spout pulse.


Assuntos
Dermatomiosite , Doenças do Nervo Facial , Síndrome de Guillain-Barré , Doença dos Neurônios Motores , Esclerose Múltipla , Miastenia Gravis , Mielite , Radiculopatia , Espondilose , Humanos
6.
Clin Neurol Neurosurg ; 194: 105811, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32330798

RESUMO

OBJECTIVES: Neurological complications of sarcoidosis are uncommon and the natural history and optimal treatments under-researched. With the advent of biological therapies, it is important to define the clinical characteristics and immunopathology of the disease. PATIENTS AND METHODS: Patients referred to and treated within the Centre for Neurosarcoidosis over a 15 year period who had biopsy proven "highly probable" disease of the central nervous system were studied prospectively. RESULTS: Corticosteroids were used effectively in all patients, immunosuppression in 79 % and TNFα antagonists in 23 %. Treatment with steroids alone inevitably led to relapse, and low dose immunosuppression was ineffective in those with severe forms of the disease. Use of biological therapies substantially improved outcome. Patients with cranial neuropathy had an excellent outcome. Those with pachymeningitis had marked radiological abnormalities but less disablement. Those with leptomeningitis had an invasive, destructive disease which responded well to treatment but with residual neurological impairments. Treatment was required for many years, but the risk of relapse following treatment withdrawal was low. Infective complications arose in six. There were two deaths, neither directly related to the neurological disease, nor its treatment. CONCLUSIONS: This prospective study of the natural history and treatment response in neurosarcoidosis provides evidence that the use of high dose immunosuppression and early and prolonged use of biological therapies is associated with greatly improved outcomes and lower mortality. The data may be used to plan further studies and treatment trials, and provide class IV evidence for the effectiveness of biological agents in the treatment of Neurosarcoidosis.


Assuntos
Terapia Biológica/métodos , Doenças do Sistema Nervoso Central/terapia , Sarcoidose/terapia , Corticosteroides/uso terapêutico , Adulto , Idoso , Biópsia , Doenças do Sistema Nervoso Central/tratamento farmacológico , Doenças do Sistema Nervoso Central/mortalidade , Terapia Combinada , Doenças dos Nervos Cranianos/epidemiologia , Doenças dos Nervos Cranianos/etiologia , Doenças do Nervo Facial/epidemiologia , Doenças do Nervo Facial/etiologia , Feminino , Humanos , Imunossupressores/uso terapêutico , Masculino , Meningite/complicações , Pessoa de Meia-Idade , Doenças do Nervo Óptico/epidemiologia , Doenças do Nervo Óptico/etiologia , Estudos Prospectivos , Sarcoidose/tratamento farmacológico , Sarcoidose/mortalidade , Resultado do Tratamento , Fator de Necrose Tumoral alfa/antagonistas & inibidores
7.
Artigo em Chinês | WPRIM | ID: wpr-828088

RESUMO

Xiaoxuming Decoction is an ancient classic herbal formula for the treatment of stroke. In ancient times, the connotation of stroke was very extensive, including facial neuritis, acute cerebral infarction, acute cerebral hemorrhage, sequelae of cerebral hemorrhage, unexplained weakness of limbs, cervical spondylosis, acute myelitis, acute radiculitis, Guillain Barre syndrome, multiple sclerosis, myasthenia gravis, motor neuron disease, dermatomyositis, hypokalemic paralysis peripheral neuritis. It has been identified that: ①Xiaoxuming Decoction is very common in the treatment of cerebrovascular diseases, such as cerebral infarction, cerebral hemorrhage and other cerebrovascular diseases, facial neuritis, acute myelitis, acute radiculitis, Guillain Barre syndrome, unexplained limb weakness, multiple sclerosis, motor neuron disease, myasthenia gravis, and rheumatic and immune system diseases, such as dermatomyositis, and can not only alleviate symptoms, but also improve prognosis and the long-term survival rate. ②Sudden limb failure, facial paralysis, and hypoalgesia without heat syndrome are the key indications of Xiaoxuming Decoction. ③This is a special prescription for the treatment of acute facial neuritis, and can cure in one week in the combination with moxibustion. ④In the treatment of facial neuritis complicated with hypertension or acute cerebrovascular disease, Xiaoxuming Decoction generally has a certain antihypertensive effect, without any hypertensive effect, which reflected its two-way regulatory effect for blood pressure. ⑤In the treatment of unknown limb weakness, acute myelitis, acute radiculitis, Guillain Barre syndrome, Xiaoxuming Decoction can rapidly alleviate the symptoms. ⑥This is the basic formula for multiple sclerosis and motor neuron disease. Long term use of Xiaoxuming Decoction can alleviate the symptom of limb weakness, reduce the occurrence of complications and delay the progress of the disease, but with a poor long-term prognosis. ⑦In the treatment of myasthenia gravis, Xiaoxuming Decoction can significantly improve muscle strength, and gradually help stop hormone reduction. After thymoma surgery, Xiaoxuming Decoction is also applicable to some patients with recurrent myasthenia gravis. ⑧Xiaoxuming Decoction also plays a role in the treatment of dermatomyositis and cervical spondylopathy. ⑨Raw ephedra is the monarch drug of Xiaoxuming Decoction, which is the key to the effect. The dosage starts with 6 g is titrated in a small dose and increases gradually. In addition, this formula is forbidden for those with red face, fast heart rate, high blood pressure, blocked stool, red tongue, yellow fur, wiry and rapid pulse or powerful pulse, and spout pulse.


Assuntos
Humanos , Dermatomiosite , Doenças do Nervo Facial , Síndrome de Guillain-Barré , Doença dos Neurônios Motores , Esclerose Múltipla , Miastenia Gravis , Mielite , Radiculopatia , Espondilose
8.
Zhongguo Zhen Jiu ; 39(3): 237-40, 2019 Mar 12.
Artigo em Chinês | MEDLINE | ID: mdl-30942007

RESUMO

OBJECTIVE: To observe the effect of different acupuncture intervention time on the improvement of the symptoms of acute facial neuritis and the length of recovery time, and to find the best interventional opportunity for acute facial neuritis. METHODS: A total of 120 patients with acute facial neuritis (all unilateral onset) were randomly divided into 4 groups, namely group A, group B, group C and group D, 30 cases in each group. Acupuncture performed within 3 days after onset in the group A; oral mecobalamin dispersible tablets and multivitamin B tablets were received within 3 days after onset, and acupuncture was started from the 4th day in the group B; oral mecobalamin dispersible tablets and multivitamin B tablets were given within 5 days after onset, and acupuncture was administered from the 6th day in the group C; oral mecobalamin dispersible tablets and multivitamin B tablets were given within 7 days after onset, and acupuncture was applied from the 8th day in the group D. Penetration needling was the main acupuncture treatment, with infrared radiation on the cheeks, once a day, 6 days a week and 3 weeks were given. After treatment, the symptom scores (Portmann scores) of the 7th, 14th and 28th day after onset were compared. The time of improvement and the clinical effect of each group were compared. RESULTS: On the 7th, 14th and 28th day after onset, the Portmann scores of the 4 groups were higher than those before treatment (all P<0.05). On the 7th, 14th and 28th day after onset, the Portmann scores in the group A were higher than those in the other 3 groups (all P<0.05). There was significant difference between both pairs of group B, group C and group D (all P<0.05). The total effective rate in the group A was 96.7% (29/30), which was higher than 93.3% (28/30), 86.7% (26/30) and 83.3% (25/30) in the other 3 groups (all P<0.05). The difference between the 4 groups in the beginning of improvement, significant improvement time and clinical recovery time was statistically significant (all P<0.05), and the group A was optimal. CONCLUSION: Early intervention of acupuncture with acute facial neuritis can appropriately slow the progression of facial nerve injury, improve the therapeutic effect, and shorten the clinical recovery time.


Assuntos
Terapia por Acupuntura , Doenças do Nervo Facial , Terapia Combinada , Doenças do Nervo Facial/terapia , Humanos
9.
Artigo em Chinês | WPRIM | ID: wpr-777237

RESUMO

OBJECTIVE@#To observe the effect of different acupuncture intervention time on the improvement of the symptoms of acute facial neuritis and the length of recovery time, and to find the best interventional opportunity for acute facial neuritis.@*METHODS@#A total of 120 patients with acute facial neuritis (all unilateral onset) were randomly divided into 4 groups, namely group A, group B, group C and group D, 30 cases in each group. Acupuncture performed within 3 days after onset in the group A; oral mecobalamin dispersible tablets and multivitamin B tablets were received within 3 days after onset, and acupuncture was started from the 4th day in the group B; oral mecobalamin dispersible tablets and multivitamin B tablets were given within 5 days after onset, and acupuncture was administered from the 6th day in the group C; oral mecobalamin dispersible tablets and multivitamin B tablets were given within 7 days after onset, and acupuncture was applied from the 8th day in the group D. Penetration needling was the main acupuncture treatment, with infrared radiation on the cheeks, once a day, 6 days a week and 3 weeks were given. After treatment, the symptom scores (Portmann scores) of the 7th, 14th and 28th day after onset were compared. The time of improvement and the clinical effect of each group were compared.@*RESULTS@#On the 7th, 14th and 28th day after onset, the Portmann scores of the 4 groups were higher than those before treatment (all <0.05). On the 7th, 14th and 28th day after onset, the Portmann scores in the group A were higher than those in the other 3 groups (all <0.05). There was significant difference between both pairs of group B, group C and group D (all <0.05). The total effective rate in the group A was 96.7% (29/30), which was higher than 93.3% (28/30), 86.7% (26/30) and 83.3% (25/30) in the other 3 groups (all <0.05). The difference between the 4 groups in the beginning of improvement, significant improvement time and clinical recovery time was statistically significant (all <0.05), and the group A was optimal.@*CONCLUSION@#Early intervention of acupuncture with acute facial neuritis can appropriately slow the progression of facial nerve injury, improve the therapeutic effect, and shorten the clinical recovery time.


Assuntos
Humanos , Terapia por Acupuntura , Terapia Combinada , Doenças do Nervo Facial , Terapêutica
10.
Auris Nasus Larynx ; 45(5): 1113-1115, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29628319

RESUMO

Tonsil surgeries are the most frequently performed surgical procedures in ENT departments. We would like to present the case of a 5-year-old patient who suffered from unilateral peripheral facial nerve palsy and laryngeal spasm following adenotonsillectomy. Paresis was observed immediately after the transfer of the patient to the postoperative room. The activity of facial muscles was restored within 2 hours from the beginning of the surgery. We assume that this was the direct effect of an anaesthetic on the extracranial processes of the facial nerve.


Assuntos
Adenoidectomia , Anestésicos Locais/efeitos adversos , Doenças do Nervo Facial/induzido quimicamente , Laringismo/induzido quimicamente , Lidocaína/efeitos adversos , Dor Pós-Operatória/prevenção & controle , Complicações Pós-Operatórias/induzido quimicamente , Tonsilectomia , Anestesia Local/efeitos adversos , Pré-Escolar , Epinefrina/uso terapêutico , Paralisia Facial , Feminino , Humanos , Recuperação de Função Fisiológica , Apneia Obstrutiva do Sono/cirurgia , Ronco/cirurgia , Simpatomiméticos/uso terapêutico
11.
Artigo em Inglês | WPRIM | ID: wpr-199170

RESUMO

A 25-years-old woman with mandibular prognathism underwent a mandibular setback by way of mandibular sagittal split ramus osteotomy (MSSRO). After 2 days of operation, she developed difficulty of closing her right eye. The blink reflex test and motor nerve conduction study of the right orbicularis oris muscle were revealed right facial neuropathy of unknown origin and House-Brackmann facial nerve grading system (HBFNGS) grade V. For treatment, we initially prescribed oral prednisolone and nimodipine including physical therapy. The samples consisted of 11 facial nerve palsy patients caused by MSSRO and were analysed about onset of facial nerve palsy, postoperative HBFNGS, final HBFNGS, treatment method and recovery time. At 10 weeks of treatment of nimodipine, she had completely regained normal function (HBFNGS grade I) of the right facial nerve. The clinical results lead to assume a fast recovery of facial nerve function by the nimodipine medication, whereas average time of recovery is 16.32 weeks in references. Despite of the limited one patient treated, the result was very promising with respect to a faster recovery of the facial nerve function. Considering the use of nimodipine treatment for peripheral facial nerve palsy following a surgical approach with an anatomically preserved nerve can be recommended.


Assuntos
Feminino , Humanos , Piscadela , Doenças do Nervo Facial , Nervo Facial , Paralisia Facial , Mandíbula , Métodos , Condução Nervosa , Nimodipina , Osteotomia Sagital do Ramo Mandibular , Paralisia , Prednisolona , Prognatismo
12.
World Neurosurg ; 91: 671.e5-7, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27064100

RESUMO

BACKGROUND: Treatment-related chronic neuropathic pain represents a major and increasing cause of discomfort in cancer survivors. Unfortunately, in approximately 10%-15% of cases, pain is scarcely relieved by opioids and common painkillers. Thus, alternative measures to manage pain have recently been adopted in these patients. CASE DESCRIPTION: We report the case of a laryngeal cancer survivor who developed an intractable bilateral mandibular radiation-induced neuropathic pain syndrome. His pain was refractory to any pharmacological treatment, whereas the implant of bilateral subcutaneous facial electrodes led to the complete resolution of pain. CONCLUSIONS: To the best of our knowledge, this is the first report in literature describing peripheral nerve field stimulation as a treatment option for intractable cancer treatment-related chronic neuropathic pain. Peripheral nerve field stimulation appears to be a safe and effective procedure.


Assuntos
Doenças do Nervo Facial/etiologia , Doenças do Nervo Facial/terapia , Neoplasias Laríngeas/complicações , Radioterapia/efeitos adversos , Estimulação Elétrica Nervosa Transcutânea/métodos , Humanos , Neoplasias Laríngeas/radioterapia , Masculino , Pessoa de Meia-Idade , Medição da Dor , Sobreviventes , Resultado do Tratamento
13.
J Otolaryngol Head Neck Surg ; 45: 7, 2016 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-26833354

RESUMO

BACKGROUND: Recent studies have examined the effects of brief electrical stimulation (BES) on nerve regeneration, with some suggesting that BES accelerates facial nerve recovery. However, the facial nerve outcome measurement in these studies has not been precise or accurate. The objective of this study is to assess the effect of BES on accelerating facial nerve functional recovery from a transection injury in the rat model. METHODS: A prospective randomized animal study using a rat model was performed. Two groups of 9 rats underwent facial nerve surgery. Both group 1 and 2 underwent facial nerve transection and repair at the main trunk of the nerve, with group 2 additionally receiving BES on post-operative day 0 for 1 h using an implantable stimulation device. Primary outcome was measured using a laser curtain model, which measured amplitude of whisking at 2, 4, and 6 weeks post-operatively. RESULTS: At week 2, the average amplitude observed for group 1 was 4.4°. Showing a statistically significant improvement over group 1, the group 2 mean was 14.0° at 2 weeks post-operatively (p = 0.0004). At week 4, group 1 showed improvement having an average of 9.7°, while group 2 remained relatively unchanged with an average of 12.8°. Group 1 had an average amplitude of 13.63° at 6-weeks from surgery. Group 2 had a similar increase in amplitude with an average of 15.8°. There was no statistically significant difference between the two groups at 4 and 6 weeks after facial nerve surgery. CONCLUSIONS: This is the first study to use an implantable stimulator for serial BES following neurorrhaphy in a validated animal model. Results suggest performing BES after facial nerve transection and neurorrhaphy at the main trunk of the facial nerve is associated with accelerated whisker movement in a rat model compared with a control group.


Assuntos
Terapia por Estimulação Elétrica/métodos , Doenças do Nervo Facial/reabilitação , Traumatismos do Nervo Facial/reabilitação , Nervo Facial/fisiopatologia , Recuperação de Função Fisiológica , Animais , Modelos Animais de Doenças , Doenças do Nervo Facial/etiologia , Doenças do Nervo Facial/fisiopatologia , Traumatismos do Nervo Facial/complicações , Traumatismos do Nervo Facial/fisiopatologia , Feminino , Estudos Prospectivos , Ratos , Ratos Wistar
14.
Am J Otolaryngol ; 36(4): 578-82, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25929977

RESUMO

OBJECTIVE: To describe the incidence and management of patients with facial nerve stimulation (FNS) associated with cochlear implant (CI) use in the setting of a prior temporal bone fracture. PATIENTS: One adult CI recipient is reported who experienced implant associated FNS with a history of a temporal bone fracture. Additionally, a literature search was performed to identify similar patients from previous descriptions of CI related FNS. MAIN OUTCOME MEASURES: Presence of FNS after implantation and ability to modify implant programming to avoid FNS. RESULTS: The patient in the present report experienced FNS for middle and basal electrodes during intraoperative neural response telemetry (NRT) in the absence of any surgical exposure or manipulation of the facial nerve. FNS was absent during device activation, but it recurred during follow-up programming sessions. However, additional programming has prevented further FNS during regular implant use. Four other patients with FNS after temporal bone fracture were identified from the literature, and the present case represents the one of two cases in which reprogramming allowed for implant use without FNS. CONCLUSIONS: CI associated FNS is uncommon in patients with a history of a temporal bone fracture, but it is likely that fracture lines provide a lower impedance pathway to the adjacent facial nerve and thus reduce the threshold for FNS. The present report suggests that, in the setting of a prior temporal bone fracture, NRT is not always a reliable predictor of FNS during implant use, and programming changes can help to mitigate FNS when it occurs.


Assuntos
Implantes Cocleares , Doenças do Nervo Facial/terapia , Nervo Facial/fisiopatologia , Perda Auditiva Neurossensorial/etiologia , Fraturas Cranianas/complicações , Osso Temporal/lesões , Estimulação Elétrica Nervosa Transcutânea/métodos , Adulto , Doenças do Nervo Facial/etiologia , Perda Auditiva Neurossensorial/fisiopatologia , Perda Auditiva Neurossensorial/cirurgia , Humanos , Masculino , Fraturas Cranianas/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X
15.
J Craniomaxillofac Surg ; 43(4): 452-61, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25773375

RESUMO

BACKGROUND: Optimum treatment of condylar head fractures (CHF) remains subject to controversy. There are currently a variety of alternative techniques applied, data in literature are often inconsistent and especially systematic long-term data on results after treatment by open reduction and internal fixation (ORIF) have so far not been available. This study in hand is the first long-term prospective study of ORIF after CHF based on osteosynthesis with 1.7 mm small-fragment positional screws (SFPSO)via a retroauricular transmeatal approach (RA). METHODS: The study made use of radiologic, anatomic and objective functional parameters (axiography and MRI) to assess vertical height, disk mobility, protrusive and translatory movement as well as potential physical complaints. Included were surgical long-term sequelae after RA, such as incidence of stenosis of the auditory canal, the facial nerve and resulting disturbance of facial skin sensitivity. Retroauricular scars were evaluated according to the Vancouver Scar Scale. Helkimo and RDC/TMD indices were applied for patient's self-assessment of quality of life aspects after ORIF via RA. The sample in the first follow-up trial (FFT) in the years 2003-2004 comprised 26 patients (36 CHF). 22 patients (31 CHF) were re-evaluated in a second follow-up trial (SFT) between 2006 and 2008. A reference collective (43 patients, 56 CHF) treated with ORIF from 1993 to 2000 mainly by mini- or microplates (MMP) served as a surgical control group. RESULTS: Five years after ORIF all fractured condyles (FC) continued to show stable anatomic restoration of the pre-trauma vertical height. FC treated with SFPSO exhibited a significantly superior range of motion (p < 0.05) of disk and condyle during mouth opening and protrusion compared to a previous MMP reference collective. Also, no difference was found between condylar mobility of FC five years after surgery and non-fractured condyles (NFC). SFPSO had thus successfully achieved a sustainable, stable physiological restoration of protrusive mobility of the articular disk and condyle. Remarkably, these long-term results were even slightly better in SFT vs. FFT (p < 0.05). Except for sporadically occurring minor complaints, the patients' subjective overall long-term perception of the success of the treatment was equally positive to the surgeons' objective assessment. CONCLUSIONS: This first long-term prospective follow-up study, based on objective assessment tools, demonstrates that in all cases the major goals of ORIF in CHF could be fully achieved. These goals are: restoration of vertical height viz. prevention of occlusal disorders, physiological function of disk and condyle as well as of the lateral pterygoid muscle. Accordingly, ORIF of CHF e.g. with SFPSO and via the RA secures both a long-term functionally and anatomically stable result and as best as possible pain-free result for the patient, a central prerequisite of optimum perceived HRQoL. The paper has been amended by an extensive review part that covers the current knowledge of the major surgical aspects regarding the treatment of condylar head fractures.


Assuntos
Parafusos Ósseos , Fixação Interna de Fraturas/instrumentação , Côndilo Mandibular/lesões , Fraturas Mandibulares/cirurgia , Adulto , Cicatriz/etiologia , Constrição Patológica/etiologia , Meato Acústico Externo/patologia , Otopatias/etiologia , Doenças do Nervo Facial/etiologia , Feminino , Seguimentos , Fixação Interna de Fraturas/métodos , Humanos , Registro da Relação Maxilomandibular/métodos , Estudos Longitudinais , Imageamento por Ressonância Magnética/métodos , Masculino , Côndilo Mandibular/cirurgia , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Prospectivos , Qualidade de Vida , Amplitude de Movimento Articular/fisiologia , Disco da Articulação Temporomandibular/fisiologia , Transtornos da Articulação Temporomandibular/etiologia , Resultado do Tratamento , Dimensão Vertical , Adulto Jovem
16.
Zhongguo Zhen Jiu ; 34(6): 602-4, 2014 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-25112104

RESUMO

The treatment plan of facial neuritis in Evidence-based Guidelines of Clinical Practice in Acupuncture and Moxibustion (2011 edition) is discussed, and case information of facial neuritis during the recent five years in department of acupuncture and moxibustion, PLA General Hospital, is retrospectively analyzed. In accordance with anatomy of the facial nerve to form the acupuncture prescription, the detailed diagnosis and treatment method for facial neuritis are introduced. The advantages of the diagnosis and treatment method for facial neuritis are summarized, hoping to establish a more comprehensive, standardized and unified treatment plan.


Assuntos
Terapia por Acupuntura/normas , Medicina Baseada em Evidências/normas , Doenças do Nervo Facial/terapia , Moxibustão/normas , Pontos de Acupuntura , Nervo Facial/anatomia & histologia , Humanos , Guias de Prática Clínica como Assunto
17.
Artigo em Chinês | WPRIM | ID: wpr-314270

RESUMO

The treatment plan of facial neuritis in Evidence-based Guidelines of Clinical Practice in Acupuncture and Moxibustion (2011 edition) is discussed, and case information of facial neuritis during the recent five years in department of acupuncture and moxibustion, PLA General Hospital, is retrospectively analyzed. In accordance with anatomy of the facial nerve to form the acupuncture prescription, the detailed diagnosis and treatment method for facial neuritis are introduced. The advantages of the diagnosis and treatment method for facial neuritis are summarized, hoping to establish a more comprehensive, standardized and unified treatment plan.


Assuntos
Humanos , Pontos de Acupuntura , Terapia por Acupuntura , Padrões de Referência , Medicina Baseada em Evidências , Padrões de Referência , Nervo Facial , Doenças do Nervo Facial , Terapêutica , Moxibustão , Padrões de Referência , Guias de Prática Clínica como Assunto
18.
Zhongguo Zhen Jiu ; 33(10): 881-4, 2013 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-24377215

RESUMO

OBJECTIVE: To evaluate the effect of Chen's needling therapy on facial neuritis. METHODS: Eighty-four patients of facial neuritis were randomized into a Chen's needling therapy group and a conventional needling group, 42 cases in each one. In the Chen's needling therapy group, the few acupoints were selected (5 acupoints). Chen's flying insertion of needle and the reinforcing and reducing techniques were applied. In the conventional needling group, the acupoint selection and needling method were used routinely. The treatment of 1 month was 1 session in the two groups. According to the symptom and physical sign quantification scale, the effect was assessed at multiple time points respectively (in 2 weeks of treatment, 1 session of treatment and 1 month after 1 session of treatment). Simultaneously, House-Brackmann scale and EMG were adopted to determine the function of facial nerve. RESULTS: After treatment, the results of symptoms and physical sign quantification scale and facial nerve EMG were different significantly as compared with those before treatment in the patients of the two groups (all P < 0.05). But the differences were not significant between the two groups (all P > 0.05). CONCLUSION: Chen's needling therapy achieves the same effect on facial neuritis as compared with the conventional acupuncture therapy, and additionally it is specialized at flying insertion of needle technique and selection of few acupoints.


Assuntos
Terapia por Acupuntura , Doenças do Nervo Facial/terapia , Pontos de Acupuntura , Adolescente , Adulto , Idoso , Criança , Nervo Facial , Doenças do Nervo Facial/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
19.
Altern Ther Health Med ; 18(3): 45-52, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22875561

RESUMO

CONTEXT: Facial spasm is one of the common facial diseases, especially in the aged. It is mostly characterized by initially progressive, involuntary, irregular, recurrent, clonic, or tonic movements of muscles innervated by the facial nerve on one side. Acupuncture is a low-risk treatment with purported claims of effectiveness for facial spasm. OBJECTIVE: To assess the efficacy of acupuncture in facial spasm comprehensively. DESIGN: The research team conducted a systematic review and meta-analysis of all randomized clinical trials (RCTs) that examined the effectiveness of acupuncture for facial spasm. OUTCOME MEASURE(S): The research team categorized results from each of the reviewed studies in two ways: (1) the number of participants who showed a positive response to therapy (total effectiveness rate) and (2) the number of participants who made a full recovery (clinical cure rate). RESULTS: The research team reviewed a total of 13 studies involving 1262 participants with facial spasm. Researchers in China had conducted all studies, and most studies were poor in methodological quality. All studies reported that acupuncture was superior to other treatments, including carbamazepine, mecobalamin, and massage, and the meta-analysis on these low-quality studies yielded similar results. CONCLUSION: Present trials evaluating the efficacy of acupuncture in treatment of facial spasm are mostly poor in methodological quality. These studies showed that acupuncture was superior to other treatments for facial spasm; however, in its meta-analysis, the research team could not draw an affirmative conclusion as to the benefits of acupuncture due to the poor methodological quality and localized population of the included trials. The field needs large international, well-conducted RCTs.


Assuntos
Terapia por Acupuntura/métodos , Paralisia de Bell/terapia , Músculos Faciais , Doenças do Nervo Facial/terapia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Resultado do Tratamento
20.
Zhen Ci Yan Jiu ; 36(5): 388-91, 2011 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-22073895

RESUMO

It has been well documented in Chinese acupuncture medicine that "Hegu (LI 4) is indicated for orofacial problems". In the present paper, the authors analyze their correlation from the learning of modern medicine and results of recent experimental studies instead of traditional meridian theory of acupuncturology. The afferent nerve fibers from the LI 4 region and the orofacial part ascend to the spinal cord, nucleus of solitary tract, reticular formation, thalamus and the cerebral cortex, respectively, and overlap in the thalamus, cerebral cortex, etc. Under the circumstances, the interaction and functional integration of the afferent signals from LI 4 acupoint and the orofacial region may occur in the central nervous system. In addition, many relevant neuroactive substances (for example, serotonin, substance P, enkephalin, y-aminobutyric acid, glycine, calcitonin gene-related peptide, etc.) released from the sensory and motor neurons in the corresponding cerebral regions may constitute part of the substantial basis of that "Hegu (LI 4) is indicated for many orofacial disorders".


Assuntos
Pontos de Acupuntura , Terapia por Acupuntura , Doenças do Nervo Facial/terapia , Animais , Doenças do Nervo Facial/fisiopatologia , Humanos
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