Cerclage sling technique using temporalis muscle fascia to manage paralytic lagophthalmos: A preliminary study.

PURPOSE: Despite various existing surgical techniques, treatment of facial nerve palsy remains difficult. The purpose of this report is to present the cerclage sling technique using temporalis fascia to manage paralytic lagophthalmos. METHODS: A series of six patients underwent a cerclage sling technique using temporalis muscle fascia to treat paralytic lagophthalmos. The technique is presented in detail. Symptoms, palpebral fissures, and lagophthalmos were assessed pre- and postoperatively. Data were submitted for statistical analysis. RESULTS: After surgery, all patients achieved a reduction in clinical symptoms. The upper eyelids had lowered, and the inferior eyelids had elevated, reducing ocular exposure even if mild residual lagophthalmos was present. CONCLUSION: Cerclage using the temporalis muscle fascia sling technique is a safe and effective procedure to treat facial nerve paralytic lagophthalmos. A reduction in ocular exposure and lagophthalmos provides improvement in clinical symptoms and eyelid function.

Auricular Cartilage Graft for Lengthening Levator Muscle Aponeurosis With Ectropion Correction for Paralytic Lagophthalmos.

BACKGROUND: Paralytic lagophthalmos can have devastating consequences for vision if left untreated. Several surgical techniques have been described, including the utilization of alloplastic and autologous materials. OBJECTIVES: The authors sought to evaluate the effectiveness of the surgical treatment of paralytic lagophthalmos with combined techniques employing autologous material and involving the upper and lower eyelids. METHODS: Patients with paralytic lagophthalmos underwent stretching of the levator aponeurosis with interposition of conchal cartilage in the upper eyelid associated with sectioning of the orbitomalar ligament and lateral canthoplasty in the lower eyelid. The effectiveness of the technique was evaluated employing subjective (symptomatology) and objective parameters (ophthalmologic evaluation and measurements of lagophthalmos and marginal reflex distances 1 and 2). RESULTS: Eight patients with paralytic lagophthalmos were subjected to the proposed technique. In the postoperative period, 85.7% reported complete improvement of symptoms and 62.5% presented a normal eye examination. The mean lagophthalmos measurement was reduced by 5.93 mm, the mean marginal reflex distance 2 was reduced by 2.61 mm, and the mean marginal reflex distance 1 was reduced by 0.69 mm. CONCLUSIONS: The technique presented herein, employing autologous material associated with sectioning of the orbitomalar ligament and lateral canthoplasty, was effective in the treatment of paralytic lagophthalmos and did not present significant complications, such as extrusion.

Masseteric-Facial Anastomosis: A Report of Three Cases

Intoduction The pathways of the facial nerve are variable, and knowledge of that is essential. The worst impact caused by facial paralysis is related to quality of life, especially regarding the self-esteem and social acceptance on the part of the patients, leading to social isolation and disruption on their mental health. Case Report A 33-year-old female patient, with a stage-T3 acoustic neurinoma, presented with a moderate dysfunction (grades II to III) according to the House- Brackmann (HB) Facial Nerve Grading System. A 43-year-old male patient, with a stage- T4B trigeminal schwannoma, underwent a resective surgery and presented grade-VI dysfunction according to the HB scale. And a female patient with a stage-T4A acoustic neurinoma presented grade-IV dysfunction according to the HB scale. Discussion We performed a literature review of papers related to surgeries for masseteric-facial nerve anastomosis and compiled the results in table; then, we compared these data with those obtained from our cases. Conclusion The masseteric nerve is the one that shows the best prognosis among all the cranial nerves that could be used, but it is also necessary to perform well the surgical technique to access the facial branch and consequently achieve a better masseteric-facial nerve anastomosis.

Síndrome de Ramsay Hunt: reporte de un caso clínico / Ramsay Hunt Syndrome: clinical case report

El virus varicela zoster produce cuadros clínicos por reactivación del mismo en años posteriores a la primoinfección, en sujetos con condiciones particulares, como situaciones de estrés, inmunodepresión, radioterapia, estados infecciosos que cursen con fiebre, entre otros. El síndrome de Ramsay Hunt es uno de ellos. Se caracteriza por una tríada de parálisis facial periférica, vesículas herpéticas en oído externo y otalgia. Objetivo: pr esentar un caso típico del síndr ome de Ramsay Hunt, métodos diagnósticos y tratamiento realizado. Presentación de caso clínico: paciente femenina, de 21 años, originaria de Tegucigalpa, Honduras, se presentó al Hospital Escuela Universitario por cuadro de seis días de evolución, de cambios inflamatorios en el oído externo izquierdo, en la región del pabellón auricular y el conducto auditivo externo, con presencia de vesículas herpéticas eritematosas con costras y restos hemáticos, otorrea, hiperemia, prurito y otalgia intermitente. También refirió parálisis de hemicara izquierda de cuatro días de evolución. Examen físico: conducto auditivo externo izquierdo presentaba vesículas con costras. Hubo ptosis palpebral izquierda e incapacidad para realizar las mímicas faciales. Tratamiento intrahospitalario: aciclovir 800 mg vía oral cada 6 horas, dexametasona 8 mg IV cada 8 horas, diclofenaco 75 mg IV cada 12 horas; citidina-5- monofosfato disódico, más uridin-5-trifosfato trisódico, 1 comprimido cada 12 horas; mupirocina ungüento al 1Universidad Nacional Autónoma de Honduras, Facultad de Ciencias Médicas, Tegucigalpa, Honduras. ORCID 0000-0002-2346-4209 2Universidad Nacional Autónoma de Honduras, Facultad de Ciencias Médicas. Departamento de Cirugía. Tegucigalpa, Honduras. 3Hospital Escuela Universitario, Departamento de Cirugía, Tegucigalpa, Honduras. Autor de correspondencia: Paola Andrea Hincapié Gaviria, paolahincapie23@gmail.com Recibido: 10/07/2020 Aceptado: 03/03/2021 al 2%, aplicado en oído externo cada 8 horas y ejercicios de fisioterapia. Conclusión: el síndrome de Ramsay Hunt se diagnóstica, fundamentalmente, mediante hallazgos clínicos. El tratamiento empírico y adecuado, acompañado de una buena terapia posterior, anticipa un pronóstico favorable sin secuelas neurológicas...(AU)

Tongue strength rehabilitation using biofeedback: a case report. / Reabilitação da força da língua utilizando biofeedback: relato de caso.

This research had the objective of reporting a clinical case in which the rehabilitation of tongue strength with biofeedback strategy was performed. This case report addresses a 20-year-old patient whose orofacial myofunctional evaluation revealed a severe decrease in the force of the anterior third of the tongue and changes in lingual mobility and coordination. The measurement of tongue pressure was performed using the Iowa Oral Performance Instrument (IOPI) during elevation, protrusion and lateralization, and it was verified a reduction in the values ​​obtained in all measured directions, compared with normality patterns. We performed 11 sessions of therapy, with weekly frequency, using a biofeedback strategy that consisted of computer games controlled by the tongue. An instrument embedded in the oral cavity functioned as a joystick as the input method for specific digital games. The patient performed at home the isometric exercises of pressing the tip of the tongue against a spatula, exaggerated retraction of tongue, tongue tapering, and isotonic exercise of touching the commissures and lips alternately, daily. After eight sessions, in relation to the elevation pressure, there was an improvement of 28.6% for the apex and 7.1% for the dorsum. As for protrusion, there was an improvement of 123.5%. In the measurements of left and right lateralization, the values ​​increased 53.8% and 7.4%, respectively. After twelve sessions, it was observed an improvement of 35.7%, 7.4%, 164%, 76.9% and 40.7% in relation to the initial evaluation, for apex elevation, dorsum elevation, protrusion, and lateralization to left and right, respectively. Despite the increase, values ​​recommended in the literature as normal for sex and age were not reached after 12 therapy sessions.

Esta pesquisa teve o objetivo de relatar um caso clínico em que foi realizada a reabilitação da força lingual com estratégia de biofeedback. Trata-se de uma paciente de 20 anos de idade, cuja avaliação miofuncional orofacial evidenciou diminuição grave de força do terço anterior da língua e alterações na mobilidade e na coordenação linguais. A quantificação da pressão lingual foi realizada por meio do Iowa Oral Performance Instrument durante a elevação, a protrusão e a lateralização, tendo se verificado redução nos valores obtidos em todas as direções medidas em comparação aos padrões de normalidade. Foram realizadas 11 sessões de terapia, com frequência semanal, utilizando estratégia de biofeedback que consistia em jogos computacionais acionados pela língua. Um instrumento encaixado na cavidade oral funcionava como um joystick, sendo método de entrada para jogos digitais específicos. Em casa, a paciente realizou exercícios isométricos de pressão de ponta de língua contra espátula, retração exagerada de língua, afilamento lingual e isotônico de tocar comissuras e lábios alternadamente, diariamente. Após oito sessões, em relação à pressão na elevação, houve melhora de 28,6% para o ápice e 7,1% para o dorso. Quanto à protrusão, houve melhora de 123,5%. Nas medidas de lateralizações esquerda e direita, os valores aumentaram 53,8% e 7,4%, respectivamente. Após 12 sessões, percebeu-se melhora, em relação à avaliação inicial, de 35,7%, 7,4%, 164%, 76,9% e 40,7%, para elevação de ápice, de dorso, protrusão, lateralizações esquerda e direita, respectivamente. Apesar do aumento, valores preconizados na literatura, como normalidade para o sexo e a idade, não foram atingidos com 12 sessões.

Reanimação estática do lábio inferior na paralisia facial como complicação de preenchimento / Static lower lip reanimation as a filler complication of facial paralysis

Procedimentos de rejuvenescimento facial substitutos da cirurgia tradicional tornaram-se cada vez mais populares para promover uma aparência jovial com procedimentos minimamente invasivos, como toxina botulínica injetável, preenchimento de tecidos moles e peelings químicos. No entanto, complicações podem ocorrer mesmo na presença de um injetor habilidoso e experiente. Apresentamos o caso de uma paciente submetida a reanimação labial estática usando retalho dermoadiposo para lesão do nervo facial direito após remoção de nódulos como complicação de preenchimento. A "abordagem modificada de bull horn" foi realizada para elevação do lábio superior em torno das asas nasais e columela e ao longo do sulco nasolabial direito. O retalho foi desepitelizado e obtido. Usando a ponta aberta de uma pequena cânula de lipoaspiração, a porção distal do retalho foi encapsulada e fixada diretamente em C-loop e foram utilizados pontos U, transfixando o retalho para o periósteo do arco zigomático. Nos três anos de seguimento não foram observadas complicações significativas e a paciente não relatou nenhuma limitação funcional ou insatisfação com o aspecto das cicatrizes no sulco nasolabial e ao redor das asas nasais e da columela.

Facial rejuvenation procedures to circumvent traditional surgery have become increasingly popular to promote a youthful appearance with minimally invasive procedures such as injectable botulinum toxin, soft-tissue fillers, and chemical peels. Nevertheless, complications can occur even with an astute and experienced injector. Here we present the case of a patient who underwent static lip reanimation using a dermoadiposal flap for right facial nerve damage following nodule removal as a filler complication. A "modified bulls horn approach" to the upper lip lift was performed around the nasal wings and columella and along the right nasolabial fold. The flap was de-epithelized and harvested. Using the open tip of a small liposuction cannula, the distal portion of the flap was tunneled and fixed directly in a C-loop fashion using U stitches, transfixing the flap to the periosteum of the zygomatic arch. At 3 years follow-up, no significant complications were observed, and the patient reported no functional limitations or dissatisfaction with the scars in the nasolabial fold or around the nasal wings and columella.

Reabilitação da força da língua utilizando biofeedback: relato de caso / Tongue strength rehabilitation using biofeedback: a case report

RESUMO Esta pesquisa teve o objetivo de relatar um caso clínico em que foi realizada a reabilitação da força lingual com estratégia de biofeedback. Trata-se de uma paciente de 20 anos de idade, cuja avaliação miofuncional orofacial evidenciou diminuição grave de força do terço anterior da língua e alterações na mobilidade e na coordenação linguais. A quantificação da pressão lingual foi realizada por meio do Iowa Oral Performance Instrument durante a elevação, a protrusão e a lateralização, tendo se verificado redução nos valores obtidos em todas as direções medidas em comparação aos padrões de normalidade. Foram realizadas 11 sessões de terapia, com frequência semanal, utilizando estratégia de biofeedback que consistia em jogos computacionais acionados pela língua. Um instrumento encaixado na cavidade oral funcionava como um joystick, sendo método de entrada para jogos digitais específicos. Em casa, a paciente realizou exercícios isométricos de pressão de ponta de língua contra espátula, retração exagerada de língua, afilamento lingual e isotônico de tocar comissuras e lábios alternadamente, diariamente. Após oito sessões, em relação à pressão na elevação, houve melhora de 28,6% para o ápice e 7,1% para o dorso. Quanto à protrusão, houve melhora de 123,5%. Nas medidas de lateralizações esquerda e direita, os valores aumentaram 53,8% e 7,4%, respectivamente. Após 12 sessões, percebeu-se melhora, em relação à avaliação inicial, de 35,7%, 7,4%, 164%, 76,9% e 40,7%, para elevação de ápice, de dorso, protrusão, lateralizações esquerda e direita, respectivamente. Apesar do aumento, valores preconizados na literatura, como normalidade para o sexo e a idade, não foram atingidos com 12 sessões.

ABSTRACT This research had the objective of reporting a clinical case in which the rehabilitation of tongue strength with biofeedback strategy was performed. This case report addresses a 20-year-old patient whose orofacial myofunctional evaluation revealed a severe decrease in the force of the anterior third of the tongue and changes in lingual mobility and coordination. The measurement of tongue pressure was performed using the Iowa Oral Performance Instrument (IOPI) during elevation, protrusion and lateralization, and it was verified a reduction in the values ​​obtained in all measured directions, compared with normality patterns. We performed 11 sessions of therapy, with weekly frequency, using a biofeedback strategy that consisted of computer games controlled by the tongue. An instrument embedded in the oral cavity functioned as a joystick as the input method for specific digital games. The patient performed at home the isometric exercises of pressing the tip of the tongue against a spatula, exaggerated retraction of tongue, tongue tapering, and isotonic exercise of touching the commissures and lips alternately, daily. After eight sessions, in relation to the elevation pressure, there was an improvement of 28.6% for the apex and 7.1% for the dorsum. As for protrusion, there was an improvement of 123.5%. In the measurements of left and right lateralization, the values ​​increased 53.8% and 7.4%, respectively. After twelve sessions, it was observed an improvement of 35.7%, 7.4%, 164%, 76.9% and 40.7% in relation to the initial evaluation, for apex elevation, dorsum elevation, protrusion, and lateralization to left and right, respectively. Despite the increase, values ​​recommended in the literature as normal for sex and age were not reached after 12 therapy sessions.

Otite externa necrotizante com paralisia facial periférica e trombose do seio cavernoso: relato de caso / Necrotizint external otitis with peripheral facial paralysis and cavernous sinus thrombosis: case report

Otite externa necrotizante (OEN), conhecida antigamente como otite externa maligna (OEM), atinge o conduto auditivo externo, causando otalgia intensa, otorreia fétida, e em casos mais severos, comprometimento dos ossos do crânio e déficit neurológico. O agente etiológico mais comum é a Pseudomonas aeruginosa. Acomete principalmente pacientes idosos, diabéticos e imunodeprimidos. O comprometimento de nervo craniano levando a paralisia facial e trombose dos seios intracranianos são de piores prognósticos. O diagnóstico depende da suspeita clínica inicialmente. Os exames complementares são imprecisos, embora essenciais no seguimento. A abordagem multidisciplinar é sempre recomendada. O objetivo do trabalho é relatar as complicações clínicas de um caso de otite externa necrotizante com paralisia facial que evoluiu para trombose do seio cavernoso, levando ao óbito.

Necrotizing external otitis (NEO), formerly known as malignant external otitis (MEO), strikes the external auditory canal, causing severe otalgia, fetid otorrhea, and in more severe cases, impairment of the skull bones and neurological deficit. The most common etiological agent is Pseudomonas aeruginosa. It mainly affects elderly, diabetic and immunodepressed patients. Cranial nerve impairment leading to facial paralysis and intracranial sinus thrombosis are of bad prognos. The diagnosis depends on the clinical suspicion. Complementary exams are imprecise, although essential in the follow-up. The multidisciplinary approach is always recommended. The objective of this paper is to report the clinical complications of a case of necrotizing external otitis with facial paralysis and cavernous sinus thrombosis, leading to death.

Clinicopathologic factors associated with recurrence in parotid carcinoma / Clinicopathologic factors associated with recurrence in parotid carcinoma

Abstract Introduction: Parotid carcinomas have varying histological types and diverse biologic behaviors. Establishing an adequate treatment plan and predicting recurrence is important. Objective: To analyze the risk factors associated with recurrence in our 5 year experience with 30 cases of primary parotid carcinoma undergoing surgery at a single institute. Methods: From January 2009 to December 2013, 30 patients with surgical treatment of parotid carcinoma were identified based on their medical records. Results: The 30 patients were comprised of 17 males and 13 females. Among 11 patients with T4 tumors, seven patients had recurrence. Among seven patients with cervical nodal metastasis, all patient except one had recurrence. Clinically late stages (stage III and IV) showed more common recurrence than early stage (stage I and II) lesions. Lymphovascular invasion was seen in 5 patients, and all patients had recurrence. Among 11 patients with extracapsular spread, 7 patients had recurrence. In 17 patients with high grade carcinomas, ten patients had recurrence. In 13 patients with low grade carcinomas, no patients experienced recurrence. Conclusion: T- and N-stage, clinical stage, lymphovascular invasion, extracapsular spread, and histopathologic grade correlate significantly with recurrence in parotid carcinoma.

Resumo: Introdução: Os carcinomas da parótida têm diferentes tipos histológicos e comportamentos biológicos diversos. O estabelecimento de um plano de tratamento adequado e a previsão de recorrência são muito importantes. Objetivo: Analisar os fatores de risco associados à recorrência em nossa experiência de cinco anos com 30 casos de carcinoma parotídeo primário submetidos a cirurgia em uma única instituição. Método: De janeiro de 2009 a dezembro de 2013, 30 pacientes com tratamento cirúrgico de carcinoma parotídeo foram identificados com base nos prontuários. Resultados: Entre os 30 pacientes, 17 eram homens e 13, mulheres. Dos 11 pacientes com tumores T4, sete apresentaram recorrência. Entre sete pacientes com metástase em linfonodo cervical, todos, exceto um, apresentaram recorrência. Lesões em estágios clínicos tardios (III e IV) apresentaram recorrência mais comumente do que as dos estágios iniciais (I e II). A invasão linfovascular foi observada em cinco pacientes e todos os cinco apresentaram recorrência. Entre 11 pacientes com disseminação extracapsular, sete apresentaram recorrência. Dos 17 pacientes com carcinomas de alto grau, dez apresentaram recorrência. Em 13 pacientes com carcinomas de baixo grau, nenhum apresentou recorrência. Conclusão: Estágios T e N, estágio clínico, invasão linfovascular, disseminação extracapsular e grau histopatológico correlacionam-se de maneira significante com recorrência do carcinoma de parótida.

The Contribution of Surface Electromyographic Assessment for Defining the Stage of Peripheral Facial Paralysis: Flaccid or Sequelae Stage

Abstract Introduction Surface electromyographic activity may not be symmetric, even in subjects with no facial paralysis history. Objective To evaluate the contribution of the index of electromyographic (IEMG) activity in the identification of the two extremes of the facial paralysis course. Methods Thirty-four subjects with unilateral peripheral facial paralysis were selected. A control group was composed of volunteers without a history of facial paralysis. The electromyographic assessment of the facial muscle was performed by placing surface electrodes during movements of the forehead, eyes and lips using MIOTEC equipment, such as the MIOTOOL (Miotec, Porto Alegre, Brazil) software. The electromyographic activity was also recorded in other channels during the primary activity to identify the presence of synkinesis. The statistical analysis was performed using the Statistical Package for Social Sciences for Macintosh (SPSS Inc, Chicago, IL, USA). The IEMG activity was obtained from the division of the electromyographic activity root mean square (RMS) values on both sides. Results There was a statistically significant difference among the groups in all the analyzed indexes. The ocular-oral synkinesis in all patients must be correctly identified (with 100% sensitivity and specificity) using an IEMG activity of 1.62 as a cutoff point. The oral-ocular synkinesis must be correctly identified (93.3% sensitivity and 95.9% specificity) using the IEMG activity of 1.79 as a cutoff point. Conclusion The IEMG activity is below the normal scores in patients in the flaccid stage, whereas patients in the sequelae stage can either show normal values or values above or below the normal scores. The IEMG activity was shown to have high sensitivity and specificity in the identification of synkinesis.

Unilateral acne after facial palsy.

We describe a case of unilateral acne which appeared after an episode of facial nerve palsy. An 18-year-old female patient presented with papules and pustules predominantly located on the side where the facial paralysis occurred. The patient suffered right facial paralysis, which was treated with prednisone and kinesiotherapy with massages, electrostimulation, and infrared light. Two weeks later, acne lesions appeared in the area affected by the paralysis. As suggested in other cases of paralysis, including cases of Parkinson's disease and spinal cord injury, an increased sebum excretion rate and the immobility of the affected area are most likely what caused the unilateral acne lesions.

Toxina botulínica para tratamento de síndrome do Choro Assimétrico: relato de caso / Botulinum toxin in the treatment of asymmetric crying face syndrome: a case report

Síndrome do choro assimétrico é uma condição congênita secundária à hipoplasia ou ausência do músculo depressor do ângulo da boca. Trata-se de uma condição não tão incomum que pode cursar com assimetria facial ao chorar e sorrir, além de poder estar associadas a outras malformações congênitas. Crianças com essa deformidade podem sofrer dificuldades psicossociais e introversão. O arsenal terapêutico dessa condição já foi estudado e discutido na literatura com ênfase em abordagens cirúrgicas e invasivas. Relatamos aqui um caso de uma criança de 9 anos com essa síndrome, tratada, de forma menos invasiva, com toxina botulínica, com um bom resultado e satisfação.

Asymmetric crying face syndrome is a congenital condition secondary to hypoplasia or absence of the depressor muscle at the mouth angle. It is a common condition that presents with facial asymmetry while crying and smiling and may be associated with other congenital malformations. Children with this deformity may experience psychosocial difficulties and introversion. The therapeutic arsenal of this condition has already been studied and discussed in the literature with an emphasis on surgical and invasive approaches. We report here a case of a 9-year-old child with this syndrome, treated less invasively with botulinum toxin, with good result and satisfaction.

Unilateral acne after facial palsy

Abstract: We describe a case of unilateral acne which appeared after an episode of facial nerve palsy. An 18-year-old female patient presented with papules and pustules predominantly located on the side where the facial paralysis occurred. The patient suffered right facial paralysis, which was treated with prednisone and kinesiotherapy with massages, electrostimulation, and infrared light. Two weeks later, acne lesions appeared in the area affected by the paralysis. As suggested in other cases of paralysis, including cases of Parkinson's disease and spinal cord injury, an increased sebum excretion rate and the immobility of the affected area are most likely what caused the unilateral acne lesions.

Clinicopathologic factors associated with recurrence in parotid carcinoma.

INTRODUCTION: Parotid carcinomas have varying histological types and diverse biologic behaviors. Establishing an adequate treatment plan and predicting recurrence is important. OBJECTIVE: To analyze the risk factors associated with recurrence in our 5 year experience with 30 cases of primary parotid carcinoma undergoing surgery at a single institute. METHODS: From January 2009 to December 2013, 30 patients with surgical treatment of parotid carcinoma were identified based on their medical records. RESULTS: The 30 patients were comprised of 17 males and 13 females. Among 11 patients with T4 tumors, seven patients had recurrence. Among seven patients with cervical nodal metastasis, all patient except one had recurrence. Clinically late stages (stage III and IV) showed more common recurrence than early stage (stage I and II) lesions. Lymphovascular invasion was seen in 5 patients, and all patients had recurrence. Among 11 patients with extracapsular spread, 7 patients had recurrence. In 17 patients with high grade carcinomas, ten patients had recurrence. In 13 patients with low grade carcinomas, no patients experienced recurrence. CONCLUSION: T- and N-stage, clinical stage, lymphovascular invasion, extracapsular spread, and histopathologic grade correlate significantly with recurrence in parotid carcinoma.

Do you know this syndrome? Heerfordt-Waldenström syndrome.

Heerfordt-Waldenström syndrome is a rare subacute variant of sarcoidosis, characterized by enlargement of the parotid or salivary glands, facial nerve paralysis and anterior uveitis. Granulomas with a peripheral lymphocyte deficit are found in the anatomic pathology of affected organs. It is normally self-limiting, with cure achieved between 12 and 36 months, but some prolonged cases have been reported. Diagnosis of the syndrome is clinical, and treatment depends on the degree of systemic impairment. Oral corticosteroids represent the first line treatment option. The mortality rate ranges between 1 and 5% of cases.

Do you know this syndrome? Heerfordt-Waldenström syndrome

Abstract: Heerfordt-Waldenström syndrome is a rare subacute variant of sarcoidosis, characterized by enlargement of the parotid or salivary glands, facial nerve paralysis and anterior uveitis. Granulomas with a peripheral lymphocyte deficit are found in the anatomic pathology of affected organs. It is normally self-limiting, with cure achieved between 12 and 36 months, but some prolonged cases have been reported. Diagnosis of the syndrome is clinical, and treatment depends on the degree of systemic impairment. Oral corticosteroids represent the first line treatment option. The mortality rate ranges between 1 and 5% of cases.

Parálisis facial y preeclampsia / Facial paralysis and preeclampsia

La parálisis facial periférica es una afectación neurológica muy frecuente. En la mayor parte de los casos no se llega a establecer una etiología precisa, denominándolas idiopáticas o parálisis facial de Bell. La asociación de parálisis facial y embarazo es conocida. Es nuestro objetivo presentar a una paciente de 27 años de edad atendida en el Policlínico Universitario 26 de Julio, que tuvo esta afección asociada a su embarazo y a la preeclampsia grave(AU)

Peripheral facial paralysis is a very frequent neurological condition. In most cases, a precise etiology, called idiopathic or facial palsy of Bell, cannot be established. The association of facial palsy and pregnancy is known. It is our objective to present a 27-year-old female patient attending the University Polyclinic 26 de Julio, who had this condition associated with her pregnancy and severe preeclampsia(AU)

Parálisis facial y preeclampsia / Facial paralysis and preeclampsia

La parálisis facial periférica es una afectación neurológica muy frecuente. En la mayor parte de los casos no se llega a establecer una etiología precisa, denominándolas idiopáticas o parálisis facial de Bell. La asociación de parálisis facial y embarazo es conocida. Es nuestro objetivo presentar a una paciente de 27 años de edad atendida en el Policlínico Universitario 26 de Julio, que tuvo esta afección asociada a su embarazo y a la preeclampsia grave(AU)

Peripheral facial paralysis is a very frequent neurological condition. In most cases, a precise etiology, called idiopathic or facial palsy of Bell, cannot be established. The association of facial palsy and pregnancy is known. It is our objective to present a 27-year-old female patient attending the University Polyclinic 26 de Julio, who had this condition associated with her pregnancy and severe preeclampsia(AU)

Vibrissal paralysis produces increased corticosterone levels and impairment of spatial memory retrieval.

This research was aimed at establishing how the absence of active whisking in rats affects acquisition and recovery of spatial memory. The mystacial vibrissae were irreversibly paralyzed by cutting the facial nerve's mandibular and buccal branches bilaterally in the facial nerve lesion group (N=14); control animals were submitted to sham-surgery (N=15). Sham-operated (N=11) and facial nerve-lesioned (N=10) animals were trained (one session, eight acquisition trials) and tested 24h later in a circular Barnes maze. It was found that facial nerve lesioned-animals adequately acquired the spatial task, but had impaired recovery of it when tested 24h after training as compared to control ones. Plasma corticosterone levels were measured after memory testing in four randomly chosen animals of each trained group and after a single training trial in the maze in additional facial nerve-lesioned (N=4) and sham-operated animals (N=4). Significant differences respecting the elevation of corticosterone concentration after either a single training trial or memory testing indicated that stress response was enhanced in facial nerve-lesioned animals as compared to control ones. Increased corticosterone levels during training and testing might have elicited the observed whisker paralysis-induced spatial memory retrieval impairment.

Moderada concordancia espectroscópica e histopatológica en pacientes con lesiones cerebrales no traumáticas, Hospital Escuela Universitario, 2012-2015 / Spectroscopic and histopathologic moderate concordance in patients with non-traumatic brain injuries, Hospital Escuela Universitario, 2012 - 2015

Antecedentes:La comparación entre diagnóstico espectroscópico e histopatológico se fundamenta en variaciones de los metabolitos encontrados en las lesiones cerebrales. En Honduras no se cuenta con datos de correlación diagnostica entre estos métodos. Objetivo: Determinar la concordancia diagnóstica entre espectroscopía por resonancia magnética e histopatología en pacientes con lesiones cerebrales no traumáticas, Sala de Neurocirugía de Adultos, Hospital Escuela Universitario, Tegucigalpa, 2012-2015. Metodología: Estudio de valoración de concordancia entre pruebas diagnósticas en pacientes mayores de 18 años, con lesión cerebral no traumática. Se registró información sociodemográfica, antecedentes, presentación clínica y resultados diagnósticos. Los datos fueron procesados en programa SPSS Statistics versión 22. La concordancia se estableció estimando índice Kappa. Resultados: De 150 casos registrados, se evaluaron 42 pacientes con criterios de inclusión; 57.1% (24) hombres, edad promedio 44.8 años (18­79), 17 (40.5%) procedentes de Francisco Morazán. Al ingreso presentaron hipertensión endocraneana 38.1% (16), hemiparesia 33.3% (14) y parálisis facial periférica 4.8% (2). Los metabolitos Colina y N-Acetil Aspartato presentaron elevación 76.2% (32) y disminución 71.4% (30), respectivamente. Astrocitomas de bajo grado 9 (21.4%) y de alto grado 8 (19.0%) fueron los diagnósticos espectroscópicos más frecuentes. Astrocitomas de bajo grado y de alto grado, 10 (23.8%) cada uno, fueron los diagnósticos histopatológicos más frecuentes. Se estimó Índice diagnósticos espectroscópicos e histopatológicos sugiere que la combinación de ambos mejora la precisión del diagnóstico pero no la diferenciación entre tipos de lesiones...(AU)