Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 11.275
Filtrar
1.
J Vis Exp ; (207)2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38884493

RESUMO

Idiopathic facial paralysis is the most common type of facial nerve injury, accounting for approximately 70% of peripheral facial paralysis cases. This disease can not only lead to a change in facial expression but also greatly impact the psychology of patients. In severe cases, it can affect the normal work and life of patients. Therefore, the research on facial nerve injury repair has important clinical significance. In order to study the mechanism of this disease, it is necessary to carry out relevant animal experiments, among which the most important task is to establish an animal model with the same pathogenesis as human disease. The compression of the facial nerve within the petrous bone, especially the nerve trunk at the junction of the distal end of the internal auditory canal and the labyrinthine segment, is the pathogenesis of idiopathic facial paralysis. In order to simulate this common disease, a compression injury model of the main extracranial segment of the facial nerve was established in this study. The neurological damage was evaluated by behavioral, neuroelectrophysiological, and histological examination. Finally, 50 g constant force and 90 s clamp injury were selected as the injury parameters to construct a stable idiopathic facial paralysis model.


Assuntos
Modelos Animais de Doenças , Traumatismos do Nervo Facial , Animais , Ratos , Traumatismos do Nervo Facial/patologia , Paralisia Facial/patologia , Paralisia Facial/etiologia , Paralisia de Bell/patologia , Nervo Facial/patologia , Ratos Sprague-Dawley
2.
Nat Commun ; 15(1): 4721, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38830884

RESUMO

Optoelectronic neural interfaces can leverage the photovoltaic effect to convert light into electrical current, inducing charge redistribution and enabling nerve stimulation. This method offers a non-genetic and remote approach for neuromodulation. Developing biodegradable and efficient optoelectronic neural interfaces is important for achieving transdermal stimulation while minimizing infection risks associated with device retrieval, thereby maximizing therapeutic outcomes. We propose a biodegradable, flexible, and miniaturized silicon-based neural interface capable of transdermal optoelectronic stimulation for neural modulation and nerve regeneration. Enhancing the device interface with thin-film molybdenum significantly improves the efficacy of neural stimulation. Our study demonstrates successful activation of the sciatic nerve in rodents and the facial nerve in rabbits. Moreover, transdermal optoelectronic stimulation accelerates the functional recovery of injured facial nerves.


Assuntos
Regeneração Nervosa , Nervo Isquiático , Animais , Coelhos , Regeneração Nervosa/fisiologia , Regeneração Nervosa/efeitos dos fármacos , Nervo Isquiático/fisiologia , Nervo Facial/fisiologia , Nervos Periféricos/fisiologia , Masculino , Ratos , Silício/química , Ratos Sprague-Dawley , Estimulação Elétrica
3.
Acta Neurochir (Wien) ; 166(1): 255, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38850321

RESUMO

BACKGROUND: In microvascular decompression (MVD) procedures for hemifacial spasm (HFS), surgeons often encounter a rhomboid lip which may obscure the root exit zone (REZ) of the facial nerve. This study aims to explore the anatomical variations of rhomboid lips and their surgical implications to improve safety and effectiveness in MVD surgeries. METHODS: A retrospective analysis was conducted on 111 patients treated for HFS between April 2021 and March 2023. The presence of a rhomboid lip was assessed through operative video records, and its characteristics, dissection methods, and impact on nerve decompression outcomes were further examined. Preoperative magnetic resonance imaging (MRI) scans were reviewed for detectability of the rhomboid lip. RESULTS: Rhomboid lips were identified in 33% of the patients undergoing MVD, with a higher prevalence in females and predominantly on the left side. Two distinct types of rhomboid lips were observed: membranous and cystic variations. The membranous type was noted for its smaller size and position ventral to the choroid plexus. In contrast, the cystic variation was distinguished by its larger size and a thin membrane that envelops the choroid plexus. Preoperative MRI successfully identified rhomboid lips in only 21% of the patients who were later confirmed to have them in the surgical procedures. Surgical approaches primarily involved incisions on the dorsal wall and along the glossopharyngeal nerve root, with only limited need for extensive dissection from lower cranial nerves. Immediate spasm relief was observed in 97% of the patients. One case exhibited a lower cranial nerve deficit accompanied by brainstem infarction, which was caused by the dissection from the lower cranial nerves. CONCLUSIONS: Recognizing the two variations of the rhomboid lip and understanding their anatomical structures are essential for reducing lower cranial nerve injuries and ensuring effective nerve decompression.


Assuntos
Espasmo Hemifacial , Cirurgia de Descompressão Microvascular , Humanos , Espasmo Hemifacial/cirurgia , Feminino , Masculino , Cirurgia de Descompressão Microvascular/métodos , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto , Idoso , Lábio/cirurgia , Lábio/inervação , Nervo Facial/cirurgia , Imageamento por Ressonância Magnética/métodos , Resultado do Tratamento
4.
Drug Des Devel Ther ; 18: 2475-2484, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38919963

RESUMO

Purpose: Ciprofol is a recently developed short-acting gamma-aminobutyric acid receptor agonist with a higher potency than that of propofol. As a new sedative drug, there are few clinical studies on ciprofol. We sought to examine the safety and efficacy of ciprofol use for general anesthesia in neurosurgical individuals undergoing neurosurgical surgery with intraoperative neurophysiological monitoring (IONM). Patients and Methods: This single-center, non-inferiority, single-blind, randomized controlled trial was conducted from September 13, 2022 to September 22, 2023. 120 patients undergoing elective microvascular decompression surgery (MVD) with IONM were randomly assigned to receive either ciprofol or propofol. The primary outcome of this study was the amplitude of intraoperative compound muscle action potential decline, and the secondary outcome included the indexes related to neurophysiological monitoring and anesthesia outcomes. Results: The mean values of the primary outcome in the ciprofol group and the propofol group were 64.7±44.1 and 53.4±35.4, respectively. Furthermore, the 95% confidence interval of the difference was -25.78 to 3.12, with the upper limit of the difference being lower than the non-inferiority boundary of 6.6. Ciprofol could achieve non-inferior effectiveness in comparison with propofol in IONM of MVD. The result during anesthesia induction showed that the magnitude of the blood pressure drop and the incidence of injection pain in the ciprofol group were significantly lower than those in the propofol group (P<0.05). The sedative drug and norepinephrine consumption in the ciprofol group was significantly lower than that in the propofol group (P<0.05). Conclusion: Ciprofol is not inferior to propofol in the effectiveness and safety of IONM and the surgical outcome. Concurrently, ciprofol is more conducive to reducing injection pain and improving hemodynamic stability, which may be more suitable for IONM-related surgery, and has a broad application prospect.


Assuntos
Monitorização Neurofisiológica Intraoperatória , Cirurgia de Descompressão Microvascular , Propofol , Humanos , Propofol/administração & dosagem , Propofol/farmacologia , Masculino , Pessoa de Meia-Idade , Feminino , Método Simples-Cego , Nervo Facial/efeitos dos fármacos , Nervo Facial/cirurgia , Anestesia Intravenosa , Anestésicos Intravenosos/administração & dosagem , Anestésicos Intravenosos/farmacologia , Idoso , Adulto
5.
Acta Otolaryngol ; 144(3): 168-174, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38753897

RESUMO

BACKGROUND: The pathway by which drugs are injected subcutaneously behind the ear to act on the inner ear has not been fully elucidated. OBJECTIVES: To compare the uptake of gadopentetate dimeglumine (Gd-DTPA) and dexamethasone (Dex) in the cochlea and facial nerve of rats following different administrations. MATERIALS AND METHODS: Magnetic resonance imaging was applied to observe the distribution of Gd-DTPA in the facial nerve and inner ear. We observed the uptake of Dex after it was injected with different methods. RESULTS: Images of the intravenous (IV) and intramuscular (IM) groups showed that the bilateral cochlea of the rat was visualized almost simultaneously. While in the left post-auricular (PA) injection group, it was asynchronous. The maximum accumulation (Cmax) of the Gd in the left facial nerve of the PA group (35.406 ± 5.32) was substantially higher than that of the IV group (16.765 ± 3.7542) (p < .01). CONCLUSIONS: Compared with systemic administration, PA has the advantages of long Gd and Dex action time and high accumulation concentration to treat facial nerve diseases. SIGNIFICANCE: The distribution of Gd and Dex in the inner ear and facial nerve of rats following PA injection might be unique.


Assuntos
Meios de Contraste , Dexametasona , Nervo Facial , Gadolínio DTPA , Imageamento por Ressonância Magnética , Animais , Dexametasona/farmacocinética , Dexametasona/administração & dosagem , Gadolínio DTPA/farmacocinética , Gadolínio DTPA/administração & dosagem , Meios de Contraste/farmacocinética , Meios de Contraste/administração & dosagem , Nervo Facial/metabolismo , Nervo Facial/efeitos dos fármacos , Ratos , Masculino , Ratos Sprague-Dawley , Orelha Interna/metabolismo , Orelha Interna/efeitos dos fármacos , Orelha Interna/diagnóstico por imagem , Injeções Intramusculares
6.
Acta Neurochir (Wien) ; 166(1): 239, 2024 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-38814504

RESUMO

BACKGROUND: Microvascular conflicts in hemifacial spasm typically occur at the facial nerve's root exit zone. While a pure microsurgical approach offers only limited orientation, added endoscopy enhances visibility of the relevant structures without the necessity of cerebellar retraction. METHODS: After a retrosigmoid craniotomy, a microsurgical decompression of the facial nerve is performed with a Teflon bridge. Endoscopic inspection prior and after decompression facilitates optimal Teflon bridge positioning. CONCLUSIONS: Endoscope-assisted microsurgery allows a clear visualization and safe manipulation on the facial nerve at its root exit zone.


Assuntos
Espasmo Hemifacial , Cirurgia de Descompressão Microvascular , Politetrafluoretileno , Humanos , Espasmo Hemifacial/cirurgia , Cirurgia de Descompressão Microvascular/métodos , Nervo Facial/cirurgia , Craniotomia/métodos , Endoscopia/métodos , Neuroendoscopia/métodos , Microcirurgia/métodos , Feminino , Pessoa de Meia-Idade , Masculino
7.
J Craniofac Surg ; 35(4): 1276-1279, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38709061

RESUMO

The purpose of this study was to evaluate the facial nerve recovery of patients with traumatic facial nerve transections after tension-free end-to-end nerve epineural anastomosis during the acute phase. A total of 11 patients with traumatic facial nerve transections during the acute phase were surgically treated in the authors' department from November 2016 to August 2022. The case data and imaging data were collected from the patients, and the House-Brackman evaluation system of the facial nerve was applied to assess the recovery of facial nerve function, and the higher the grade, the worse the facial nerve function. Of the patients, 90.9% recovered to H-B grade II or below, and there were differences in the degree of recovery of the facial nerve function among the branches, and the ones that recovered to H-B grade II or below after surgery were 100% of the zygomatic branch, of which 80% were H-B grade I, 100% of the buccal branch, of which 44.4% were H-B grade I, 88.9% of the marginal mandibular branch, and 66.7% of the temporal branch. The study showed that the recovery rate of young patients was better than that of middle-aged and old people, and the best recovery of each branch of the facial nerve was the zygomatic branch, followed by the buccal branch, the marginal mandibular branch, and the worse was the temporal branch.


Assuntos
Traumatismos do Nervo Facial , Nervo Facial , Recuperação de Função Fisiológica , Humanos , Masculino , Traumatismos do Nervo Facial/cirurgia , Feminino , Pessoa de Meia-Idade , Adulto , Nervo Facial/cirurgia , Idoso , Resultado do Tratamento , Anastomose Cirúrgica/métodos , Adolescente , Adulto Jovem , Paralisia Facial/cirurgia
8.
World Neurosurg ; 187: e759-e768, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38705267

RESUMO

BACKGROUND: Blink reflex (BR) is an oligosynaptic reflex that involves the ophthalmic branch of the trigeminal nerve (TN), ipsilateral main sensory and trigeminospinal nuclei, bilateral facial nuclei, and the facial nerves (FNs). Theoretically, as BR tests the function of both TN and FNs simultaneously, it is an ideal tool for monitoring the status of TN and FNs during skull base surgeries. Nevertheless, it has been used only recently in surgeries as the use of anesthesia limits its use. METHODS: For this systematic review, 2 authors input the search terms [(Blink Reflex) AND (Intraoperative Neuromonitoring OR Neuro Intraoperative Monitoring OR Intraoperative OR NIOM OR IONM) AND (skull base surgery OR Facial Nerve OR Trigeminal Nerve OR Microvascular Decompression OR Hemifacial Spasm)] in MEDLINE through its PubMed interface and other search engines. Articles that fulfilled the inclusion and exclusion criteria were obtained and scrutinized. RESULTS: Seven observational articles with a total of 437 participants were included. All 5 studies that described the use of BR in FN surgery noted that intraoperative BR is beneficial, safe, sensitive, specific, and predictive of outcomes, while 2 articles describing patients with trigeminal neuralgia recommended use of BR in microvascular decompression of TN. CONCLUSIONS: Intraoperative BR is a sensitive, specific, and safe monitoring technique that has good predictability of facial paresis and paresthesia among patients undergoing MVD for trigeminal neuralgia and primary hemifacial spasm and patients undergoing cerebellopontine angle tumor resection.


Assuntos
Piscadela , Nervo Facial , Base do Crânio , Nervo Trigêmeo , Humanos , Piscadela/fisiologia , Nervo Facial/fisiopatologia , Nervo Trigêmeo/cirurgia , Base do Crânio/cirurgia , Prognóstico , Monitorização Neurofisiológica Intraoperatória/métodos , Procedimentos Neurocirúrgicos/métodos , Cirurgia de Descompressão Microvascular/métodos , Monitorização Intraoperatória/métodos , Neuralgia do Trigêmeo/cirurgia , Espasmo Hemifacial/cirurgia , Espasmo Hemifacial/fisiopatologia
9.
Oral Maxillofac Surg Clin North Am ; 36(3): 401-409, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38724423

RESUMO

Facial nerve pathology in children has devastating functional and psychosocial consequences. Facial palsy occurs less commonly in children than adults with a greater proportion caused by congenital causes. Most pediatric patients have normal life expectancy and few comorbidities and dynamic restoration of facial expression is prioritized. This article will focus on the unique aspects of care for facial palsy in the pediatric population.


Assuntos
Doenças do Nervo Facial , Paralisia Facial , Humanos , Criança , Paralisia Facial/etiologia , Nervo Facial
12.
Otol Neurotol ; 45(5): e427-e434, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38693092

RESUMO

OBJECTIVE: To examine the clinical features and surgical outcomes in patients with congenital absence of the oval window (CAOW), and to investigate the potential factors that affect audiologic results. STUDY DESIGN: A retrospective chart review. SETTING: A tertiary academic center. PATIENTS AND INTERVENTION: A total of 17 ears among 16 patients were confirmed to have CAOW. Among them, 13 ears underwent vestibulotomy for hearing reconstruction. Clinical parameters associated with the hearing outcomes were analyzed. MAIN OUTCOME MEASURES: A mean air-bone gap (ABG) after 6-month and long-term follow-up was compared with preoperative measurements. RESULTS: Intraoperative findings showed that anomalies of the malleus or incus were observed in 11 ears (64.7%), stapes anomalies were present in all ears (100%), and facial nerve anomalies were present in 10 ears (58.8%). Because of unfavorable facial nerve anomalies, hearing reconstruction was aborted in four cases (23.5%). In the hearing reconstruction group, the mean ABG at 6 months postoperation was significantly reduced after compared with the preoperative value (44.0 ± 8.4 dB versus 58.8 ± 9.1 dB, p = 0.006). After dividing ears into a success subgroup (ABG ≤ 30 dB, seven ears) and non-success subgroup (ABG > 30 dB, six ears), the use of a drill during vestibulotomy was significantly related to a poor hearing outcome (100% versus 16.7%, p = 0.015). The long-term follow-up result (mean, 60 mo) revealed no deterioration compared with the 6-month postoperative result. Five ears (29.4%) underwent revision surgery, and three of them showed ABG improvements. No serious complications were reported. CONCLUSION: Vestibulotomy is an effective and safe option for hearing restoration in patients with CAOW, particularly when the use of a drill is not required. The long-term audiologic outcome is also reliable.


Assuntos
Janela do Vestíbulo , Humanos , Masculino , Feminino , Estudos Retrospectivos , Adulto , Resultado do Tratamento , Janela do Vestíbulo/cirurgia , Janela do Vestíbulo/anormalidades , Adolescente , Criança , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otológicos/métodos , Nervo Facial/cirurgia , Nervo Facial/fisiopatologia , Nervo Facial/anormalidades , Adulto Jovem , Condução Óssea/fisiologia , Estribo/anormalidades , Audiometria de Tons Puros , Audição/fisiologia , Martelo/cirurgia
14.
Acta Neurochir (Wien) ; 166(1): 168, 2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38575773

RESUMO

BACKGROUND: Apparent diffusion coefficient (ADC) in MRI has been shown to correlate with postoperative House-Brackmann (HB) scores in patients with vestibular schwannoma despite limited methodology. To rectify limitations of single region of interest (ROI) sampling, we hypothesize that whole-tumor ADC histogram analysis will refine the predictive value of this preoperative biomarker related to postoperative facial nerve function. METHODS: Of 155 patients who underwent resection of vestibular schwannoma (2014-2020), 125 patients were included with requisite clinical and radiographic data. After volumetric analysis and whole-tumor ADC histogram, regression tree analysis identified ADC cutoff for significant differences in HB grade. Outcomes were extent of resection, facial nerve function, hospital length of stay (LOS), and complications. RESULTS: Regression tree analysis defined three quantitative ADC groups (× 10-6 mm2/s) as high (> 2248.77; HB 1.7), mid (1468.44-2248.77; HB 3.1), and low (< 1468.44; HB 2.3) range (p 0.04). The mid-range ADC group had significantly worse postoperative HB scores and longer hospital LOS. Large tumor volume was independently predictive of lower rates of gross total resection (p <0.0001), higher postoperative HB score (p 0.002), higher rate of complications (p 0.04), and longer LOS (p 0.003). CONCLUSIONS: Whole-tumor histogram yielded a robust regression tree analysis that defined three ADC groups with significantly different facial nerve outcomes. This likely reflects tumor heterogeneity better than solid-tumor ROI sampling. Whole-tumor ADC warrants further study as a useful radiographic biomarker in patients with vestibular schwannoma who are considering surgical resection.


Assuntos
Neuroma Acústico , Humanos , Neuroma Acústico/diagnóstico por imagem , Neuroma Acústico/cirurgia , Nervo Facial/diagnóstico por imagem , Nervo Facial/cirurgia , Estudos Retrospectivos , Imagem de Difusão por Ressonância Magnética , Biomarcadores , Complicações Pós-Operatórias/etiologia , Resultado do Tratamento
16.
Am J Otolaryngol ; 45(4): 104276, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38604099

RESUMO

OBJECTIVES: Patients with Bell's palsy, the sudden onset of facial paralysis, have variable recovery. Frailty has been recognized as an important factor in predicting recovery. This study investigated the relationship between frailty and facial nerve recovery in Bell's palsy patients. METHODS: A retrospective review was conducted on 95 Bell's palsy patients at a single institution's Department of Otolaryngology from 2014 to 2023. A clinically relevant facial nerve recovery was defined as a House-Brackmann (HB) score decrease>1 between the initial and most recent visit. Patients without follow-up visits or initial HB scores <3 were excluded. Frailty was measured by modified frailty index-5 (mFI-5) at the time of Bell's palsy diagnosis. Elderly patients were those over 65 years at presentation (n = 29). Frail patients had mFI-5 > 1 (n = 8). Chi-squared analyses, Fisher's exact tests, and logistic regression models were conducted in SPSS. RESULTS: The analytic sample included 95 patients (median age = 56.8 years, IQR = 24.1) presenting with an initial HB score > 2. 36 % of patients' HB scores decreased by ≥2 within the follow-up period. Frailty (unadjusted Odds Ratio (OR) = 6.3, 95 % CI = [1.2, 33.1], p = .023) was associated with facial nerve recovery while age was not (unadjusted OR = 1.07, 95 % CI = [0.44, 2.59], p = .889). The mFI-5 adjusted OR was 8.43 (95 % CI = [1.38, 51.4], p = .021) when adjusting for age, gender, treatment modality, access to care, and follow-up duration in a logistic regression. CONCLUSIONS: Frailty correlated with enhanced facial nerve recovery after Bell's palsy in this cohort; age was not significantly associated. Further investigation into factors associated with frailty, including increased surveillance and treatment frequency, is warranted.


Assuntos
Paralisia de Bell , Nervo Facial , Fragilidade , Recuperação de Função Fisiológica , Humanos , Paralisia de Bell/fisiopatologia , Masculino , Feminino , Pessoa de Meia-Idade , Nervo Facial/fisiopatologia , Estudos Retrospectivos , Fragilidade/complicações , Idoso , Adulto
17.
J Clin Neurosci ; 124: 1-14, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38615371

RESUMO

BACKGROUND: Vestibular schwannomas (VS) are benign tumors arising from vestibular nerve's Schwann cells. Surgical resection via retrosigmoid (RS) or middle fossa (MF) is standard, but the optimal approach remains debated. This meta-analysis evaluated RS and MF approaches for VS management, emphasizing hearing preservation and Cranial nerve seven (CN VII) outcomes stratified by tumor size. METHODS: Systematic searches across PubMed, Cochrane, Web of Science, and Embase identified relevant studies. Hearing and CN VII outcomes were gauged using the American Academy of Otolaryngology-Head and Neck Surgery, Gardner Robertson, and House-Brackmann scores. RESULTS: Among 7228 patients, 56 % underwent RS and 44 % MF. For intracanalicular tumors, MF recorded 38 % hearing loss, compared to RS's 54 %. In small tumors (<1.5 cm), MF showed 41 % hearing loss, contrasting RS's lower 15 %. Medium-sized tumors (1.5 cm-2.9 cm) revealed 68 % hearing loss in MF and 55 % in RS. Large tumors (>3cm) were only reported in RS with a hearing loss rate of 62 %. CONCLUSION: Conclusively, while MF may be preferable for intracanalicular tumors, RS demonstrated superior hearing preservation for small to medium-sized tumors. This research underlines the significance of stratified outcomes by tumor size, guiding surgical decisions and enhancing patient outcomes.


Assuntos
Neuroma Acústico , Procedimentos Neurocirúrgicos , Humanos , Fossa Craniana Média/cirurgia , Nervo Facial/cirurgia , Audição/fisiologia , Perda Auditiva/etiologia , Perda Auditiva/prevenção & controle , Perda Auditiva/cirurgia , Neuroma Acústico/cirurgia , Procedimentos Neurocirúrgicos/métodos
18.
Artigo em Chinês | MEDLINE | ID: mdl-38686480

RESUMO

The difficulty of cochlear implantation in patients with congenital microtia is usually increased due to the vague anatomical marks and facial nerve malformation. The common types of facial nerve malformation include facial nerve bony cover loss, aberrant position, and bifurcation malformation. Bifurcation malformation may obscure the oval window, press against stapes, and bifurcate in the vestibular window while obscuring the round window. It is important to correctly identify the facial nerve and choose a reasonable surgical approach to avoid postoperative complications. This article describes a case of profound sensorineural hearing loss due to facial nerve malformation in our institution. The patient underwent cochlear implantation through the retro-facial approach. There was no facial nerve injury or dysfunction symptoms such as facial paralysis and hemifacial spasm 2 years after the operation, and the cochlear implant works well. The score of the categories of the auditory performance(CAP) questionnaire was 7, and the score of the speech intelligibility rating(SIR) questionnaire was 4. When the round window cannot be exposed through the facial recess approach during surgery, the retro-facial approach is a feasible method. To avoid facial nerve injury, a thin-section CT of the temporal bone should be performed before the middle and inner ear surgery for patients with facial nerve malformation, and the intraoperative facial nerve monitor should be used to clarify the course of the facial nerve to avoid injury.


Assuntos
Implante Coclear , Microtia Congênita , Nervo Facial , Humanos , Implante Coclear/métodos , Microtia Congênita/cirurgia , Nervo Facial/anormalidades , Nervo Facial/cirurgia , Perda Auditiva Neurossensorial/cirurgia , Osso Temporal/anormalidades , Osso Temporal/cirurgia
19.
Artigo em Chinês | MEDLINE | ID: mdl-38686470

RESUMO

Objective:To summarize the results of different facial nerve management modalities applied to tumor resection in the jugular foramen region. Methods:The clinical data of 54 patients with tumors in the jugular foramen region who underwent surgery from January 2015 to March 2023 were retrospectively analyzed: 18 males and 36 females; Age ranges from 21 to 67 years, with an average age of 44.4 years; and median follow-up time: 12 months. The House-Brackmann(HB) grading system was applied to assess the patients' facial nerve function before surgery, 1-2 weeks after surgery and at the final follow-up (HBⅠ-Ⅱ grade for good function): 42 cases with preoperative HB grades Ⅰ-Ⅱ; partial facial nerve transposition(9 cases), complete facial nerve transposition(28 cases), and facial nerve excision and re-construction(17 cases) were used, respectively(stage Ⅰor Ⅱ). Relevant factors affecting postoperative facial nerve function were analyzed. Results:Postoperative pathology confirmed 39 cases of paraganglioma, 9 cases of nerve sheath tumor, 3 cases of meningioma, and 1 case each of fibromucinous sarcoma, chondrosarcoma, and intravascular myofibroma. Facial nerve function after partial facial nerve transposition was HB grade Ⅰ-Ⅱ in 89%(8/9); after complete facial nerve transposition was HB grade Ⅰ-Ⅱ in 86%(24/28) in 28 cases; after facial nerve severance and reconstruction was HB grade Ⅰ-Ⅱ in 2/7(Stage Ⅰ) and 0/3(Stage Ⅱ), respectively. Tumor size and surgical approach were correlated with postoperative facial nerve function in patients with facial nerve transposition(P<0.05). There was no statistically significant difference in facial nerve function after complete and partial facial nerve transposition(P>0.05). Conclusion:Intraoperative stretching of the facial nerve may be an important factor affecting facial nerve function during surgical treatment of tumors in the jugular venous foramen region; for patients with facial nerve dissection, facial nerve reconstruction should be adopted according to the situation, aiming at the recovery of facial nerve function.


Assuntos
Nervo Facial , Forâmen Jugular , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Nervo Facial/cirurgia , Estudos Retrospectivos , Idoso , Forâmen Jugular/cirurgia , Adulto Jovem , Meningioma/cirurgia , Paraganglioma/cirurgia , Período Pós-Operatório
20.
Artigo em Chinês | MEDLINE | ID: mdl-38686472

RESUMO

Objective:To retrospectively analyze the effectiveness of transcranial facial nerve bridging in the treatment of facial nerve dysfunction. Methods:A retrospective analysis was conducted on 27 patients with facial nerve dysfunction who underwent transcranial facial nerve bridging at the Eye, Ear, Nose, and Throat Hospital affiliated with Fudan University from 2017 to 2022. The main collected data includes the patient's age, gender, primary lesion, damaged location, interval from facial paralysis to surgery, and preoperative and postoperative House-Brackmann(HB) scale for facial nerve function. Statistical comparisons were made between the average HB level of patients before and after surgery. Results:A total of 27 patients included 17 males and 10 females. The average age of patients during surgery is(42.50±3.38) years old. Primary lateral skull base diseases include trauma(n=3), tumors(n=22), and infections(n=2). The duration of facial paralysis varies from 6 months to 5 years. Statistics analysis has found that the average postoperative HB score of patients who underwent transcranial facial nerve bridging was significantly lower at(3.750 ± 0.183) compared to preoperative(4.875±0.168). The proportion of patients with good facial nerve function increased significantly from 7.4% before surgery to 42.9% after surgery. Conclusion:Transcranial facial nerve bridging surgery with interpositional graft has a significant effect on improving facial nerve function in patients with facial nerve injury. Further research is still needed to evaluate the long-term effectiveness of this surgery, to determine the optimal patient selection criteria and postoperative rehabilitation strategies.


Assuntos
Traumatismos do Nervo Facial , Nervo Facial , Humanos , Masculino , Feminino , Adulto , Estudos Retrospectivos , Traumatismos do Nervo Facial/cirurgia , Nervo Facial/cirurgia , Paralisia Facial/cirurgia , Resultado do Tratamento , Pessoa de Meia-Idade
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...