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1.
J Stroke Cerebrovasc Dis ; 29(11): 105139, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33066880
2.
Vestn Oftalmol ; 136(5): 52-57, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33056964

RESUMO

Combined lesions of the facial and trigeminal cranial nerves are typical after neurosurgical treatment. Violation of the innervation of orbicularis muscle leads to inability to completely close the eyelids, while denervation of the cornea is often manifested as a long-term ongoing and recurring neurotrophic keratitis. The restoration of corneal innervation is a pathogenetically targeted treatment for this pathology. For this purpose, neurotrophic keratitis could be reversed via the method of corneal neurotization using contralateral n. ophthalmicus. The presented clinical case demonstrates the results of the first operation of neurotization of the cornea in a patient with combined lesions of the facial and trigeminal nerves.


Assuntos
Distrofias Hereditárias da Córnea , Paralisia Facial , Ceratite , Transferência de Nervo , Córnea/cirurgia , Paralisia Facial/diagnóstico , Paralisia Facial/etiologia , Paralisia Facial/cirurgia , Humanos , Ceratite/complicações , Ceratite/diagnóstico
3.
J Biol Regul Homeost Agents ; 34(4): 1245-1255, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32935528

RESUMO

Idiopathic facial palsy is the most common disease of the VII cranial nerve. There are many treatments to facilitate recovery from this condition: pharmacological, surgical, rehabilitative, but the effectiveness of some of these treatments, especially the latter, is still under discussion. The purpose of this umbrella review of systematic reviews is to analyse the literature in order to investigate the different rehabilitation interventions in patients suffering from idiopathic facial palsy. A scientific literature search was carried out from January 2009 until August 2019, using Mesh the terms "facial palsy", "Bell's Palsy", "idiopathic facial nerve palsy", combined with "rehabilitation" and "therapy". Initially all the systematic reviews and meta-analyses of the last 10 years concerning rehabilitation treatments for the recovery of injured functions in facial palsy were included. Given the heterogeneity of the studies in the literature, which do not differentiate the different causes of facial palsy, all the causes of idiopathic facial palsy were included in the review. The research resulted in 94 published systematic reviews but only 6 were considered in respect to the inclusion criteria. All studies agree on the lack of high-quality scientific work to be able to say that Bell's physiotherapy treatments for facial palsy are effective, in particular with regard to recovery times during the rehabilitation process. Future studies are needed, in order to highlight the therapeutic implications of the different rehabilitation methods, with standardized protocols, in patients suffering from facial palsy of different aetiology.


Assuntos
Paralisia de Bell , Paralisia Facial , Paralisia de Bell/etiologia , Paralisia de Bell/terapia , Paralisia Facial/etiologia , Paralisia Facial/terapia , Humanos , Metanálise como Assunto , Modalidades de Fisioterapia , Revisões Sistemáticas como Assunto
5.
BMJ Case Rep ; 13(8)2020 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-32784234

RESUMO

Acute facial nerve disease leading to peripheral facial paralysis is commonly associated with viral infections. COVID-19 may be a potential cause of peripheral facial paralysis and neurological symptoms could be the first and only manifestation of the disease. We report a case of a term pregnancy diagnosed with COVID-19 after presenting with isolated peripheral facial palsy.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Paralisia Facial/etiologia , Pneumonia Viral/complicações , Complicações Infecciosas na Gravidez/etiologia , Adulto , Paralisia Facial/terapia , Feminino , Humanos , Pandemias , Modalidades de Fisioterapia , Gravidez , Complicações Infecciosas na Gravidez/terapia
6.
AJNR Am J Neuroradiol ; 41(9): 1707-1711, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32586958

RESUMO

We report a case of bifacial weakness with paresthesia, a recognized Guillain-Barré syndrome subtype characterized by rapidly progressive facial weakness and paresthesia without ataxia or other cranial neuropathies, which was temporally associated with antecedent coronavirus 2019 (COVID-19). This case highlights a potentially novel but critically important neurologic association of the COVID-19 disease process. Herein, we detail the clinicoradiologic work-up and diagnosis, clinical course, and multidisciplinary medical management of this patient with COVID-19. This case is illustrative of the increasingly recognized but potentially underreported neurologic manifestations of COVID-19, which must be considered and further investigated in this pandemic disease.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Paralisia Facial/etiologia , Síndrome de Guillain-Barré/complicações , Parestesia/etiologia , Pneumonia Viral/complicações , Humanos , Masculino , Pandemias , Adulto Jovem
10.
J Clin Neurosci ; 77: 230-232, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32410788

RESUMO

We present a case of facial diplegia after 10 days of SARS-CoV-2 confirmed infection symptoms in a 61 year old patient without prior clinically relevant background. There are few known cases of Guillain-Barré Syndrome (GBS) related to SARS-CoV-2 infection; we propose this case as a rare variant of GBS in COVID-19 infection context, due to Its chronology, clinical manifestations and cerebrospinal fluid (CSF) findings.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/complicações , Paralisia Facial/etiologia , Pneumonia Viral/complicações , Infecções por Coronavirus/virologia , Paralisia Facial/diagnóstico , Paralisia Facial/virologia , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/etiologia , Síndrome de Guillain-Barré/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia
11.
J Laryngol Otol ; 134(5): 409-414, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32425144

RESUMO

OBJECTIVE: To investigate the prevalence of bony dehiscence in the tympanic facial canal in patients with acute otitis media with facial paresis compared to those without facial paresis. METHOD: A retrospective case-control study was conducted on acute otitis media patients with facial paresis undergoing high-resolution temporal bone computed tomography. RESULTS: Forty-eight patients were included (24 per group). Definitive determination of the presence of a bony dehiscence was possible in 44 out of 48 patients (91.7 per cent). Prevalence of bony dehiscence in acute otitis media patients with facial paresis was not different from that in acute otitis media patients without facial paresis (p = 0.21). Presence of a bony dehiscence was associated with a positive predictive value of 66.7 per cent in regard to development of facial paresis. However, an intact bony tympanic facial canal did not prevent facial paresis in 44.8 per cent of cases (95 per cent confidence interval = 34.6-55.6). CONCLUSION: Prevalence of bony dehiscence in acute otitis media patients with facial paresis did not differ from that in acute otitis media patients without facial paresis. An intact tympanic bony facial canal does not protect from facial paresis development.


Assuntos
Orelha Média , Paralisia Facial/etiologia , Otite Média/complicações , Doença Aguda , Adulto , Estudos de Casos e Controles , Paralisia Facial/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Otite Média/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
15.
Acta otorrinolaringol. esp ; 71(2): 99-118, mar.-abr. 2020. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-192447

RESUMO

La parálisis de Bell es la forma más común de paresia o parálisis facial. Sin embargo, no todos los pacientes con parálisis facial tienen una parálisis de Bell. Otras causas frecuentes incluyen las secuelas del tratamiento del neurinoma del VIII par, el cáncer de cabeza y cuello, la iatrogenia, el zóster ótico y los traumatismos. El abordaje de cada una de estas situaciones es totalmente diferente. El objetivo de esta guía es servir de consejo para el tratamiento y el seguimiento de los pacientes con parálisis facial. Nuestra idea es que la guía sea práctica, haciendo hincapié en recomendaciones efectivas y útiles en el manejo diario de los pacientes. Esta guía ha sido promovida por la Sociedad Española de ORL y escrita por médicos con experiencia en la enfermedad del nervio facial, incluyendo al menos un especialista de cada comunidad autónoma. Redactada en un formato de preguntas y respuestas, incluye 56 cuestiones relevantes relacionadas con el nervio facial


Bell's palsy is the most common diagnosis associated with facial nerve weakness or paralysis. However, not all patients with facial paresis/paralysis have Bell's palsy. Other common causes include treatment of vestibular schwannoma, head and neck tumours, iatrogenic injuries, Herpes zoster, or trauma. The approach to each of these conditions varies widely. The purpose of this guideline is to provide clinicians with guidance on the treatment and monitoring of patients with different causes of facial paralysis. We intend to draft a practical guideline, focusing on operationalised recommendations deemed to be useful in the daily management of patients. This guideline was promoted by the Spanish Society of Otolaryngology and developed by a group of physicians with an interest in facial nerve disorders, including at least one physician from each Autonomous Community. In a question and answer format, it includes 56 relevant topics related to the facial nerve


Assuntos
Humanos , Paralisia Facial/diagnóstico , Paralisia Facial/terapia , Sociedades Médicas/normas , Otolaringologia/métodos , Paralisia de Bell/etiologia , Espanha , Nervo Facial/fisiopatologia , Paralisia Facial/etiologia
16.
World Neurosurg ; 139: 182-185, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32305607

RESUMO

BACKGROUND: Intracranial bronchogenic cysts (BCs) are extremely rare. To our knowledge, this is the first report of a BC in which lesions involve the middle and posterior cranial fossa, as well as the infratemporal fossa. CASE DESCRIPTION: We present the case of a 38-year-old woman who suffered from a cranial nerve dysfunction for 2 years. Magnetic resonance imaging showed that there were skull base communication lesions across the middle and posterior fossa. The patient was operated on through an infratemporal fossa approach. The final diagnosis was BC after histopathologic examination and immunohistochemical verification. The patient's neurologic dysfunction was partially ameliorated at the half-year follow-up. CONCLUSIONS: Intracranial BCs are rare. However, they should be considered in the differential diagnosis for cystic lesions with edge enhancement or extracranial extension.


Assuntos
Cisto Broncogênico/cirurgia , Base do Crânio/cirurgia , Adulto , Cisto Broncogênico/complicações , Cisto Broncogênico/diagnóstico por imagem , Cisto Broncogênico/patologia , Fossa Craniana Média , Fossa Craniana Posterior , Craniotomia , Paralisia Facial/etiologia , Feminino , Perda Auditiva/etiologia , Humanos , Hipestesia/etiologia , Imagem por Ressonância Magnética , Procedimentos Neurocirúrgicos , Base do Crânio/diagnóstico por imagem , Base do Crânio/patologia , Tomografia Computadorizada por Raios X
17.
J Laryngol Otol ; 134(3): 205-212, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32122408

RESUMO

OBJECTIVE: To review the management of temporal bone fractures at a major trauma centre and introduce an evidence-based protocol. METHODS: A review of reports of head computed tomography performed for trauma from January 2012 to July 2018 was conducted. Recorded data fields included: mode of trauma, patient age, associated intracranial injury, mortality, temporal bone fracture pattern, symptoms and intervention. RESULTS: Of 815 temporal bone fracture cases, records for 165 patients met the inclusion criteria; detailed analysis was performed on the records of these patients. CONCLUSION: Temporal bone fractures represent high-energy trauma. Initial management focuses on stabilisation of the patient and treatment of associated intracranial injury. Acute ENT intervention is directed towards the management of facial palsy and cerebrospinal fluid leak, and often requires multidisciplinary team input. The role of nerve conduction assessment for immediate facial palsy is variable across the UK. The administration of high-dose steroids in patients with temporal bone fracture and intracranial injury is not advised. A robust evidence-based approach is introduced for the management of significant ENT complications associated with temporal bone fractures.


Assuntos
Prática Clínica Baseada em Evidências/métodos , Equipe de Assistência ao Paciente , Fraturas Cranianas/terapia , Osso Temporal/lesões , Adulto , Vazamento de Líquido Cefalorraquidiano/etiologia , Vazamento de Líquido Cefalorraquidiano/terapia , Criança , Protocolos Clínicos , Paralisia Facial/etiologia , Paralisia Facial/terapia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fraturas Cranianas/complicações , Fraturas Cranianas/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Centros de Traumatologia , Reino Unido
18.
Acta Neurochir (Wien) ; 162(5): 1205-1213, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32152754

RESUMO

BACKGROUND: Facial nerve palsy is a severe morbid condition that occurs after vestibular schwannoma (VS) surgery. The objective of this study was to evaluate facial nerve outcomes based on surgical techniques, tumour size, and immunohistochemical factors. METHODS: One hundred eighteen patients with VS were retrospectively analysed. Gross total resection (GTR) was achieved in 83 patients, and subtotal resection (STR) was achieved in 35 patients. Follow-up was 60 months (median). Facial nerve outcomes were assessed for 24 months after surgery. Analysis of the MIB-1 index was performed in 114 patients (97%) to evaluate recurrence and facial nerve outcomes. RESULTS: Immediately after surgery, 16 of 35 patients (45.7%) with STR and 21 of 83 patients (25.3%) with GTR had a good (House-Brackmann (HB) score ≤ 2) facial nerve outcome (p = 0.029). Semi-sitting positioning (p = 0.002) and tumour size class of 3 (> 4 cm) were also associated with worse HB outcomes after 2 years (p = 0.004) in univariate analyses. The MIB-1 index was significantly correlated with diffuse infiltration of tumour-associated CD45+ lymphocytes (r = 0.63, p = 0.015) and CD68+ macrophages (r = 0.43, p = 0.021). ROC analysis found an AUC of 0.73 (95% CI = 0.60-0.86, p = 0.003) for the MIB-1 index in predicting poor facial nerve outcomes. Binary logistic regression analysis revealed an MIB-1 index ≥ 5% (16/28 (57.1%) vs. 5/40 (12.5%); p < 0.001, OR = 14.0, 95% CI = 3.2-61.1) and a tumour size class of 3 (6/8 (75.0%) vs. 2/8 (25.0%); p = 0.01, OR = 14.56, 95% CI = 1.9-113.4) were predictors of poor HB scores (≥ 3) after 1 year. CONCLUSIONS: An MIB-1 index ≥ 5% seems to predict worse long-term facial nerve outcomes in VS surgery.


Assuntos
Paralisia Facial/epidemiologia , Antígeno Ki-67/metabolismo , Neuroma Acústico/cirurgia , Procedimentos Neurocirúrgicos/métodos , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Nervo Facial/cirurgia , Paralisia Facial/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neuroma Acústico/metabolismo , Procedimentos Neurocirúrgicos/efeitos adversos
19.
Plast Reconstr Surg ; 145(3): 791-801, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32097327

RESUMO

BACKGROUND: Corneal protection is a priority in flaccid facial palsy patients. Denervation of the orbicularis oculi muscle results in weak palpebral closure and predisposes patients to severe corneal sequelae. While periorbital static procedures enhance corneal coverage in repose, voluntary closure is only regained through dynamic reinnervation of the muscle. This study aims to elucidate the added effect of dynamic reinnervation of the orbicularis oculi muscle on long-term corneal integrity as well as on dynamic closure of the palpebral aperture. METHODS: Retrospective review was performed on two groups of complete palsy patients: those who received solely periorbital static procedures and those who underwent concomitant orbicularis oculi muscle reinnervation and static lid procedures. Only patients with complete ophthalmic examinations were included. Corneal punctate epithelial erosions in addition to static and dynamic palpebral measurements were serially assessed preoperatively and postoperatively. RESULTS: Of 272 facial palsy patients, 26 fit the inclusion criteria. Eleven patients underwent combined muscle reinnervation involving facial-to-masseteric nerve coaptation in addition to static eye procedures, and 15 patients underwent solely static interventions. Analysis revealed a 65.3 percent lower mean punctate epithelial erosion score in reinnervation patients as compared with static patients when evaluated at more than 9 months postoperatively (p < 0.01). Reinnervation patients were also found to have 25.3 percent greater palpebral aperture closure (p < 0.05) and 32.8 percent higher closure velocity (p < 0.01) compared with static patients. CONCLUSION: In patients with subacute facial palsy, dynamic reanimation of the orbicularis oculi muscle with concomitant static interventions provides lasting corneal protection not seen in patients who receive solely static interventions. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.


Assuntos
Doenças da Córnea/prevenção & controle , Músculos Faciais/inervação , Doenças do Nervo Facial/cirurgia , Paralisia Facial/cirurgia , Transferência de Nervo/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Piscadela/fisiologia , Criança , Córnea/diagnóstico por imagem , Córnea/patologia , Doenças da Córnea/diagnóstico , Doenças da Córnea/etiologia , Doenças da Córnea/fisiopatologia , Pálpebras/fisiopatologia , Pálpebras/cirurgia , Músculos Faciais/cirurgia , Nervo Facial/cirurgia , Doenças do Nervo Facial/complicações , Paralisia Facial/etiologia , Feminino , Humanos , Masculino , Nervo Mandibular/transplante , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
20.
Cancer Radiother ; 24(2): 135-137, 2020 Apr.
Artigo em Francês | MEDLINE | ID: mdl-31992517

RESUMO

We report a rare case of salivary duct carcinoma and we study its clinical and evolutionary features. A 64-year-old patient was referred for right peripheral facial paralysis. MRI showed suspected formation of the right parotid gland. Treatment included total parotidectomy and ipsilateral neck lymph node dissection. The histology concluded to a ductal carcinoma of the parotid with lymph node metastasis. Radiation therapy has been indicated. Salivary duct carcinoma of the parotid gland is a highly aggressive and uncommon tumor. Treatment of localized forms is based on surgery and radiotherapy.


Assuntos
Carcinoma Ductal , Neoplasias Parotídeas , Carcinoma Ductal/complicações , Carcinoma Ductal/diagnóstico por imagem , Carcinoma Ductal/patologia , Carcinoma Ductal/terapia , Paralisia Facial/etiologia , Humanos , Excisão de Linfonodo , Metástase Linfática , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias Parotídeas/complicações , Neoplasias Parotídeas/diagnóstico por imagem , Neoplasias Parotídeas/patologia , Neoplasias Parotídeas/terapia
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