Physiotherapy Outcomes in a male patient with Post-traumatic Bilateral Facial Nerve Paralysis: a case report (original) (raw)
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Nonsurgical Treatment for Posttraumatic Complete Facial Nerve Paralysis
JAMA otolaryngology-- head & neck surgery, 2018
Current recommendations envisage early surgical exploration for complete facial nerve paralysis associated with temporal bone fracture and unfavorable electrophysiologic features (response to electroneuronography, <5%). However, the evidence base for such a practice is weak, with the potential for spontaneous improvement being unknown, and the expected results from alternative nonsurgical treatment also undefined. To document the results of nonsurgical treatment for posttraumatic complete facial paralysis with undisplaced temporal bone fracture and unfavorable electrophysiologic features. Prospective cohort study recruiting from April 2010 to April 2013 at a tertiary care university hospital. Follow-up continued until 9 months or until complete recovery if earlier. Study group included 28 patients with head injury-associated complete unilateral facial nerve paralysis with unfavorable results of electroneuronography (<5% response) with or without undisplaced temporal bone fract...
Evaluation of Clinical Outcome in Traumatic Facial Nerve Paralysis
2021
Introduction The facial nerve is the most commonly paralyzed nerve in the human body, resulting in far-reaching functional, aesthetic and emotional concerns to the patient. Objective Evaluation of the clinical outcome of 47 patients with traumatic facial nerve paralyses, with respect to clinical recovery and audiological sequelae. Methods A descriptive longitudinal study was conducted over 24 months between January 2017 and December 2018 at a tertiary center with detailed clinical, topodiagnostic, audiometric and radiological evaluation and regular follow-up after discharge. Results Road traffic accidents constituted 82.98% of the trauma cases, out of which 76.60% were found to be under the influence of alcohol. Delayed facial paralysis was observed in 76.60% cases. Temporal bone fracture was reported in 89.36%, with otic capsule (OC) sparing fractures forming 91.49% of the cases. Topologically, the injury was mostly at the suprachordal region around the second genu. The majority of...
Efficacy of Surgical Treatment in Patients with Post-traumatic Facial Nerve Palsy
Otolaryngologia Polska, 2021
Introduction: The most common mechanism of post-traumatic facial nerve palsy are road accidents and falls. Treatment schemes as well as proper timing of surgery are still controversial. Purpose: The aim of the study was the evaluation of the effects of surgical treatment in patients with post-traumatic facial nerve palsy. Treatment results were correlated with epidemiological factors, mechanism of injury, level of nerve damage, time of surgery and its extent. Material and methods: 9 patients with facial nerve palsy after head trauma were analyzed. In all patients complete paresis of the VII nerve occurred immediately after the injury. In 5 patients the nerve was damaged in the course of the longitudinal fracture of the temporal bone, in 3 as a result of its transverse fracture while in one woman there was no evident fracture line. In all cases, surgical treatment was performed between 4 days and 13 weeks after the trauma. In all cases transmastoid approach was used. Edema lesions of...
Rehabilitation of patients with facial nerve injuries after neurosurgical treatment
Vestnik of Saint Petersburg University. Medicine, 2020
The facial nerve is most often, as compared with other cranial nerves, damaged due to surgical interventions. In the first place, as the cause of iatrogenic damage, is neurosurgical treatment for neoplasms of the ponto-cerebellar angle and temporal bone, brain injuries. The neuropathy of the facial nerve is the cause of neurological and cosmetic defects that have a serious traumatic effect on the patient. The psychological consequences of facial neuropathy are more important for the patient than physical damage. Paresis of mimic muscles cannot be hidden and often leads to social maladjustment, isolation and a marked reduction in the quality of life. Facial neuropathy, in most cases, is not a life-threatening condition, but it definitely changes the patient’s life. This article proposes an effective rehabilitation system, tested on 172 patients with facial nerve damage after neurosurgical treatment. The combined use of physiotherapy, massage, therapeutic gymnastics, including posture...
JMS SKIMS
BACKGROUND: Bell's palsy is an acute weakness of seventh cranial nerve leading to loss of movement on one side of the face. It usually recovers of its own without treatment in most of the patients but not all. Physical therapy in the form of electrotherapy, massage and facial exercises is used as adjuvant to hasten recovery. OBJECTIVES: To analyze the role of physiotherapy in the form of electrotherapy in patients with peripheral facial paralysis attending multispecialty hospital in Kashmir. METHODS: A prospective study was carried out on 50 patients of facial nerve paralysis attending OPD between Jan 2009 and Jan 2010. All of the patients were subjected to medical treatment. The patients were put to Physical Therapy in the form of electrotherapy followed by facial exercises. All patients received electrotherapy to the paralyzed facial muscles for a period of 2 weeks but some were given extended doses for 4 weeks. 20 patients presented for the treatment in the first week, 12 in ...
Recovery of Facial Nerve Paralysis After Temporal Nerve Reconstruction: A Case Report
Trauma Monthly, 2015
Introduction: Facial paralysis is common following accidents, trauma, viral infection or tumors. Case Presentation: A 24-year-old male patient was referred to us with a history of sharp penetrating trauma to the right temporal region causing unilateral paralysis of the muscles of the right forehead. He was unable to scowl or elevate his right eyebrow and there were no folds on his right forehead. Anastomosis of branches of the temporal nerve was done one month after trauma following regular physical therapy sessions, outcome was good and paralysis of the muscles of the right forehead improved after several months. Conclusions: Immediate repair of the facial nerve injury will improve the process of recovery and rehabilitation of the face and forehead muscles and may play a very important role in the patient's mental satisfaction and improve their quality of life.
Facial Paralysis after Trauma: A Simplified Method to Find and Repair the Facial Nerve
Otolaryngology, 2018
This study aims to identify the digastric nerve as an alternative to access the facial nerve in case of post-traumatic facial nerve paralysis. Study design Retrospective study. Setting Tertiary care hospital. Subjects and Methods Eleven peripheric facial paralysis cases between 2005-2016 following trauma to the parotid gland are presented. Initial emergency treatments were done elsewhere but all returned back to treat facial paralysis after 11-18 months to our institute. The digastric nerve was identified and a facial-hypoglossal nerve anastomosis was performed. Results Pre-operative House-Brackmann scores were 6 for all cases. Post-operative scores were between 3 and 4. Pre-operative needle electromyography revealed no motor unit action potentials; after 7 months post-operatively, we had motor unit action potentials in every case. Conclusion In cases of trauma and secondary approaches of the parotid gland, a safe step for finding the facial nerve is to find the digastric nerve and follow it through the main trunk.
Facial nerve trauma: evaluation and considerations in management
Craniomaxillofacial trauma & reconstruction, 2015
The management of facial paralysis continues to evolve. Understanding the facial nerve anatomy and the different methods of evaluating the degree of facial nerve injury are crucial for successful management. When the facial nerve is transected, direct coaptation leads to the best outcome, followed by interpositional nerve grafting. In cases where motor end plates are still intact but a primary repair or graft is not feasible, a nerve transfer should be employed. When complete muscle atrophy has occurred, regional muscle transfer or free flap reconstruction is an option. When dynamic reanimation cannot be undertaken, static procedures offer some benefit. Adjunctive tools such as botulinum toxin injection and biofeedback can be helpful. Several new treatment modalities lie on the horizon which hold potential to alter the current treatment algorithm.
International Ophthalmology Clinics, 2002
Because speech, mastication, and expression of moods and emotions are based on the ability to move facial musculature-be it voluntary or involuntary-successful treatment of facial nerve paralysis is a vital concern. This article informs the reader about the extracranial etiology of facial nerve paralysis and its current reconstructive options.The diagram below presents a treatment algorithm for facial nerve paralysis according to facial region involvement. Treatment algorithm according to facial region involvement. Anatomy The keystone of successful surgical treatment for facial paralysis, the details of facial nerve anatomy, is recapitulated briefly to review topographic anatomy of the facial nerve and to enable the physician to localize the suspected site of injury. (See the image below.) Facial nerve anatomy.