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At least 361 records · Page 20Linked to original sources
PubMed2003

The anatomy of buccinator--insights from functional casts of the oral vestibule.

OBJECTIVE: When a dental elastomer is placed in the oral vestibule and the facial muscles contracted while it sets, the functional cast produced frequently shows a deep anteroposterior groove, and marked posterosuperior and smaller anteroinferior bulges. This study investigates whether these features have a structural or a physiological basis. DESIGN: Casts of the right side of the oral vestibule of dissecting room cadavers and living volunteers were made using a polyvinylsiloxane dental elastomer. The volunteers each produced two functional casts in each of the following situations: while the teeth were clenched but the facial muscles inactive, while grimacing, and while swallowing. RESULTS: Grooves and bulges were largely absent in casts from the dissecting room cadavers and of living volunteers with the teeth clenched but the facial muscles inactive. They were present when the elastomer set while the subjects grimaced but most marked when they had been swallowing their saliva. The depth of the grooves varied between individuals and generally was greatest alongside the second molar teeth. We found that the posterosuperior bulge did not coincide with the position of the parotid duct. CONCLUSIONS: The anteroposterior groove represents a well developed horizontal part of buccinator. The regions of the casts bulging superior and inferior to the groove probably represent weaker regions of buccinator towards its maxillary and mandibular attachments. The bulge superior to the groove was not explained by a weakness in buccinator where it is pierced by the parotid duct.

Adult↗
PubMed1994

Occurrence of the ventral component of the third branchial nerve as the supernumerary branch of the glossopharyngeal nerve.

The authors found supernumerary branches of the glossopharyngeal nerve in 7 out of 368 head sides (184 bodies) of Japanese individuals. The branches entered the submandibular triangle and connected with the superficial cervical ansa. Teasing revealed that the components of the glossopharyngeal nerve were distributed not only in the subcutaneous layer of the neck but also in the lower facial muscles such as the orbicularis oris. This suggests that the third branchial arch sometimes participates in the formation of the facial muscles which are usually composed of the ventral component of the second branchial arch. Therefore, this supernumerary branch of the glossopharyngeal nerve is probably the ventral component of the third branchial nerve, which is originally distributed in the ventral component of the third branchial arch and usually disappears during later development. The present findings will clearly show how the branchiogenous region is demarcated against the somatic body wall.

Aged↗
PubMed2002

Lateral spread response elicited by double stimulation in patients with hemifacial spasm.

In patients with hemifacial spasm (HFS), a lateral spread response (or abnormal muscle response) is recorded from facial muscles after facial nerve stimulation. The origin of this response is not completely understood. We studied the lateral spread responses elicited by double stimulation in 12 patients with HFS during microvascular decompression. The response was recorded from the mentalis muscle by electrical stimulation of the temporal branch of the facial nerve or from the orbicularis oculi muscles by stimulation of the marginal mandibular branch. The interstimulus intervals (ISIs) of double stimulation ranged from 0.5 to 7.0 ms. R1 was defined as the response elicited by the first stimulus, and R2 as the response elicited by the second stimulus. R1 had a constant latency and amplitude regardless of the ISI, whereas R2 appeared after a fixed refractory period without facilitation or depression in a recovery curve of latency and amplitude. From these findings, we consider that the lateral spread response is due to cross-transmission of facial nerve fibers at the site of vascular compression rather than arising from facial nerve motor neurons.

Adult↗
PubMed1987

Facial-nerve and vocal-cord monitoring during otoneurosurgical operations.

We describe a newly developed instrument to monitor facial muscles and vocal-cord function during neurosurgical and otoneurosurgical operations. The device (Myo-Alarm) transforms into acoustic signals the pressure variations that are induced by facial muscles and vocal-cord contractions on air-inflated rubber sensors that are positioned, respectively, beneath the superior lip and between the vocal cords. It represents an effective and dependable method to monitor facial and vocal-cord functional preservation during surgery.

Ear↗
PubMed1999

The influence of the muscles of facial expression on the development of the midface and the nose in cleft lip and palate patients. A reflection of functional anatomy, facial esthetics and physiology of the nose.

The further improvement of well-established techniques in primary and secondary cleft surgery requires a detailed and interdisciplinary knowledge and observation of anatomical, functional and developmental problems. An investigation into the macroscopic and microscopic anatomy of the perinasal and perioral muscles and parts of the human nasal septum, as well as into the pathomorphology of ancient skulls with untreated clefts is presented. On this basis an interpretation of clinical findings in untreated newborns compared with surgically treated CLP-patients has been undertaken. The 3D-CT, superimposing photography and coloured experimental settings of nasal airflow complete the visualisation of the anatomical and functional findings.

Adult↗
PubMed1998

Permanent rescue of lesioned neonatal motoneurons and enhanced axonal regeneration by adenovirus-mediated expression of glial cell-line-derived neurotrophic factor.

Axotomy of peripheral nerves in neonatal rats induces motoneuron death that can be delayed but not arrested by the application of several neurotrophic factors (NFs) or adenoviral vectors carrying genes for NFs. We tested whether an adenoviral vector carrying the gene for glial cell-line-derived neurotrophic factor (Adv.RSV-GDNF) would prevent neonatal motoneuron death after facial nerve transection or crush. Nerve transection eliminates the pathway for axonal regeneration, while nerve crush preserves the pathway necessary for target reinnervation that may be required for the permanent rescue of motoneurons. Both types of injury cause substantial motoneuron death in neonatal animals. Adv.RSV-GDNF or a control vector carrying the beta-galactosidase gene (Adv.RSV-betagal) was injected into facial muscles 2 days before the nerve was transected, or Adv.RSV-GDNF, Adv.RSV-betagal, Adv.d1312 (a vector lacking a transgene), or vehicle was injected into facial muscles immediately after nerve crush. Four weeks after nerve transection, few motoneurons survived after Adv.RSV-GDNF and Adv.RSV-betagal treatment (6.1% and 2.4%, respectively). Four weeks after nerve crush, 40% of the motoneurons survived after Adv.RSV-GDNF treatment but only 17% survived in control groups. By 20 weeks, 39% of the motoneurons of the Adv.RSV-GDNF treatment groups survived but only 15-19% survived in controls. The numbers of myelinated axons of the buccal nerve branch of Adv.RSV-GDNF treatment groups were also higher than controls at 4 and 20 weeks (24% and 100% compared to 4.4-6.2% and 25-33% for Adv.RSV-GDNF and controls, respectively). By 20 weeks, Adv.RSV-GDNF-treated animals recovered 50% of the contralateral vibrissal function, while in controls only 5-11% of function was restored.

Adenoviridae↗
PubMed1990

Topography of the facial musculature within the facial (VII) motor nucleus of the neonatal rat.

WGA-HRP, HRP and fluorescent tracers were used to determine the representation of the facial muscles in the facial motor nuclear complex (FMNC) of the newborn rat. Tracer injections of the superficial cervical and anterior mandibular portions of platysma, the orbicularis oculi muscle, the nasolabial musculature and the posterior auricular musculature revealed an adult-like topographic organization across FMNC subnuclei. Tracer delivery to individual vibrissa follicle loci of the whiskerpad also demonstrated an adult-like musculotopic organization within the lateral subnucleus.

Animals↗
PubMed1999

Insulin-like growth factor-I promotes nerve regeneration through a nerve graft in an experimental model of facial paralysis.

Among the pathological sequelae of facial paralysis is a paralytic eye. Apart from the psychological and aesthetic deficits, facial paralysis if left untreated can lead to dryness, ulceration and eventual blindness. Although numerous restorative microsurgical approaches have been introduced to address the sequelae of this problem, complete restoration of function to denervated facial muscles remains elusive.Utilizing the rat model of facial paralysis the present research has as an objective to examine a dual treatment approach. Specifically, this study combined the current microsurgical treatment of the cross-facial nerve graft with local administration of insulin-like growth factor I (IGF-I).The efficacy of this combined approach (cross-facial nerve graft + IGF-I) was assessed in the following ways: (a) behavior measurement of the blink response and (b) histomorphometry light and electron microscopy of the entire nerve graft. These data will help provide insight into the restoration of facial muscle function after trauma and assist in the future development of more potent treatment strategies.7he local adnünistration of IGF-I (50 micro g/ml) to the cross-facial nerve graft was found to restore the blink response faster and to strengthen the degree of eye closure. Light microscopy examination revealed that IGF-I significantly enhanced axonal regeneration within a nerve graft (a 22% increase in the mean number of axons), and increased the mean nerve fiber diameter and myelin thickness. Electron microscopy assessment of the nerve grafts demonstrated that the IGF-I treated grafts possessed a greater density of microtubules, which were evenly distributed within the axoplasm.

Journal Article↗
PubMed1988

Neuromuscular and cardiovascular effects of atracurium administered to healthy horses anesthetized with halothane.

Neuromuscular and cardiovascular effects of atracurium, a nondepolarizing neuromuscular blocking agent, were evaluated in 10 halothane-anesthetized adult horses. Hind limb digital extensor tension (hoof twitch) was measured with a strain gauge to quantitate the muscle relaxant effects of atracurium. Response of facial muscles was compared with hoof twitch. Five injections of atracurium were given. Initial mean (+/- SEM) dosage of 0.07 +/- 0.01 mg of atracurium/kg of body weight caused 98.6 +/- 0.8% reduction of the preinjection hoof twitch. Subsequent dosages of 0.04 +/- 0.003 mg/kg induced a degree of relaxation similar to that induced by the initial dose. Duration of paralysis from maximal effect to 10% recovery of twitch was 12.2 +/- 1.5 minutes for the first injection. This was significantly (P less than 0.05) different from subsequent paralysis periods, which lasted approximately 7 minutes. The 10% to 75% recovery time after all injections was similar-approximately 16 minutes. The facial muscles were less affected objectively by atracurium than was the hind limb. Atracurium did not cause cardiovascular changes. When the hoof twitch had recovered to 95% of its tension before atracurium administration, 0.5 mg of edrophonium/kg, was given to antagonize neuromuscular blockade. Within 5 minutes of edrophonium administration, twitch tension exceeded that measured before atracurium administrations. Within 2 minutes of edrophonium administration, blood pressure began to increase and continued to increase approximately 10 mm of Hg above the value measured before edrophonium administration. Heart rate was not affected by edrophonium. Other muscarinic side effects of edrophonium were not observed. Of the 10 horses, 9 had good, unremarkable recovery to standing position. One horse had a violent recovery period.

Anesthesia, Inhalation↗
PubMed1991

Regional differences in the orbicularis oculi muscle: conservation between species.

The orbicularis oculi muscle is a complex facial muscle involved in eyelid closure. The central parts of pretarsal and preseptal regions of the palpebral part of the orbicularis oculi muscle in rabbit and cynomolgus monkey lower eyelids were examined histologically and were analyzed for muscle fiber number, muscle fiber cross-sectional area and fiber type composition. Distinct regional differences were seen in the muscle fiber composition in these two regions of the muscle. The pretarsal portion of the muscle, that closest to the eyelid margin, was quite homogeneous and almost completely composed of type 2 fibers. These fibers were the smallest in cross-sectional area. Type 2 fibers also predominated in the preseptal portion of the muscle, but this region contained between 10 and 20% type 1 fibers. They appeared to be a gradient in muscle fiber size, whereby the fiber size increased as a function of the distance from the eyelid margin. The same pattern of regional differences were found in both rabbit and monkey orbicularis oculi. Thus, there is a clear conservation of these regional differences in these two species. While the developmental significance is unknown, the identification of this pattern may facilitate the evaluation of chemomyectomy agents for treatment of eyelid spasms in humans and allow a more accurate analysis of biopsy material from this muscle.

Animals↗
PubMed2003

Intraoperative monitoring and facial nerve outcomes after vestibular schwannoma resection.

OBJECTIVE: To determine the predictive value of proximal facial nerve electrical threshold and proximal-to-distal facial muscle compound action potential amplitude ratio on facial nerve outcomes after resection of vestibular schwannomas. STUDY DESIGN: Retrospective case review. SETTING: Tertiary care hospital. PATIENTS: Two hundred twenty-nine patients undergoing resection of vestibular schwannomas with intraoperative facial nerve monitoring at a single institution. INTERVENTION: All patients underwent resection of vestibular schwannomas with the use of intraoperative monitoring. MAIN OUTCOME MEASURE: Facial nerve function was classified according to the House-Brackmann scale at the patient's last office follow-up. Last follow-up was at least 6 months after surgery. RESULTS: Good facial nerve function (House-Brackmann Grade I or II) was observed in 87% of the patients at their last office follow-up. Proximal-to-distal amplitude ratio and proximal electric threshold were statistically significant in predicting facial nerve outcome. A mathematical model predicting the probability of good outcome on the basis of the intraoperative parameters is presented. CONCLUSION: Intraoperative monitoring has significantly decreased facial nerve morbidity in vestibular schwannoma surgery. Despite the advances in surgery and monitoring, a group of patients still have poor facial nerve outcomes. The use of intraoperative nerve monitoring may be able to predict poor long-term facial nerve outcomes and thus modify the timing of rehabilitation.

Action Potentials↗
PubMed2004

[The hypolossal-facial anastomosis in man. A model for studying peripheral and central nervous system plasticity].

Hypoglossal-facial anastomosis (HFA) is a cross-over between the proximal stump of the hypoglossal nerve (XII) and the distal one of the facial nerve (VII). The hypoglossal axons regrow within the sheaths of facial fibres, allowing the progressive reinnervation of the facial muscles. This model is interesting to study some mechanisms of plasticity of the nervous system for several reasons: 1) It is a quite simple and reproducible model of pathophysiological state. It allows the study of 2) the modifications of the nervous system induced by the HFA, both upwards and downwards to the lesion and 3) the modifications of reflex activities involving intrapontine connections such as the blink reflex. The electrophysiological features of the trigemino-facial (TF) and trigemino-hypoglossal (TG) connections demonstrated that a central reorganisation of the blink reflex (BR) was induced by HFA: the afferent volleys of the TF and TH reflexes elicited by cutaneous and mucosal trigeminal afferents respectively have been shown to project onto common interneurones located within the trigeminal principal sensory nucleus. A long-term prospective study showed: 1) a reinnervation of the facial muscles by the hypoglossal axons is a necessary perequisite for the central reorganisation of BR, 2) a hyperinnervation of the facial muscles by the hypoglossal axons, 3) a transient and regressive cross-innervation of paralyzed face by the healthy contralateral facial nerve.

Central Nervous System↗
PubMed1993

Temporalis muscle for facial reanimation. A 13-year experience with 224 procedures.

A procedure for temporalis muscle transposition was used to reanimate the paralyzed face in 219 patients. In most cases, facial paralysis had followed an operation to remove an acoustic tumor. Analysis of the results showed this procedure to be highly successful and the method of choice, alone in cases of long-standing facial paralysis or to augment the effects of facial nerve grafting or hypoglossal-facial nerve anastomosis, in reanimating the mouth. It was successful in restoring a smile to 80% of the 219 patients and provided overall improvement in mouth function in 96%. Complications occurred in 21% of patients, with the most common being infection (12% of patients). Since one of us began to use the procedure to reanimate the eye and mouth, results of temporalis muscle transposition have been improved by the following: (1) using the procedure to reanimate the mouth only; (2) performing revision surgery, most often tightening the corner of the mouth (25% of patients), as indicated; (3) transposing only the midsection of the muscle; (4) implanting a prefabricated Silastic prosthesis to fill the muscle defect; (5) when indicated, lengthening the muscle with polytef (Gore-Tex+); and (6) placing the muscle in a tunnel lateral to the superficial musculoaponeurotic system to avoid injuring the underlying facial nerve should some spontaneous recovery of facial nerve function be possible.

Adolescent↗
PubMed2004

Impairment in Guillain-Barré syndrome during the first 2 years after onset: a prospective study.

OBJECTIVES: To provide a comprehensive description of impairment in patients with Guillain-Barre syndrome (GBS) in Sweden during the first 2 years after disease onset. METHODS: In this prospective multi-centre study, 42 patients, mean age 52 years, were evaluated at 2 weeks, 2 months, 6 months, 1 year and 2 years. Evaluations made use of validated, reliable measures of muscle strength, grip strength, finger dexterity, balance, facial-muscle function, respiratory function, gait, motor performance and sensory examination, and included patients' own assessments of pain, fatigue and paraesthesia. RESULTS: Mechanical ventilation was required in 21% of patients. At 2 weeks, 1 year and 2 years after GBS onset: 100%, 62% and 55% of patients had submaximal overall muscle strength; 98%, 38% and 31% subnormal grip strength; and 38%, 14% and 12% affected facial-muscle function. At the same time points, 62%, 10% and 7% of patients were unable to walk 10 m independently; and affected sensation was detected in 93%, 55% and 52%. CONCLUSIONS: Recovery occurred mainly during the first year after onset. At 2 years, motor impairment and sensory impairment were each still detectable in more than 50% of patients. We conclude that residual impairment is significant, somatically widespread and, likely, persistent.

Activities of Daily Living↗
PubMed1998

Atypical hemifacial spasm.

Among 155 cases of hemifacial spasm (HFS), the authors found two cases of atypical HFS (1.3%) in which spasm started with the orbicularis oris and buccinator muscles, and gradually spread upward to involve the orbicularis occuli muscle, whereas the reverse process is usually seen in cases of typical HFS. The compression site in cases of atypical HFS is the posterior/rostral aspect of the facial nerve (FN), whereas it was the anterior/caudal aspect of the FN in all cases of typical HFS except for one. The meatal loop of the anterior inferior cerebellar artery (AICA) compressed the FN when the vessel passed between the FN and the eighth cranial nerve (8th N). These findings suggest that the topographical organization in the FN in the cerebellopontine cistern may be reversed to a peripheral distribution: the fibres on the posterior/rostral side of the FN innervate the lower part of the facial muscles, and those in the anterior/caudal side of the nerve innervate the upper part of the facial muscles. When examining patients with HFS, we must very carefully determine whether patients have typical or atypical HFS, to determine whether blood vessels (usually the meatal loop of the AICA) between the FN and the 8th N as well as at the root exit zone of the FN are to be decompressed.

Adult↗
PubMed2005

Radiologic evidence for absence of the facial nerve in Möbius syndrome.

OBJECTIVE: To detail the radiologic findings in Möbius syndrome, in order to clarify its pathogenetic mechanisms. METHODS: High resolution three-dimensional T1 (MP rage) and T2 (CISS) weighted MRI were used to study the cisternal and canalicular portion of the seventh cranial nerve in six Möbius patients. Also, the anteroposterior dimension of the brainstem was measured at the level of the pons in the authors' 6 patients and in 20 age-matched healthy control subjects. Furthermore, the MRIs were evaluated for associated congenital brain anomalies. RESULTS: The facial nerves were absent in all six patients despite residual function in some facial muscles. The authors confirmed brainstem hypoplasia but did not find tegmental calcifications. The anteroposterior dimension of the brainstem ranged between 17 and 25 mm vs 20 to 27 mm for controls. In three patients there were congenital abnormalities in the posterior fossa. CONCLUSION: The absent facial nerves on MRI and the unusual distribution of the facial weakness, which is characteristic of Möbius syndrome, suggests that other cranial nerves, possibly the trigeminal, hypoglossal, or glossopharyngeal nerve, aberrantly innervate some lower facial muscles. Radiologic findings support the notion that Möbius syndrome is part of a more complex congenital anomaly of the fossa posterior.

Adult↗
PubMed2004

[Treatment of Bell's palsy with combination of traditional Chinese medicine and western medicine].

OBJECTIVE: To evaluation the clinical effect of combination of traditional Chinese medicine and western medicine on Bell's palsy. METHODS: 83 patients with Bell's palsy were randomly divided into two groups (trail group 54 cases and control group 29 cases). Patients in two groups were treated with medicine, acupuncture, physiotherapy, while patients in the trail group were treated with massage and functional exercise as the same time. The results of both groups were evaluated according to Portmann's Simple Scale. RESULTS: The score before treatment of trail group was 2.907 +/- 1.794, while control group was 2.931 +/- 2.034. And the score after treatment of trail group was 18.593 +/- 1.743, while control group was 9.862 +/- 3.091. Score of the function of facial muscles obtained from trail group was distinctly higher than that was from the control group (P < 0.01), as well as the improvement index (P < 0.01, trail group: 0.844 +/- 0.095, control group: 0.712 +/- 0.129). CONCLUSION: There is significant curative effect and suitability in the treatment of Bell's palsy with combination of traditional Chinese medicine and western medicine. The improvement of facial muscles' motive function pre- and post-treatment and quantitative evaluation of curative effect can be objectively obtained by evaluation of facial muscles' function.

Acupuncture Therapy↗