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PubMedDate not supplied

[A comparative assessment of the results of plastic surgery on the facial nerve following total removal of neurinomas of the acoustic nerve].

The study was conducted in 3 patients following the application of intracranial facial nerve anastomoses, in 25 patients with the facial nerve anastomosed with the accessory nerve, and in 17 patients with facial-hypoglossal nerve anastomoses. Apart from the clinical observations of the facial muscle contractions, the comparative evaluation of the plastic operations was conducted with the aid of electromyography, electrogustometry and salivary glands secretion studies. The authors concluded that the intracranial anastomosis results in better restoration of the motor function of the facial muscles, the gustation being also partially restored on the side on the intervention. Among the anastomoses of the VII nerve with the XII and XI that with the XII is preferred.

Adult↗

PubMed1985

Emotion and facial efference: a theory reclaimed.

A theory of emotional expression, ignored since 1906, holds that facial muscles act as ligatures on facial blood vessels and thereby regulate cerebral blood flow, which, in turn, influences subjective feeling. The theory, developed by Israel Waynbaum, a French physician, hypothesizes the subjective experience of emotions as following facial expression rather than preceding it. It answers Darwin's question of why different muscles contract or relax in different emotions better than Darwin's own theory. When restated in terms of contemporary neurophysiological knowledge, it explains and organizes several ill-understood emotional processes and phenomena.

Blushing↗

PubMedDate not supplied

Nuclear facial palsy in multiple sclerosis: a case report.

We encountered an unusual case of isolated subacute nuclear palsy of the facial nerve in a 31-year-old man with a 3-year history of clinically established relapsing form of multiple sclerosis. Typical positive sharp waves and fibrillation potentials in the affected facial muscles detected by means of electromyography showed that the lesion was located in the lower motor neuron. Transcranial magnetic stimulation of the cortex could not evoke normal compound motor unit potentials, however, transcranial magnetic stimulation of the facial nerve, which is strongly supposed to depolarize the peripheral nerve in the area of the root exit zone near the internal acoustic meatus, elicited an adequate response. Taking these findings as well as the results of positive magnetic resonance imaging into consideration, we concluded that the clinical symptom was due to a plaque of demyelinization in the nucleus of the facial nerve or in the proximal intramedullary course of facial fibres.

Adult↗

PubMed2005

Neonatal asymmetric crying facies: a new look at an old problem.

Neonatal asymmetric crying facies, described 75 years ago, is a clinical phenotype resembling unilateral partial peripheral facial nerve paralysis, with an incidence of approximately 1 per 160 live births. The cause is either facial nerve compression or faulty facial muscle and/or nerve development. Spontaneous resolution is expected with the former, but not necessarily with the latter etiology. Approximately 10% of the developmental cases have associated major malformations. Mandibular asymmetry and maxillary-mandibular asynclitism (non-parallelism of the gums) are frequently overlooked visual clues to nerve compression. Ultrasound imaging of facial muscles and electrodiagnostic testing may be useful for differential diagnosis and management.

Crying↗

PubMedDate not supplied

Magnetically elicited blink reflex: an alternative to conventional electrical stimulation.

Magnetically and electrically elicited blink reflexes were studied in 11 normal subjects and in 5 patients with partial peripheral facial nerve palsy. Both methods were able to elicit a reproducible blink reflex. In both groups the latencies of the magnetically elicited reflexes were equal to those that followed electrical stimulation. The magnetic stimulation technique offered 2 advantages over the electrical stimulation: (1) it was less painful and therefore better tolerated and (2) the coil position in the middle of the forehead was sufficient to elicit a bilateral blink reflex because the windings of the stimulation coil excited both supraorbital nerves simultaneously. This bilateral response enables one to reduce the number of stimuli and can be used in the examination of patients that have peripheral facial nerve palsies without the concomitant impairment of the reflex pathway in the brainstem. The magnetic technique can also elicit a blink reflex at stimulation points distant from the supraorbital notch. This finding offers an alternative explanation of the late responses of facial muscles following transcranial magnetic stimulation of the motor cortex.

Adult↗

PubMed2005

[Role of ciliary neurotrophic factor in regeneration of severed facial nerve of cats].

OBJECTIVE: To study the role of extrinsic (CNTF) in the regeneration of severed facial nerve in cats. METHOD: The facial nerve in temporal bone of adult cats were severed and the severed ends were connected with CNTF or saline applied at the connection. Electrophysiological examination and immunocytochemistry were performed with immunoelectron microscope for morphological analysis at 2, 4 and 8 weeks after the operation. RESULTS: Two weeks after operation, both CNTF and saline groups failed to exhibit muscular excitement by facial nerve stimulation, but the amount of myelinated nerve fibers had statistical difference between the two groups (P<0.05). At 4 weeks, the latency of the facial muscle excitement was 7.832+/-2.695 ms in CNTF group and 16.120+/-3.516 ms in saline group, and the average number of myelinated axons was significantly different between the two groups (1,435+/-318 vs 957+/-269, P<0.05). At the 8th weeks, the latency of facial muscle excitement was reduced to 3.125+/-0.165 ms in CNTF group and to a comparable level of 3.095+/-0.178 ms in saline group (P>0.05), and the average number of myelinated axons increased to 1,695+/-283 and 1,543+/-320 respectively in the two groups (P>0.05). Significant increase of Schwann cells was noted in both groups at this stage. CONCLUSION: Local application of CNTF may enhance facial early-stage nerve regeneration in adult cats, but its long-term effects remain unclear.

Animals↗

PubMed1996

Recurrence of hemifacial spasm after microvascular decompression.

The success of medical and surgical treatment for hemifacial spasm, and involuntary paroxysmal unilateral contraction of the facial muscles, has been mixed. Although microvascular decompression has the greatest reported success, symptom recurrence affects many patients in whom treatment was initially successful. In this study, we report the results of 34 patients who underwent microvascular decompression of the facial nerve from 1976 to 1989 as well as review the literature concerning the incidence and timing of recurrence in more than 600 patients who underwent microvascular decompression. In this series, 94% of 34 patients had continuous relief of spasm after surgical treatment (mean duration, > 6 yr). Of those patients whose spasms were completely initially relieved, 10.3% developed some degree of recurrent spasm; however, no patient developed a recurrence after 24 months without spasm. Our review of the literature discloses that 86% of all recurrences occurred within 2 years of surgery. Patients who have no recurrence of symptoms 2 years after surgical treatment have only a 1% chance of developing recurrent hemifacial spasm. We also comment on possible causes of treatment failure and recurrence of hemifacial spasm after surgical treatment.

Adult↗

PubMed2002

Cross-facial and functional microvascular muscle transplantation for longstanding facial paralysis.

Functional results continue to improve with advancing microsurgical techniques and monitoring to detect and correct problems within minutes [47]. However, failures do occur, even when one can project a 98% survival for the transplant. Figs. 9 and 10 show two of our early cases that were fortunately salvaged with a second microvascular transplant. Evaluation of the result is a continuing challenge--anatomically, physiologically, and psychologically [37]. If one can remove the stigma or stigmata of facial paralysis in the patient's mind. success has been achieved (Fig. II) [48].

Eyelids↗

PubMed1976

Prognosis in Bell's palsy.

This is a concluding report of a study in which only patients with Bell's palsy initially seen within ten days of onset are included. The purposes are to observe the natural course of the disorder and to illustrate electromyographic EMG) criteria by which early forecast of recovery is possible. Appraisals of facila muscle strength, nerve stimulation responses and electromyographic needle electrode examinations correlated with the time required for recovery and the relative degree of recovery of patients with Bell's palsy. Three categories of recovery are evident. Of 90 patients, 79% recovered completely within two months (class I), 7% recovered adequately within two to six months (class II) and 14% required longer than six months (class III). Using clinical and electromyographic methods it should be possible to forecast recovery within three days after onset in order to preselect patients in need of any proposed curative treatment program designed to salvage the facial nerve. For prognosis in patients without clinically detectable facial muscle function, the data suggest that they be evaluated on a daily basis from onset until day 4 (past 72 hours). Finding that residual motor unit potentials are sustained in four to five muscles during that period strongly indicates a favorable outcome. Finding activity in two to three muscles could be less favorable and finding zero to one muscle with activity is clearly unfavorable. During this period of time there is a tendency for progressive loss of EMG activity in the facial muscles, both in patients with favorable and with less favorable outcomes.

Adolescent↗

PubMed1998

Reflexes elicited from cutaneous and mucosal trigeminal afferents in normal human subjects.

It has been shown that in patients in whom the central stump of the hypoglossal nerve has been anastomosed to the peripheral stump of a lesioned facial nerve, supraorbital nerve stimulation can elicit a short-latency reflex (12.5+/-0.6 ms; mean+/-S.D.) in facial muscles similar to the R1 disynaptic blink reflex response, but not followed by an R2 blink reflex component46. Thus in addition to replacing the facial neurons at peripheral synapses, these hypoglossal nerves contribute to a trigemino-hypoglossal reflex. The aim of this work was to study the type of reflex activities which can be elicited in both facial and tongue muscles by electrical stimulation of cutaneous (supraorbital nerve) or mucosal (lingual nerve) trigeminal (V) afferents in normal subjects. The results show that although stimulation of cutaneous V1 afferents elicits the well-known double component (R1-R2) blink reflex response in the orbicularis oculi muscles, it does not produce any detectable reflex response in the genioglossus muscle, even during experimental paradigms designed to facilitate the reflex activity. Conversely, stimulation of mucosal V3 afferents can elicit a single reflex response of the R1 type in the genioglossus muscle but not in the orbicularis oculi muscles, even during experimental paradigms designed to facilitate the reflex activity. These data are discussed in terms of two similar but separate circuits for the R1 responses of cutaneous (blink reflex) and mucosal (tongue reflex) origins. They suggest that in patients with hypoglossal-facial (XII-VII) nerve anastomosis, the short-latency trigemino-'hypoglossal-facial' reflex of the R1 blink reflex type observed in facial muscles following supraorbital nerve stimulation could be due to changes in synaptic effectiveness of the central connectivity within the principal trigeminal nucleus where both cutaneous and mucosal trigeminal afferents project.

Adult↗

PubMed1997

Trigeminal neo-neurotization of the paralyzed face.

Sporadic reports throughout the literature have documented the spontaneous return of facial function following deliberate intraoperative sacrifice of the facial nerve. Trigeminal reinnervation of the facial muscles has been suggested as one possible mechanism for this occurrence. Evidence for the phenomenon of trigeminal neo-neurotization has been documented experimentally. The case of a 62-year-old woman who underwent total left parotidectomy with transection of a large facial nerve segment is presented in order to provide further clinical evidence supporting trigeminal neo-neurotization of the facial nerve. Despite the lack of any efforts to reinnervate the patient or graft the facial nerve defect, the patient spontaneously developed return of facial function. Postoperative clinical and electrical testing in this case supports trigeminal-facial reinnervation as the cause for return of facial function. The case report is summarized with a brief discussion, and the relevant literature is thoroughly reviewed.

Electromyography↗

PubMed1997

The modern face of prejudice and structural features that moderate the effect of cooperation on affect.

Facial muscle activity and self-reports were examined for racial bias in 3 studies. In the first 2 experiments, While participants imagined cooperating with a Black or White partner. Experiment 1 manipulated reward structure in the context of cooperating with a deficient partner. Experiment 2 manipulated partner deficiency and willingness to expend compensatory effort. On both facial EMG and self-report measures, joint rewards produced more negative affect than independent rewards. However, all partners were liked more when they were willing to try to compensate for their deficits. In addition, more liking was reported for Black partners, but EMG activity indicated bias against Blacks. Experiment 3 investigated individual differences in prejudice. Again, a greater preference for Blacks than Whites occurred on self-report measures, but in their facial muscle activity, high-prejudiced participants exhibited bias against Blacks.

Adult↗

PubMed1999

[An anatomical study of the nasolabial fold region].

OBJECTIVE: This study of the nasolabial fold is to provide the morphological basis for maxillofacial plastic and cosmetic surgery. METHODS: Twenty fresh adult cadavers' heads were dissected with microsurgical technique and the structure of the nasolabial region was observed and measured. RESULTS: 1. The data about the length, width and thickness of each mimetic muscle were obtained and presented in the paper. 2. The medial and lateral subcutaneous fat of the nasolabial groove was 1.3 mm and 4.5 mm in thickness respectively. 3. There existed muscle fiber attachments in the medial dermis of nasolabial groove, and in the lateral dermis there were only a few muscle bundle attachments. 4. Among the superficial facial muscles there were not only fasciae but also aponeuroses. The muscles, fasciae and aponeuroses composed a three-dimensional reticular structure. CONCLUSION: This study gave a further support to the theoretical hypothesis of SMAS intermediate tendon.

Adult↗

PubMed1996

Development of a sensitive clinical facial grading system.

Clinicians require a reliable and valid method of evaluating facial function after facial nerve injury. This tool should be clinically relevant and easy to administer, provide a quantitative score for reporting purposes, and be sensitive enough to detect clinically important change over time or with treatment. The proposed facial grading system has all essential information, including precise definitions for each item, presented on one page. The facial grading system is based on the evaluation of resting symmetry, degree of voluntary excursion of facial muscles, and degree of synkinesis associated with specified voluntary movement. Different regions of the face are examined separately with the use of five standard expressions. All items are evaluated on point scales, and a cumulative composite score is tabulated. Construct validity was addressed by comparing the proposed facial grading system to prerehabilitation and postrehabilitation treatment scores of 19 patients with varying degrees of facial nerve injury. All patients had documented change in a controlled study of feedback training. The proposed system reports results in a more continuous manner with a wider response range than the House-Brackmann grades. Each component of the grading system is sensitive to change and individually contributes to a change in the composite score. Tests of interrater reliability are currently near completion.

Facial Expression↗

PubMed1978

Computed tomography of the paranasal sinuses and face: part I. Normal anatomy.

With the ability to image both bone and soft tissue structures, computed tomography (CT) is capable of visualizing many normal anatomical structures of the paranasal sinuses and face not seen with other radiological techniques. The superficial and deep fat planes, all of the muscles of mastication, and many of the facial muscles are readily identified. The extraocular muscles, optic nerves, and globes are clearly seen. The purpose of this report is to review the normal anatomy of the paranasal sinuses and face imaged by CT in both the transverse and coronal planes.

Face↗

PubMed1976

Mask wiggling as a potential cause of wound contamination.

Some operating-theatre staff have a habit of wiggling their surgical masks by moving their facial muscles. The field contamination which can result from this practice was studied. A firmly fitting, moulded, synthetic-fibre mask produced significant bacterial contamination of culture plates held beneath the mask, compared with that found on simultaneously exposed control plates placed nearby. Softer fibreglass masks produced less contamination when moved by facial muscles, and are more suitable for mask wigglers.

Face↗

PubMed1995

Generation of masticatory rhythm in the brainstem.

Mastication is a typical rhythmical behavior in mammals. Like respiration, it is now generally accepted that the motor command for the basic pattern of rhythmical oral-facial movements is generated by a neuronal population in the brainstem (central pattern generator, CPG). The central pattern generation of rhythmical masticatory movements can be divided into three processes: (1) generation of the masticatory rhythm, (2) generation of a pattern of activities of the jaw, tongue and facial muscles, and (3) coordination of the activities of these muscles. There are several lines of evidence that the masticatory CPG is functionally subdivided into two neuronal groups: one for generation of the masticatory rhythm, giving the timing signal for rhythmical alternation of jaw closing and jaw opening (central rhythm generator, CRG), and the other for generation of the spatiotemporal pattern of activities of the jaw, tongue and facial muscles. This review will deal, first of all, with the localization of the CRG for rhythmical masticatory jaw movements, sources for its activation, and the premotor neurons mediating its output to the trigeminal motoneurons. Next, we will discuss the neurochemical basis for rhythmical trigeminal motoneurons activity as well as central masticatory rhythm generation. Finally, our recent attempt at induction of neural activities reflecting sucking movements (fictive sucking) in an in vitro preparation is presented.

Animals↗

PubMed2002

Difficulty does not account for emotion-specific heart rate changes in the directed facial action task.

Boiten (1996) used the Directed Facial Action task (a task we developed in which participants follow instructions, based on theory about how emotion is expressed in the face, to move facial muscles deliberately to produce different facial configurations) to investigate heart rate differences among six emotional configurations. Boiten's findings closely replicated ours (Levenson, Ekman, & Friesen, 1990) in terms of heart rate change, self-reported emotion, and rated difficulty during the configurations. Boiten concluded that differences in difficulty were responsible for found differences in heart rate; in contrast, we had concluded that heart rate findings could not be explained in this manner. In this paper, we argue that neither Boiten nor we did the critical analyses needed to determine whether heart rate changes were mediated in this way. Performing these analyses, we conclude that neither reported difficulty nor two other potential mediators (time required to make the facial configurations; activity of nonfacial muscles) mediated the heart rate differences that we found between emotional configurations in the Directed Facial Action task.

Adult↗