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At least 1,261 records · Page 70Linked to original sources
PubMed2002

Objective facial motion analysis in patients with facial nerve dysfunction.

OBJECTIVES/HYPOTHESIS: To objectively measure facial motion at various facial landmarks using a video-computer interactive system. STUDY DESIGN: Clinical, prospective, non-randomized. METHODS: A video-computer interactive system, The Peak Motus Motion Measurement System, was used to study linear displacement at preselected facial landmarks in the normal and abnormal face. Subjects with normal facial function (n = 34) and patients with abnormal facial function (n = 26) from various etiologies were studied. The sites studied were marked with reflective beads. Of a larger repertoire of expressions, two expressions (eyes closed and closed-lip smile) were studied in all subjects. The percent asymmetry in facial displacement between the sides of the face was calculated. The sensitivity of this measurement to facial dysfunction was evaluated. The presence of synkinesis was examined by quantifying the displacement at facial sites that were remote to the sites primarily involved in a given facial expression. Test-retest reliability of the percent asymmetry measurement was evaluated with the paired t test. RESULTS: The video-computer interactive approach used accurately detected and quantified gross and subtle changes in facial function. The sensitivity of the percent asymmetry measurement was 95% (both expressions) for patients with apparent facial dysfunction (House-Brackmann rating >I/VI). In patients with facial nerve dysfunction, displacement on the presumably normal side was significantly excessive in 27% to 35%, depending on the expression. With this interactive computer-video system, synkinesis was detected in 58% of the pathologic subjects during the eyes closed or closed-lip smile expressions. The paired t test indicated strong test-retest reliability (r = 0.73-0.99) of the percent asymmetry measurement. CONCLUSIONS: The present report indicates that this approach to the assessment of facial motion is sensitive to facial dysfunction. This computer-video interactive system is able to quantify synkinesis. A grading system for the magnitude of synkinesis, based on the magnitude of the displacement at remote facial sites, is proposed. The common occurrence of excessive facial motion on the presumably normal side of affected individuals indicates that patients with facial paralysis often overcompensate by exaggerating the normal side in an effort to move the affected side. This system is of value in the objective measurement of normal facial function and may prove a useful tool to quantify the outcomes of various medical and surgical treatments for facial nerve dysfunction.

Adult↗
PubMed1986

Acoustic (loudspeaker) facial electromyographic monitoring: Part 1. Evoked electromyographic activity during acoustic neuroma resection.

A modification of the technique of acoustic facial electromyographic (EMG) monitoring, involving the use of a bipolar wire electrode, was used to monitor facial EMG activity during 13 consecutive unselected acoustic neuroma resections. EMG activity was synchronously recorded on the audio channels of operative video tapes so that the patterns of evoked EMG activity could be analyzed in relation to specific intraoperative events. Despite a relatively wide variety of apparent eliciting mechanisms, evoked EMG activity occurred in only three general acoustic patterns; these were bursts, trains, and pulses. These respective patterns are described in detail and related to specific etiological mechanisms. The possible clinical significance of various patterns of evoked EMG activity is discussed.

Adult↗
PubMed1990

Delayed hearing loss after neurovascular decompression.

We report two unusual cases of delayed hearing loss after neurovascular decompression of structures within the cerebellopontine angle. In the first case, the patient noted a unilateral hearing loss 3 weeks after undergoing vascular decompression of the trigeminal nerve for tic douloureux. This gradually improved over an 18-month period. In the second case, the patient awoke on the 4th day after vascular decompression of the facial nerve for hemifacial spasm with a bilateral hearing loss that has remained unchanged after the onset. These are examples of delayed acoustic dysfunction occurring with a shift in surgically freed vessels and may have been induced by newly directed neurovascular compression or distortion.

Adult↗
PubMed1991

Vestibular nerve injury as a complication of microvascular decompression.

We report a case of hemifacial spasm in which hearing was well preserved after microvascular decompression, but the vestibular nerve was injured selectively. We review the pathophysiological mechanisms relevant to this complication in the light of results of animal experimental studies we have conducted. In addition, we discuss the clinical significance of this particular type of cranial nerve injury.

Arteries↗
PubMed1976

The superficial musculo-aponeurotic system (SMAS) in the parotid and cheek area.

We have investigated the superficial musculo-aponeurotic system (SMAS) in the parotid and cheek areas by anatomical dissections, by radiographs, and by histological sections. The SMAS may be helpful in corrective surgery for facial palsy and during face lifting operations if a retrofascial approach is used. This procedure, safe in the parotid area, can become dangerous in the area anterior to the parotid gland.

Cheek↗
PubMed1979

Pseudo-paralysis of the mandibular branch of the facial nerve after platysmal face-lift operation.

With the increasing popularity of platysmal face lifts, the anatomy of the cervical branch of the facial nerve should be noted. The postoperative appearance of lack of ability to retrude the corner of the mouth, in someone who had a "full denture" smile preoperatively, could possibly be due to severance or stretching of the rami of the cervical branch of the facial nerve--rather than an injury of the facial nerve of the marginal mandibular branch.

Aged↗
PubMed1979

Avoiding facial nerve injuries in rhytidectomy. Anatomical variations and pitfalls.

Injury to the facial nerve in rhytidectomy has been occurring in less than one percent of the cases, and a spontaneous return of function in more than 80 percent of these injuries has resulted within 6 months. With the introduction of the newer and more aggressive techniques of platysmal and subplatysmal flaps and SMAS dissections, the risk of injury to facial nerve branches is obviously increased. Though there has not yet been an increase in the facial nerve injuries reported, these techniques are still relatively recent additions to the face-lift operation-and usually they have been done by more experienced surgeons, taking more time and working under direct vision with a more careful dissection. More care is needed to prevent injuries. We discuss here the detailed anatomy of the muscular branches of the facial nerve, how to prevent injuries to them during rhytidectomy, and how to manage injuries when they do occur.

Face↗
PubMed1981

Progress in rhytidectomy by platysma-SMAS rotation and elevation.

Our experience in 1 1/2 years of follow-up with 64 patients with a musculofascial flap to support the lower face and anterior neck is presented. We anticipate that the skilled plastic surgeon will find this procedure helpful for the aesthetic reconstruction of the aging face and neck.

Aged↗
PubMed1994

Development of a new documentation system for facial movements as a basis for the international registry for neuromuscular reconstruction in the face.

None of the paresis scoring systems used satisfies an adequate description of all the details necessary to document the degree of facial paresis before and after any treatment. We developed a new documentation system considering all details of the history of the patient and of the treatment that could have any influence on the functional result. The third part of this "international registry for neuromuscular reconstruction in the face" concerns paralysis assessment, including quantitative measurements of the resting and moving face, besides qualitative parameters. A map of standardized static and dynamic points in the face was designed, and three-dimensional measurements of the movements of these facial points were performed with a VICON system in 16 healthy individuals. On the basis of the results, three real static points and representative dynamic points were selected as well as relations of these points most representative for the different facial movements. For data collection, a simple instrument (Frey's faciometer) was developed. A preliminary report is given on the clinical application of this new instrument.

Adult↗
PubMed1998

Clinical experience with orbicularis oculi myocutaneous flaps in the temporal area.

There are many methods to repair facial skin defects in clinical practice. The desired outcome for the surgeon and the patient is the restoration of facial appearance and function. The temporal region is one of the ideal donor sites for the repair of a facial skin defect, because this area is relatively inconspicuous and the skin quality is similar to that of the face. In the past, the temporal region was always used as the donor site of the local flap for repairing the facial skin defect. Because the blood supply of the skin comes from the subjacent tissue mainly rather than from the contiguous tissue, the pedicles of the local flaps are short, limiting the use of this area as a donor site. From 1993 to 1996, the anatomy of the orbicularis oculi myocutaneous flap in five cadavers was studied; what was learned allowed for the use of this flap to repair skin defects of the face in 13 patients. In this paper, the clinical experiences using the orbicularis oculi myocutaneous flaps to repair skin defects of the face and the surgical anatomy of this myocutaneous flap are discussed.

Adolescent↗
PubMed1999

Endoscopically assisted facial suspension for treatment of facial palsy.

Static suspension remains an option for certain patients with facial paralysis. Endoscopically assisted facial suspension obviates the need for a counter-incision at the oral commissure to distally inset the fascia lata graft as described in the standard technique. The endoscopic technique is simple, allows secure placement of perioral fascial strips, and can be performed as an outpatient.

Adult↗