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The role of facial muscle resection in reconstruction of the paralyzed face.

The technique of resecting the levator labii superioris alaeque nasi muscle can help improve nasal symmetry and is a useful ancillary procedure in reconstruction of the paralyzed face. In 3 patients with facial paralysis, this technique markedly changed the nasal deviation seen at rest and also affected the nasolabial angle and medial nasolabial fold. A patient report is presented.

Adult↗

Characteristic of facial muscle and efferent nerve on physiology and anatomy.

OBJECTIVE: To study the specialty of orbicularis oculi muscles, nerves and oris muscles, nerves and mechanism of difference of facial muscular injury in facial paralysis deeply. METHODS: The conductive velocity of the efferent nerves of orbicularis oculi and oris muscles of the health human beings and guinea pigs is measured with electromyogram (EMG) apparatus. RESULTS: The conductive velocity of orbicularis oculi nerve is quicker and oris muscles are controlled by facial nerves on both sides. Measuring the threshold of Strength-Duration (S-D) curves of the motor point of orbicularis oculi and oris muscles shows the threshold of the former is lower. Measuring the diameter of orbicularis oculi and oris nerve fibers on the guinea pigs and rabbits shows the diameter of orbicularis oculi nerve fiber is bigger. The area of secondary synapse space of orbicularis oculi motor end plate is larger than that of oris under scanning electron microscope. CONCLUSIONS: Orbicularis oculi muscles, orbicularis oculi nerves and oris muscles, oris nerves all have their own characteristic on physiology and anatomy. It elucidated the mechanism that orbicularis oculi muscle is easy to be injured.

Action Potentials↗

Facial muscle reinnervation: a comparison of neuromuscular pedicle with direct nerve implant.

Two methods of reinnervation, the neuromuscular pedicle (NMP) and the nerve implant (NI), were compared in a model using the rabbit's denervated mentalis muscle. Results from evoked electromyographic (EMG) and muscle tension studies (twitch and tetanic contraction) provided the basis of comparison. In addition, the timing of denervation was studied (ie, at the time of implantation of the NMP or NI, or 2 weeks following implantation). The NMP achieved more rapid reinnervation and produced stronger contractions than the NI. Demonstrable reinnervation with an NMP was accelerated when the implantation occurred prior to the denervation. This was not the case with the NI. There was poor correlation between the evoked EMG potential and the strength of both twitch and tetanic contraction. It was concluded on the basis of this study that muscle tension provided a more accurate means of assessing reinnervated muscle function. Of the two methods, the NMP would seem, therefore, to be the technique of choice when it is available. The NI is certainly effective and should be used when a satisfactory NMP is not available.

Animals↗

The development of facial muscles and nerves in relation to the Möbius syndrome.

This paper discusses descriptive and experimental embryologic material that may be of relevance in understanding the pathologic findings of, and attempting treatment of, congenital facial paralysis. The embryology of the human facial nerves and muscles is described. In experimental animals muscles undergo early stages of morphogenesis and differentiation in the absence of nerves and then undergo gradual atrophy. In th absence of muscle fibers, the bulk of embryonic motor nerves that would normally innervate the muscle die.

Branchial Region↗

Facial muscle spasms: an Australian study.

PURPOSE: A group of patients suffering from blepharospasm, hemifacial spasm and Meige's syndrome were surveyed to determine the delay from the onset of their condition until a correct diagnosis was reached, the attitudes of practitioners towards them and their condition, the effect of their condition on their lifestyle and the effects of different types of treatment on their conditions. METHODS: Questionnaires were offered to all patients with blepharospasm, hemifacial spasm and Meige's syndrome presenting to three ophthalmologists licensed to treat patients with botulinum toxin injections over a 12 month period. RESULTS: Patients consulted an average of 4.4 practitioners before a correct diagnosis was made and many waited a number of years before obtaining satisfactory treatment. Approximately two-thirds of all practitioners consulted were unaware of their condition. Ten per cent of patients reported a family history of similar conditions. Most patients received relief from their symptoms with treatment using injections of botulinum toxin. More than 55% of patients considered themselves to have psychological problems (usually relating to stress and trauma) that they associated with the onset of their condition. CONCLUSIONS: Facial muscle dystonias are rare and patient experiences suggest that they are poorly appreciated in the medical community. From the time they first see a practitioner with symptoms of facial dystonia, patients typically wait 2 years and see four practitioners before a correct diagnosis is made. Stress may be a factor in the symptomatic onset of this condition. Many patients describe pain as part of the presenting symptomatology. Botulinum toxin seems to be effective in the management of facial spasm.

Adult↗

The restoration of control in facial muscles affected by Bell's palsy.

Electromyographic biofeedback and behavioral control techniques were used to treat two patients who suffered from Bell's palsy. Both patients (one case with a long history of Bell's Palsy which included extensive surgery to her face, the other of more recent onset) appeared to have benefited from these procedures and also perceived themselves as having done so. It is recommended that the noninvasive techniques outlined should be tried at an early stage in this condition in order to: (1) prevent the acquisition of inappropriate behavior; (2) accelerate progress toward normal facial functioning; and (3) reduce the need for any surgical intervention.

Adult↗

[Studies on the facial muscles in the aged].

The dissection of the facial musculature in the elderly made on 2 bodies, confirmed the mode of evolution noted earlier in the Primates. The reduction in the m. platysma myoides was confirmed; this muscle showed only two parts: a rudimentary pars buccalis and a relatively developed pars mentalis. This reduction was accompanied by fundamental transformations since the m. quadratus of the chin appeared at the anterior part of the pars mentalis of the platysma myoides. The derivatives of the deep m. sphincter coli showed an arrangement very similar to that of the Simians. However some modifications already observed became stronger, particularly the verticilisation of the m. caninus and the separation of the two m. zygomaticus. Curiously, the extrinsic ear musculature persisted and remained well developed despite its absence of activity.

Aged↗