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At least 19 recordsLinked to original sources
PubMed1992

Long-term results of spinal accessory nerve-facial nerve anastomosis.

A number of methods have been developed to reduce the cosmetic and functional disability resulting from facial nerve loss. It has often been suggested that the major trunk of the spinal accessory nerve should not be sacrificed for providing dynamic facial function because of shoulder disability and pain. A review of Mayo Clinic records has revealed that, between the years of 1975 and 1983, 25 patients underwent spinal accessory nerve-facial nerve anastomosis using the major division (branch to the trapezius muscle) of the spinal accessory nerve. There were 11 males and 14 females, ranging in age from 16 to 60 years (mean 41 years). The interval between facial nerve loss and anastomosis was 1 week to 34 months (mean 4.62 months). The duration of follow-up study ranged from 7 to 15 years (mean 10.8 years). Twenty patients had no complaints or symptoms related to their shoulder or arm at the time of this review and no patient had significant shoulder morbidity. The facial function achieved was "minimal" in five cases, "moderate" in six, and good to excellent in 14. Most patients appeared to benefit significantly from the spinal accessory nerve-facial nerve anastomosis. The morbidity of the procedure seemed quite minimal even in the young and active. The authors continue to believe that the spinal accessory nerve-facial nerve anastomosis, even when using the major trunk of the spinal accessory nerve, is a very useful and beneficial procedure.

Accessory Nerve↗
PubMed1989

Computed tomographic analysis of the intratemporal facial nerve and facial nerve neuromas.

High-resolution computed tomography (HRCT) has replaced multidirectional tomography in the detailed analysis of the temporal bone because of its excellent resolution of fine bony detail. Small soft-tissue masses not discernible on plain tomograms are easily seen using HRCT. Unsuspected early disease which has not caused recognizable bone erosion in also demonstrable by HRCT. Last but not least, the amount of radiation received by a patient as a result of HRCT is considerably less. We illustrate the normal course of the facial nerve through the temporal bone, its anatomical relationship to various adjacent structures, and the numerous branches given off during its course through the temporal bone. The clinical features of facial nerve neuromas (schwannomas) depend on their location and include facial nerve weakness or paralysis, otalgia or facial pain, hearing loss or imbalance, and loss of taste sensation. HRCT allows the identification of a soft-tissue mass along the course of the facial nerve, with its bony canal usually enlarged by the mass. Pressure erosion of the underlying bone is often noted and erosion of the ossicles may be demonstrated in the case of middle ear involvement. The importance of both clinical and radiological correlation cannot be overemphasized in the discovery of these tumors.

Adult↗
PubMed1997

Cavernous haemangioma of the facial nerve.

Facial nerve haemangiomas are probably the most frequent benign tumours involving the facial nerve in its intratemporal portion. Usually facial nerve dysfunction is present when these tumours are of extremely small size, the average tumour being less than 10 mm. We present a case of a 15 mm diameter cavernous haemangioma of the geniculate region, with histological findings of nerve infiltration, without facial nerve symptoms. The atypical clinical presentation justifies the report and subsequent literature review.

Adult↗
PubMed2001

Transtemporal facial nerve schwannoma without facial nerve paralysis.

Facial schwannoma is a relatively rare but well documented lesion, presenting either as a mass or with facial nerve symptoms. In this report, an extensive facial schwannoma, extending from the brain stem to the periphery with minimal facial nerve symptoms and normal facial function is presented.

Adult↗
PubMed2004

Communication of infraorbital nerve and facial nerve: anatomic and histologic study.

The maxillary nerve, second division of the trigeminal nerve, is entirely sensory. It has been reported that drooling may occur later in the event of fracture of the zygoma in which hypesthesia prevails. The aim of the study is to elucidate additional detailed anatomy of the infraorbital plexus, consisting of the superior labial branch of the infraorbital nerve and facial nerve in the cheek. The authors dissected infraorbital nerves and facial nerves in 16 cadavers. Most terminals of the zygomatic branch of the facial nerve emerged from under the levator labii superiors and zygomatic muscle and infraorbital nerve. A hazardous zone of infraorbital plexus is found in a circle 36 mm in diameter. Its center is located 22 mm below the inferior orbital foramen. This hazardous zone of infraorbital plexus should be kept in mind when performing any procedures related to zygoma, maxilla, or deep cheek injuries.

Cheek↗
PubMedDate not supplied

[Neurinoma of the primary facial nerve].

Facial nerve neurinomas are unusual tumors which originate fin the Schwann cells of the nerve sheath. Diagnosis of these tumors has improved in the last years due to radiological and clinical advances. Here presented is a case study of a patient with neurinoma of the primary facial nerve which clinically manifested itself as a recurrent facial paralysis. A high resolution T-C scan was sufficient for tumour identification, treatment consisted in a middle fossa approach and tumour removal followed by hypoglossa-facial anastomosis.

Aged↗
PubMed1999

A complication of intraoperative facial nerve monitoring: facial skin burns.

OBJECTIVE: To report on three cases of severe facial skin burns resulting from intraoperative facial nerve monitoring in patients undergoing parotidectomies. STUDY DESIGN: This study is a retrospective case review. SETTING: A tertiary referral center. PATIENTS: This study includes three patients who underwent parotidectomies with concurrent facial nerve monitoring. RESULTS: Facial skin burns were proven to result from a technical defect of the intraoperative facial nerve monitoring device. Burns were sustained at electrode insertion sites and their extent was related to the duration of monitoring. The most probable explanation of these burns is electrolysis. CONCLUSIONS: Successful retracing of technical defaults with biomedical engineers at the device manufacturer have led to the upgrade of the facial nerve monitor apparatus. The benefits of facial nerve monitoring largely outweigh the fortuitous occurrence of skin burns reported in this study. Therefore, this complication should not represent a drawback to the use of facial nerve monitoring.

Adult↗
PubMed1993

Differential expression of immediate early genes after transection of the facial nerve.

Facial motoneurons respond to peripheral transection of the facial nerve with a number of molecular changes. In order to obtain insight into the transcriptional mechanisms underlying the changes induced by axotomy, the expression of a number of immediate early genes was investigated after facial nerve lesion in the rat. Some immediate early genes (such as c-fos, c-jun or jun B) are known to encode transcription factors that bind to DNA at sites that regulate gene expression and they could therefore contribute to long-term changes in motoneurons. Northern blot analysis of RNA extracted from the facial nucleus from postoperative intervals covering hours and days revealed that axotomy results in a unique pattern of immediate early gene induction in the facial nucleus. c-Jun, jun B and 12-O-tetradecanoylphorbol-13-acetate-induced sequence (TIS) 11 messenger RNA, also present in low amounts in the unoperated nucleus, were strongly induced in a long-term fashion after nerve injury. Increased levels of these messenger RNAs were first detectable at 5 h, reaching a maximum (300-500% compared to control) within 24 h followed by a gradual decline during the following week. Elevated levels were maintained at least up to eleven days compared to the unoperated side. On the other hand, c-fos messenger RNA was neither expressed in the unoperated nucleus, nor was c-fos messenger RNA induced by axotomy at any of the time-points studied. Another member of the TIS family of immediate early genes TIS 7 (PC4), however, was detectable at low levels in normal facial nucleus, but its expression was unaffected by lesion. The three axotomy-induced messenger RNAs, c-jun, jun B and TIS 11, were all localized in the facial motoneurons by in situ hybridization histochemistry indicating that their induction occurs as part of the retrograde reaction of the motoneurons in response to lesion. These data suggest that c-jun, jun B and TIS 11 may play a role in triggering the regeneration programme of motoneurons.

Animals↗
PubMed1992

Hypoglossal-facial nerve anastomosis for facial nerve palsy following surgery for cerebellopontine angle tumors.

Hypoglossal-facial nerve anastomosis is one of the procedures frequently performed to restore function after facial palsy secondary to surgery for removal of cerebellopontine angle tumors. The published results of hypoglossal-facial nerve anastomosis have been variable, and there are still questions about the indications, timing, and surgical techniques for this procedure. The goals of the present retrospective analysis of 22 cases of hypoglossal-facial nerve anastomosis were to assess the extent of the functional recovery and to analyze the factors affecting this recovery. The 22 cases of complete facial palsy were gleaned from a series of 245 cases of cerebellopontine angle tumors treated surgically by one of the authors. Twenty patients had an acoustic neuroma (average size 3.5 cm), one patient had a petrous meningioma, and one patient had a facial neuroma. The average age of the patients was 47.3 years (range 19 to 69 years). The average interval from tumor surgery to hypoglossal-facial nerve anastomosis was 6.4 months (range 12 days to 17 months), and the average follow-up period after the procedure was 65 months. The results were graded as good, fair, poor, or failure according to a new method of classifying facial nerve function after hypoglossal-facial nerve anastomosis. The results were good in 14 cases (63.6%), fair in three (13.6%), and poor in four (18.2%); one (4.5%) was a failure. Good and fair results occurred with higher frequency in younger patients who were operated on within shorter intervals, although these relationships were not statistically significant. There were no surgical complications. Good or fair results were achieved in 17 (77.3%) of the 22 cases, and thus hypoglossal-facial nerve anastomosis is considered an effective procedure for most patients with facial palsy after surgery for cerebellopontine angle tumors.

Adult↗
PubMed1992

Facial nerve to facial canal cross-sectional area ratio in children.

The incidence of facial palsy among children is lower than that among adults, and the recovery rate after facial palsy among children is higher than that of adults. To investigate these differences, we compared the cross-sectional area ratio of the facial nerve to that of the facial canal in 26 pediatric temporal bone specimens with that of 10 adult temporal bone specimens. The ratios were 0.31 +/- 0.08, 0.35 +/- 0.10, and 0.18 +/- 0.12, respectively, in the labyrinthine, horizontal, and mastoid segments of pediatric specimens. The ratios for adult specimens were 0.46 +/- 0.07, 0.52 +/- 0.17, and 0.37 +/- 0.04, respectively, in the labyrinthine, horizontal, and mastoid segments. These ratios were all significantly smaller than those for the corresponding segments of the adult specimens (P < .01). The results indicate that in children there is less possibility for entrapment of the facial nerve in the facial canal, and that children require facial nerve decompression less often than adults.

Adult↗
PubMedDate not supplied

Interstitial fluid pressure in the facial nerve: relationship between facial nerve pressure and cerebrospinal fluid pressure.

The possibility of measuring interstitial pressure in the facial nerve using a servo-nulling system was investigated. As a pilot study, interstitial fluid pressure in the extirpated medulla oblongata was measured using this system, and was found to be proportional to the pressure applied to the surrounding tissue block. Interstitial fluid pressure of the facial nerve in guinea pigs was also measurable with this system. The pressure in the facial nerve fluctuated with respiration and/or heart beat, as did CSF pressure. Respiratory fluctuations in facial nerve and CSF pressures ceased when the respirator was stopped. Facial nerve pressure appeared to be closely related to CSF pressure; the injection of saline into the CSF space resulted in an increase in facial nerve pressure. Measurement of facial nerve pressure by a servo-nulling system should be useful in evaluating the pathogenesis underlying facial palsy.

Animals↗
PubMed1985

Patterns of degeneration of the facial nerve.

Facial palsy is a distressing nonfatal disorder that creates an emotional crisis for the patient and often a therapeutic enigma for the physician. Among the causes for facial palsy are neoplasia, infection, trauma, and dysmorphogenesis. Histologic studies of the temporal bones of twelve subjects with facial nerve pathology demonstrate the susceptibility of the nerve to pressure atrophy in its course in the temporal bone. Lesions located central to the genu cause degeneration of the motor component distally and the sensory component medially. Lesions located peripheral to the genu cause degeneration of both sensory and motor bundles distally.

Adult↗