1
|
Targino da Costa MGES, Maranhão-Filho PDA, Santos IC, Luiz RR. Post-parotidectomy facial nerve rehabilitation outcomes: Comparison between benign and malignant neoplasms. NeuroRehabilitation 2024; 54:259-273. [PMID: 38306064 DOI: 10.3233/nre-230220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND Facial nerve dysfunction can be a devastating trouble for post-parotidectomy patients. OBJECTIVE To assess rehabilitation outcomes concerning patients with post-parotidectomy facial nerve dysfunction, comparing benign versus malignant neoplasms. METHODS Prospective study enrolling adults who underwent parotidectomy with facial nerve sparing between 2016 and 2020. The Modified Sunnybrook System (mS-FGS) was used for facial assessments. Physiotherapy began on the first post-operative day with a tailored program of facial exercises based on Neuromuscular Retraining, to be performed at home 3 times/day. From the first outpatient consultation, Proprioceptive Neuromuscular Facilitation was added to the treatment of cases with moderate or severe facial dysfunctions. RESULTS Benign and malignant groups had a statistically significant improvement in mS-FGS (p < 0.001 and p = 0.005, respectively). There was no significant difference between groups regarding treatment duration or number of physiotherapy sessions performed. The history of previous parotidectomy resulted in more severe initial dysfunctions and worse outcome. Age over 60 years and initially more severe dysfunctions impacted the outcome. CONCLUSION Patients with benign and malignant parotid neoplasms had significant and equivalent improvement in postoperative facial dysfunction following an early tailored physiotherapy program, with no significant difference in the final facial score, treatment duration, or number of sessions required.
Collapse
Affiliation(s)
| | - Péricles de Andrade Maranhão-Filho
- Department of Neurology, University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Izabella Costa Santos
- Department of Head and Neck Surgery, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil
| | - Ronir Raggio Luiz
- Institute for Studies in Public Health (IESC), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| |
Collapse
|
2
|
Loyo Li M, Cameron MH, Volk GF. Does electrical stimulation still have a place in the treatment armamentarium for Bell's palsy? Expert Rev Neurother 2024; 24:1-3. [PMID: 38105767 DOI: 10.1080/14737175.2023.2295426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Myriam Loyo Li
- Facial Nerve Center, Department of Otolaryngology- Head and Neck Surgery, Oregon Health & Science University, Oregon, USA
| | - Michelle H Cameron
- Department of Neurology, Oregon Health & Science University, MS Center of Excellence-West, VA Portland Health Care System, Portland, OR, USA
| | - Gerd Fabian Volk
- Facial-Nerve-Center, Department of Otorhinolaryngology, Head and Neck Surgery, Center of Rare Diseases, Jena University Hospital, Jena, Germany
| |
Collapse
|
3
|
Horibe G, Itoh A, Yamaguchi S. Electroneurography Values Based on Degree of Facial Muscle Contraction Response to Electroacupuncture in Patients with Peripheral Facial Nerve Palsy: A Retrospective Study. Med Acupunct 2023; 35:305-310. [PMID: 38162555 PMCID: PMC10753937 DOI: 10.1089/acu.2023.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Objective Japanese acupuncture practice cannot easily predict the prognosis of patients with peripheral facial palsy. Electroneurography (ENoG) predicts prognosis in patients with peripheral facial palsy; however, the difference between ENoG values and degree of facial muscle contraction response (FMCR) to electroacupuncture stimulation (ES) targeting the affected facial nerve is unexplored. Therefore, an exploratory evaluation of the differences in ENoG values was conducted across the degrees of FMCR induced by ES targeting the affected facial nerve in patients with peripheral facial nerve palsy. Methods In total, 90 patients with peripheral facial nerve palsy were selected who underwent acupuncture treatment at the Department of Oriental Medicine, Saitama Medical University Hospital, between January 2005 and December 2014. The FMCR degree and ENoG values were assessed through patients' medical records. The patients were divided into excellent, moderate, and noresponse groups (65, 16, and 9 patients, respectively) according to the FMCR degree. The differences in ENoG values were analyzed among the groups. Results The ENoG values were 26.6% (10.4%-55.9%), 2.45% (0.35%-8.80%), and 2.00% (0.00%-5.10%) for the excellent, moderate, and no-response groups, respectively. These values significantly differed between the excellent group and the no-response (P < 0.01) and moderate (P < 0.01) groups. Conclusion The ENoG values varied according to degree of FMCR induced by ES targeting the facial nerve in patients with peripheral facial nerve palsy. This might allow to predict the prognosis based on the ES-induced FMCR.
Collapse
Affiliation(s)
- Go Horibe
- Department of Oriental Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Akinori Itoh
- Department of Neuro-Otology, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Satoru Yamaguchi
- Department of Oriental Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan
| |
Collapse
|
4
|
Di Pietro A, Cameron M, Campana V, Leyes L, Zalazar Cinat JAI, Lochala C, Johnson CZ, Hilldebrand A, Loyo M. Efficacy of adding selective electrical muscle stimulation to usual physical therapy for Bell's palsy: immediate and six-month outcomes. Eur J Transl Myol 2023; 33:11630. [PMID: 37877154 PMCID: PMC10811644 DOI: 10.4081/ejtm.2023.11630] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/28/2023] [Indexed: 10/26/2023] Open
Abstract
Bell's palsy is the most common cause of facial paralysis, affecting one in every 60 people in their lifetime. Transcutaneously applied selective electrical muscle stimulation could potentially accelerate recovery from Bell's palsy but this intervention remains controversial. Studies have shown benefit, but concerns for lack of efficacy and potential for worsening synkinesis remain. We performed a prospective controlled trial comparing outcomes at initial recovery and six months later with selective electrical muscle stimulation and usual physical therapy versus usual physical therapy alone in adults with acute Bell's palsy. Outcomes were facial function assessed with the House Brackman and eFACE scales. Outcomes were evaluated at discharge and six months after discharge. Discharge occurred when participants were judged to be fully recovered by their treating therapist and supervisor. 38 adults participated in the study. Participants in the electrical stimulation group achieved maximal recovery twice as fast as the control group (2.5 weeks versus 5.2 weeks) with no significant differences in facial function or synkinesis between groups at any time point. This study is the first human trial of electrical stimulation in Bell's palsy to follow patients 6 months from recovery and supports that selective electrical muscle stimulation accelerates recovery and does not increase synkinesis.
Collapse
Affiliation(s)
| | - Michelle Cameron
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA; VA Portland Health Care System.
| | - Vilma Campana
- Department of Biomedical Physics, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba.
| | - Laura Leyes
- Department of Kinesiology and Physical Therapy, Universidad Nacional del Nordeste, Corrientes.
| | | | - Carly Lochala
- Department of Rehabilitation, Oregon Health & Science University, Portland, OR, USA; Division of Biokinesiology & Physical Therapy, University of Southern California.
| | - Christopher Z Johnson
- Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University, Portland, OR.
| | - Andrea Hilldebrand
- Biostatistics and Design Program, Oregon Health & Science University, Portland, OR, USA; Portland State University School of Public Health, Portland, OR.
| | - Myriam Loyo
- Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University, Portland, OR.
| |
Collapse
|
5
|
Yu G, Luo S, Zhu C, Chen L, Huang H, Nie B, Gu J, Liu J. Global Trends and Performances of Acupuncture Therapy on Bell's Palsy from 2000 to 2023: A Bibliometric Analysis. J Pain Res 2023; 16:2155-2169. [PMID: 37397274 PMCID: PMC10312334 DOI: 10.2147/jpr.s401086] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 05/05/2023] [Indexed: 07/04/2023] Open
Abstract
Purpose Recent studies have shown that acupuncture may have great potential in the treatment of Bell's palsy. However, the bibliometric analysis of this field has not been summarized properly. Thus, the purpose of this study is to analyze the hotspot of acupuncture for Bell's Palsy. Methods The core collection database of Web of Science was searched for relevant publications from 2000 to 2023, and countries, institutions, authors, keywords, and literature were analyzed and visualized by bibliometric softwareCiteSpace 5.1.R6, Vosviewer, BICOMB, and gCLUTO to explore the scientific achievements, research collaboration networks, research hot spots, and research trends. Results 229 publications were included in this study. The most cited journal is Journal of Otolaryngology-Head & Neck Surgery; the most prolific country is China; the most prolific author is Li Ying, moreover, the collaboration among scholars is poor; Kyung Hee University is the most prolific institution studying acupuncture for Bell's Palsy. Reference burst detection indicates that traditional Chinese Medicine philosophy, the role of acupuncture in the prognosis of facial palsy, mechanism of acupuncture to improve facial nerve function, and the use of electroacupuncture are starting to become new research hotspots. Conclusion The field of acupuncture for Bell's Palsy has developed rapidly in recent years, and new research trends are mainly: combination with traditional Chinese medicine, the role of acupuncture in the prognosis of facial palsy, mechanism of acupuncture to improve facial nerve function, and the use of electroacupuncture. However, research in this field is still dominated by case reports and clinical trials, and there is a lack of large-scale, multicenter clinical trials and animal experiments there are still many problems in institutional cooperation and experimental design, which requires relevant researchers to strengthen cooperation and improve experimental design.
Collapse
Affiliation(s)
- Guangbin Yu
- Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou City, People’s Republic of China
| | - Shuping Luo
- Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou City, People’s Republic of China
| | - Cuilian Zhu
- Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou City, People’s Republic of China
| | - Li Chen
- Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou City, People’s Republic of China
| | - Hao Huang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou City, People’s Republic of China
| | - Bin Nie
- Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou City, People’s Republic of China
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou City, People’s Republic of China
| | - Jianhao Gu
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou City, People’s Republic of China
| | - Jianxin Liu
- Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou City, People’s Republic of China
| |
Collapse
|
6
|
Muacevic A, Adler JR, Huang A, Usman M, Subhedar S, Decker T, Quansah R. Spider Bite-Induced Facial Nerve Palsy. Cureus 2022; 14:e32162. [PMID: 36601209 PMCID: PMC9806285 DOI: 10.7759/cureus.32162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 12/03/2022] [Indexed: 12/05/2022] Open
Abstract
Spider bites, while rarely confirmed beyond a doubt, should always be in the differential for any severe symptoms or infection out of proportion to presentation with the suspected presence of appropriate vectors. While most arthropod bites will only result in mild localized irritation, the potential to cause severe cutaneous and systemic effects should not be overlooked. We present one such case, in which a presumed brown recluse (Loxosceles reclusa) bite on the neck resulted in severe illness with systemic manifestations. The patient presented to the emergency room minimally responsive with left-sided facial nerve palsy and septic shock. While the admitting physician initially prioritized stabilizing the patient, he noted the left-sided cervical cellulitis. Thorough history taking revealed that the patient had been worsening since being bitten by a spider three days prior to admission. After a month-long hospital stay and multidisciplinary treatment, the patient was transferred to a larger center with facial paralysis still present.
Collapse
|
7
|
Characteristics and Treatment Methods of Bell’s Palsy in Patients Visiting Korean Medicine Hospitals From August 2018 to July 2021. JOURNAL OF ACUPUNCTURE RESEARCH 2022. [DOI: 10.13045/jar.2022.00073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: This study was designed to statistically analyze the data of patients who had Bell’s palsy (BP) who visited a Korean Medicine hospital in the last 3 years to determine the tendency or characteristics of their visit.Methods: This study retrospectively analyzed the medical records of 816 patients. Based on the data collected through medical records demographics, condition/disease, and therapeutic characteristics of the patients were analyzed using IBM SPSS Version 23.0.Results: Patients in their teens or younger, and 50s or older had a higher frequency of inpatient treatment, and 20s to 40s had a higher rate of outpatient treatment. The proportion of men who received steroid combination treatment was higher than women. The number of patients with BP, and the total treatment period of the patients has decreased every year. The total treatment period was shorter in the steroid group than the Korean medicine alone group. Inpatients were more likely to receive steroid combination therapy than outpatients. The proportion of patients who received steroid combination therapy was higher than patients with recurrence of BP. Patients with hypertension or diabetes had a higher rate of hospitalization and received more treatments than patients without the condition/disease.Conclusion: Visit characteristics and treatment methods preferred by patients with BP were identified. This research may help to establish a treatment model for BP in Korean Medicine institutions in the future.
Collapse
|
8
|
Relationship between serum gonadal hormone levels and synkinesis in postmenopausal women and man with idiopathic facial paralysis. Auris Nasus Larynx 2022; 49:782-789. [DOI: 10.1016/j.anl.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 01/17/2022] [Accepted: 02/13/2022] [Indexed: 11/22/2022]
|
9
|
Shankar A, George S, Somaraj S. Evaluation of Clinical Outcome in Traumatic Facial Nerve Paralysis. Int Arch Otorhinolaryngol 2021; 26:e010-e019. [PMID: 35096154 PMCID: PMC8789492 DOI: 10.1055/s-0040-1718962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 08/28/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction
The facial nerve is the most commonly paralyzed nerve in the human body, resulting in far-reaching functional, aesthetic and emotional concerns to the patient.
Objective
Evaluation of the clinical outcome of 47 patients with traumatic facial nerve paralyses, with respect to clinical recovery and audiological sequelae.
Methods
A descriptive longitudinal study was conducted over 24 months between January 2017 and December 2018 at a tertiary center with detailed clinical, topodiagnostic, audiometric and radiological evaluation and regular follow-up after discharge.
Results
Road traffic accidents constituted 82.98% of the trauma cases, out of which 76.60% were found to be under the influence of alcohol.
Delayed facial paralysis was observed in 76.60% cases. Temporal bone fracture was reported in 89.36%, with otic capsule (OC) sparing fractures forming 91.49% of the cases. Topologically, the injury was mostly at the suprachordal region around the second genu. The majority of the patients (65%) attained full recovery of facial nerve function with conservative medical management. Audiometrically, 77.27% of the patients had hearing loss at the time of presentation, of which 64.71% were conductive in nature; 51.22% attained normal hearing at follow-up visits. Conclusion
Early initiation of steroid therapy, concurrent eye care and physiotherapy are the cornerstones in the management of traumatic facial nerve paralysis.
Collapse
Affiliation(s)
- Abhijit Shankar
- Department of ENT, Government Medical College, Kottayam, Kerala, India
| | - Shibu George
- Department of ENT, Government Medical College, Kottayam, Kerala, India
| | - Satheesh Somaraj
- Department of ENT, Government Medical College, Kottayam, Kerala, India
| |
Collapse
|
10
|
Bell’s palsy: clinical and neurophysiologic predictors of recovery. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00171-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The annual incidence of Bell’s palsy (BP) is 15 to 20 per 100,000 with 40,000 new cases each year, and the lifetime risk is 1 in 60. For decades, clinicians have searched the prognostic tests of sufficient accuracy for acute facial paralysis.
Objective
The present study was designed to verify in BP which clinical or electrophysiological parameters could be considered as predictive of the degree of recovery of normal facial muscle function.
Methods
Sixty-three patients with BP were initially assessed according to the House and Brackmann facial function scoring system “HB system”. All patients were followed for 3 months, the functional recovery then reassessed according to HB system. Nerve conduction studies were measured on the affected side via a bipolar surface stimulator placed over the stylomastoid foramen.
Results
We could not find statistically significant differences between BP with good and poor prognosis as regard age, sex, onset, diabetes, hypertension, dyslipidemia, or the initial HB Score. Compound motor action potential amplitude (CMAP) detected during the initial electroneurography (ENoG) was statistically significant between BP with good and poor prognosis.
Conclusions
The initial ENoG is more predictive of recovery of Bell’s palsy than the initial clinical grading using the HB system. Age, sex, hypertension, diabetes, and dyslipidemia do not seem to correlate with the degree of recovery in Bell’s palsy.
Collapse
|
11
|
Picard D, Leroy R, Poussy T, Tankéré F, Gatignol P. [Sequelae in bell's palsy: Prognostic factors for recovery]. ANN CHIR PLAST ESTH 2020; 66:364-370. [PMID: 33036789 DOI: 10.1016/j.anplas.2020.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/09/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Facial palsy can be assessed using objective and subjective tools. The main purpose of this work was to use these tools to determine at 12 months the percentage of patients with sequelae and to specify the type of sequelae. MATERIAL AND METHODS Twenty-three patients with facial palsy were followed in this prospective and longitudinal study. They have been evaluated every 3 months during a year with the House and Brackmann grading scale and the Sunnybrook Facial Grading System. At 12 months, group A was composed of patients with complete recovery and group B, patients with sequelae. RESULTS At 3 months, in patients of group B, the House-Brackmann grading scale (P=0.0134), the Sunnybrook Facial Grading System global score (P=0.0283) and dynamic score (P=0.0148) were lower than group A. Moreover, the movement "brow lift" (P=0.0181) seems to be relevant to predict follow-up. Synkinesis on "brow lift" (P=0.0270) and the treatment delay (P=0.0384) increased for group B. Sex, age, paralyzed side and recurrence of facial palsy had no influence. CONCLUSION Objective and subjective tools determine thresholds and predictive scores of recovery with sequelae at 1 year. Nevertheless, it is relevant to assess clinically specific facial movements, such as "brow lift", to specify a recovery potential and to predict sequelae a year after the onset of facial palsy. As the treatment delay influences recovery, drug treatment should be recommended as early as possible.
Collapse
Affiliation(s)
- D Picard
- Service d'ORL, hôpital universitaire Pitié-Salpêtrière, AP-HP, Paris, France; Inserm, UMRS1158 neurophysiologie respiratoire expérimentale et clinique, Sorbonne Université, Paris, France.
| | - R Leroy
- Service d'ORL, hôpital universitaire Pitié-Salpêtrière, AP-HP, Paris, France
| | - T Poussy
- Service d'ORL, hôpital universitaire Pitié-Salpêtrière, AP-HP, Paris, France
| | - F Tankéré
- Service d'ORL, hôpital universitaire Pitié-Salpêtrière, AP-HP, Paris, France
| | - P Gatignol
- Service d'ORL, hôpital universitaire Pitié-Salpêtrière, AP-HP, Paris, France; Inserm, UMRS1158 neurophysiologie respiratoire expérimentale et clinique, Sorbonne Université, Paris, France
| |
Collapse
|
12
|
Tomita H, Detmar K, Manava P, Nakajima Y, Lell M, Adamus R. Predictive Value of VIBE using Subtraction to Evaluate Idiopathic Facial Palsy after Starting Therapy. ROFO-FORTSCHR RONTG 2020; 192:1183-1189. [DOI: 10.1055/a-1160-6047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose To determine the predictive value of 3-dimensional spoiled gradient-echo volumetric interpolated breath-hold examination (VIBE) using subtraction to evaluate the short-term effect of therapy for facial palsy.
Materials and Methods We included 97 patients with idiopathic facial palsy (52 male, 45 female; aged 50.7 ± 19.4 years) who underwent MR imaging with a contrast agent after starting therapy. The mean interval between onset and therapy was 1.55 ± 1.69 days, between therapy and MR imaging was 3.19 ± 2.78 days, and between MR imaging and assessment of the therapeutic effect was 3.50 ± 0.71 days. The degree of therapeutic effect was determined using a 4-grade scale based on the House–Brackmann scale for grading facial nerve function. Two radiologists reviewed VIBE with pre- and postcontrast subtraction using the 4-point scale. We evaluated the diagnostic performance and compared the degree of therapeutic effect and enhancement of facial nerves that were divided into 5 segments bilaterally.
Results We identified 98 facial palsy initially and significant enhancement in 55 facial nerves after the start of therapy and residual palsy in 87. Sensitivity for all facial palsy was 62.0 %, specificity was 90.9 %, positive predictive value was 98.2 %, negative predictive value was 23.3 %, and accuracy was 65.3 %. Eleven patients recovered completely, 1 showed significant enhancement, and the remaining 10 did not show significant enhancement of the facial nerve.
Conclusion VIBE has a potential to predict the prognostic outcome and assess facial palsy after the start of therapy.
Key points:
Citation Format
Collapse
Affiliation(s)
- Hayato Tomita
- Radiology and Nuclear Medicine, Klinikum Nuernberg, Paracelsus Medical University, Nürnberg, Germany
- Radiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Klaus Detmar
- Radiology and Nuclear Medicine, Klinikum Nuernberg, Paracelsus Medical University, Nürnberg, Germany
| | - Panagiota Manava
- Radiology and Nuclear Medicine, Klinikum Nuernberg, Paracelsus Medical University, Nürnberg, Germany
| | - Yasuo Nakajima
- Radiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Michael Lell
- Radiology and Nuclear Medicine, Klinikum Nuernberg, Paracelsus Medical University, Nürnberg, Germany
- Radiology, Erlangen University Hospital, Erlangen, Germany
| | - Ralf Adamus
- Radiology, Erlangen University Hospital, Erlangen, Germany
| |
Collapse
|
13
|
Loyo M, McReynold M, Mace JC, Cameron M. Protocol for randomized controlled trial of electric stimulation with high-volt twin peak versus placebo for facial functional recovery from acute Bell's palsy in patients with poor prognostic factors. J Rehabil Assist Technol Eng 2020; 7:2055668320964142. [PMID: 33354350 PMCID: PMC7734495 DOI: 10.1177/2055668320964142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/26/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Electric stimulation (ES) can prevent muscle atrophy and promote tissue healing and therefore may help prevent sequelae of Bell's palsy but due to lack of high-quality studies, the effectiveness of ES in Bell's palsy remains controversial. Here we describe a protocol to evaluate the effects of monophasic high volt ES in patients with Bell's palsy and poor prognosis for recovery. RESULTS This is a protocol for a prospective, double-blinded, randomized, placebo-controlled study. Participants include adults with acute Bell's palsy with poor prognosis for full recovery due to complete paralysis or being over age 60. ES will be a monophasic, high-volt pulsed waveform, 100μsec pulse duration, 35 hertz, motor-level intensity. Follow up will be at months 1, 2, 3 and 6. The primary outcome will be the proportion of patients with complete recovery using the eFACES tool. Secondary outcomes include patient reported quality of life measured by FaCE and the synkinesis assessment questionnaires, objective photographs, time to complete recovery, adverse effects, and tolerability. CONCLUSION This protocol has the potential to provide high quality evidence regarding the effects, up to 6 months after onset, of pulsed monophasic high-volt ES for patients with acute Bell's palsy and poor prognosis for complete recovery.
Collapse
Affiliation(s)
- Myriam Loyo
- Department of Otolaryngology – Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Margaret McReynold
- Department of Rehabilitation, Oregon Health & Science University, Portland, OR, USA
| | - Jess C Mace
- Department of Otolaryngology – Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Michelle Cameron
- Department of Neurology, Oregon Health & Science University, Oregon Health & Science University, Portland, OR, USA
- VA Portland Health Care System, Oregon Health & Science University, Portland, OR, USA
| |
Collapse
|
14
|
Kim SH, Jung J, Jung SY, Dong SH, Byun JY, Park MS, Kim SH, Yeo SG. Comparative prognosis in patients with Ramsay-Hunt syndrome and Bell's palsy. Eur Arch Otorhinolaryngol 2019; 276:1011-1016. [PMID: 30707280 DOI: 10.1007/s00405-019-05300-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 01/16/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE Patients with Ramsay-Hunt syndrome have a poorer prognosis than patients with Bell's palsy. Factors of metabolic syndrome affecting prognosis were therefore compared between patients with Ramsay-Hunt syndrome and those with Bell's palsy. METHODS This retrospective study included 106 with Ramsay-Hunt syndrome and 182 with Bell's palsy. Age, sex, body mass index, blood pressure, blood test results, and ENoG results, stratified by House-Brackmann grade, were compared in patients with Ramsay-Hunt syndrome and Bell's palsy. Both groups of patients were treated with steroids and the antiviral agent famciclovir. RESULTS Age, sex, body mass index, dyslipidemia, triglyceride, diabetes, hypertension, and onset of palsy did not differ in patients with Ramsay-Hunt syndrome and Bell's palsy. Rates of favorable recovery in patients with severe facial palsy and DM were lower in patients with Ramsay-Hunt syndrome than with Bell's palsy and were also lower in low-weight, normal weight, and overweight patients with Ramsay-Hunt syndrome than with Bell's palsy. Rates of favorable recovery in patients with severe facial palsy and normal HDL, as well as in patients with severe facial palsy and < 10% ENoG, were lower in patients with Ramsay-Hunt syndrome than with Bell's palsy. CONCLUSIONS Among patients with severe facial palsy, along with diabetes and < 10% ENoG, unfavorable recovery rates were significantly higher in those with Ramsay-Hunt syndrome than with Bell's palsy.
Collapse
Affiliation(s)
- Seok Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, #1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Republic of Korea
| | - Junyang Jung
- Department of Anatomy and Neurobiology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Su Young Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Myongji Hospital, Hanyang University Medical Center, Goyang, Republic of Korea
| | - Sung Hwa Dong
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, #1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Republic of Korea
| | - Jae Yong Byun
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, #1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Republic of Korea
| | - Moon Suh Park
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, #1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Republic of Korea
| | - Sang Hoon Kim
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, #1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Republic of Korea
| | - Seung Geun Yeo
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, #1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Republic of Korea.
| |
Collapse
|
15
|
Khedr EM, Abo El-Fetoh N, El-Hammady DH, Ghandour AM, Osama K, Zaki AF, Gamea A. Prognostic role of neurophysiological testing 3-7 days after onset of acute unilateral Bell's palsy. Neurophysiol Clin 2018; 48:111-117. [PMID: 29496378 DOI: 10.1016/j.neucli.2018.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 01/26/2018] [Accepted: 02/02/2018] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Recovery from acute Bell's palsy (BP) is variable and there are few predictors of response. We evaluated the usefulness of a range of neurophysiological parameters to predict outcome in BP. METHODS Fifty-nine patients (age: 33.7±15.4 years) with acute unilateral BP were recruited within 3-7 days of onset. They were evaluated with electroneurography, facial nerve excitability, and the blink reflex. House-Brackmann (HB) clinical scores were obtained at the same time and three months later. All patients received prednisolone treatment and regular rehabilitation. RESULTS At three months, 41 patients (69.5%) had good recovery, while 18 patients (30.5%) had poor recovery according to the HB scale. The facial nerve excitability threshold and threshold difference between sides were significantly lower in patients with good recovery than those with poor recovery (P values=0.022 and 0.006 respectively). Facial nerve degeneration rate (1 - affected/unaffected amplitude of CMAP of muscle ×100%) recorded in frontalis (P=0.002) and orbicularis oris (P=0.038) were also smaller in good recovery than poor recovery patients. There were no differences in latency and amplitude of CMAPs recorded from frontalis or orbicularis oris muscle, nor in latencies of the components of the blink reflex. ROC analysis showed that patients who had a threshold side difference <13mA (35 cases), had a higher chance of good recovery (85.7% versus 14.3% poor recovery). Patients who had a degeneration rate<50% (38 cases) also had a higher chance of good recovery (78.9%) versus 21.1% who had poor recovery, while patients with a degeneration rate>50% (21 cases) had a 47.8% chance of good recovery versus 52.2% poor recovery (P=0.004). Logistic regression analysis showed that the most significant predictive indicator of BP recovery was the facial nerve degeneration rate of frontalis muscle (P=0.011). CONCLUSION Facial nerve degeneration rate of frontalis muscle provides the most sensitive prognostic indicator of recovery from acute BP and may provide useful management strategies.
Collapse
Affiliation(s)
- Eman M Khedr
- Department of Neuropsychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt.
| | - Noha Abo El-Fetoh
- Department of Neuropsychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Dina H El-Hammady
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Abeer M Ghandour
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Khaled Osama
- Department of Neuropsychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed F Zaki
- Department of Neuropsychiatry, Faculty of Medicine, South Valley University, Egypt
| | - Ayman Gamea
- Department of Neuropsychiatry, Faculty of Medicine, South Valley University, Egypt
| |
Collapse
|
16
|
Hah YM, Kim SH, Jung J, Kim SS, Byun JY, Park MS, Yeo SG. Prognostic value of the blink reflex test in Bell's palsy and Ramsay-Hunt syndrome. Auris Nasus Larynx 2018; 45:966-970. [PMID: 29402606 DOI: 10.1016/j.anl.2018.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 12/20/2017] [Accepted: 01/16/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study was designed to evaluate the prognostic value of the blink reflex (BR) test in patients with Bell's palsy (BP) or Ramsay Hunt syndrome (RHS). METHODS The House-Brackmann (HB) grade of patients diagnosed with BP and RHS was determined at first visit and 3 months later. Final HB grade III-VI was defined as an incomplete recovery. Factors evaluated as prognostic of poor recovery included electroneurography (ENoG) degeneration rate (DR)>90%, and absence of BR. Rates of complete and incomplete recovery were calculated and the associations between prognostic factors and recovery were determined. RESULTS Of the 129 included patients, 98 (76%) had BP and 31 (24%) had RHS. Absence of BR and low mean ENoG value were significantly associated with incomplete recovery in both the BP and RHS groups (p<0.05 each). Initial HB grade V-VI was significantly associated with rate of incomplete recovery in patients with RHS (p<0.05 each). Severe residual palsy (final HB grade V-VI) in the absence of BR was significantly more frequent in patients with RHS than with BP (p<0.05). CONCLUSION BR test results were a good prognostic indicator in patients with BP and RHS, as were ENoG value. Absence of BR was more frequently associated with severe residual palsy in RHS than in BP.
Collapse
Affiliation(s)
- Young Min Hah
- Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Sang Hoon Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Junyang Jung
- Department of Anatomy, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sung Su Kim
- Department of Biochemistry and Molecular Biology, Medical Science and Engineering Research Center for Bioreaction to Reactive Oxygen Species, BK-21, School of Medicine, Kyung Hee University, Seoul 130-701, Republic of Korea
| | - Jae Yong Byun
- Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Moon Suh Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Seung Geun Yeo
- Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
| |
Collapse
|
17
|
Alanazi WL, El-Fetoh NMA, Alanazi SL, Alkhidhr MA, Alanazi MA, Alonazi DS, Alanzi AB, Alshammari RH, Alshammari MJ, Alanazi BA, Alanazi SS. Profile of facial palsy in Arar, northern Saudi Arabia. Electron Physician 2017; 9:5596-5602. [PMID: 29238502 PMCID: PMC5718866 DOI: 10.19082/5596] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 09/08/2017] [Indexed: 11/20/2022] Open
Abstract
Background The term facial palsy generally refers to weakness of the facial muscles, mainly resulting from temporary or permanent damage to the facial nerve. Common causes of facial paralysis include infection or inflammation of the facial nerve, head trauma, head or neck tumor, stroke. Objective To outline the incidence of several etiologies and the profile of patients with peripheral facial paralysis attending the outpatient clinic of the neurology department in Hospitals of Arar City, Saudi Arabia. Methods This cross-sectional study was carried out in Arar city from October 2016 to May 2017. The study was conducted in the outpatient clinic of the neurology department in hospitals of Arar City. Any ages of both sexes of all newly diagnosed unilateral facial palsy were included in the study. Data were analyzed by SPSS version 15, using descriptive statistics and Chi-square test. P-value was considered significant if <0.05 Results The mean age of the facial palsy cases was 33.65 (±11.71) years. Among the studied participants, the total prevalence of facial palsy was 26.3% (61% females and 39% males). The right side of the face was affected in 51.2% and the etiology was exposure to cold air current in 92.7% of cases. The treatment was physiotherapy in 80.5% of the cases, medical in 17.1% and surgical in 2.4%. There was significant relationship between smoking and the occurrence of facial palsy (p<0.05). Conclusion The study revealed that facial palsy was common in Arar city. The rate is higher among males than females. We also concluded that exposure to cold air current was the main etiology. We recommend health education sittings to bring awareness to the public about the nature, causes, risk factors, prevention and treatment of the disease.
Collapse
Affiliation(s)
- Wasan Lafi Alanazi
- Intern, Faculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia
| | - Nagah Mohamed Abo El-Fetoh
- Associate Professor of Community Medicine, Faculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia
| | - Shahad Lafi Alanazi
- Medical Student, Faculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia
| | | | | | - Dounia Saleh Alonazi
- Medical Student, Faculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia
| | - Atheer Bader Alanzi
- Medical Student, Faculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia
| | - Reem Homoud Alshammari
- Medical Student, Faculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia
| | - Mashael Jaza Alshammari
- Medical Student, Faculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia
| | - Basmah Abdullah Alanazi
- Medical Student, Faculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia
| | | |
Collapse
|
18
|
Kopala W, Kukwa A. Evaluation of the acoustic (stapedius) reflex test in children and adolescents with peripheral facial nerve palsy. Int J Pediatr Otorhinolaryngol 2016; 89:102-6. [PMID: 27619038 DOI: 10.1016/j.ijporl.2016.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 08/01/2016] [Accepted: 08/02/2016] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The stapedius nerve is one of the branches of the facial nerve in the temporal bone. It supplies the stapedius muscle, which is responsible for the attenuation reflex that protects the inner ear from loud noises. The stapedius (acoustic) reflex (SR) test is useful in identifying the site of facial nerve injury. The return of the SR (acoustic) to normal after an injury is a good prognostic factor in the treatment of facial nerve palsy. OBJECTIVE The aim of this study was to evaluate the effect of FNP on the SR (acoustic) response and determine the acoustic reflex threshold (ART) levels on the affected side. MATERIAL AND METHOD In this study, 70 patients, 3-7 years old, were screened. The study population consisted of 26 boys (37%) and 44 girls (63%). Follow-up tests were performed 3-18 months after the initial tests. RESULTS Most patients in the study population had a negative SR (acoustic) response on the affected side. In other patients, mean ART values were statistically higher on the affected side. There was no statistically significant relationship between a reflex response and the time from the onset of facial nerve palsy. DISCUSSION In the available literature, the SR (acoustic) testing is limited in determining whether or not the reflex is present without stimulus frequency or ART measurements. It is estimated that the reflex response is negative with ipsilateral stimulation on the affected side in 35-80% patients. CONCLUSIONS The SR (acoustic) is absent in most patients on the affected side. The ART value was statistically higher on the affected side. The SR (acoustic) response was statistically time independent.
Collapse
Affiliation(s)
- Wacław Kopala
- The Provincial Children's Specialized Hospital, Department of Otolaryngology, Olsztyn, Poland.
| | - Andrzej Kukwa
- University Hospital, Department of Otolaryngology, Olsztyn, Poland
| |
Collapse
|
19
|
Ferreira M, Firmino-Machado J, Marques EA, Santos PC, Simões AD, Duarte JA. Prognostic factors for recovery in Portuguese patients with Bell’s palsy. Neurol Res 2016; 38:851-6. [DOI: 10.1080/01616412.2016.1209620] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Margarida Ferreira
- Faculty of Sport, Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
- Department of Physiotherapy, CESPU, North Polytechnic Institute of Health, Gandra and Vila Nova de Famalicão, Portugal
| | | | - Elisa A. Marques
- Research Center in Sports Sciences, Health and Human Development (CIDESD), University Institute of Maia (ISMAI), Maia, Portugal
- National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Paula C. Santos
- Faculty of Sport, Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
- Department of Physical Therapy, School of Health Technology of Porto, Polytechnic Institute of Porto, Vila Nova de Gaia, Portugal
| | - Ana Daniela Simões
- Department of Physiotherapy, CESPU, North Polytechnic Institute of Health, Gandra and Vila Nova de Famalicão, Portugal
| | - José A. Duarte
- Faculty of Sport, Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
| |
Collapse
|
20
|
Chao X, Xu L, Li J, Han Y, Li X, Mao Y, Shang H, Fan Z, Wang H. Facilitation of facial nerve regeneration using chitosan-β-glycerophosphate-nerve growth factor hydrogel. Acta Otolaryngol 2016; 136:585-91. [PMID: 26881479 DOI: 10.3109/00016489.2015.1136432] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Conclusion C/GP hydrogel was demonstrated to be an ideal drug delivery vehicle and scaffold in the vein conduit. Combined use autologous vein and NGF continuously delivered by C/GP-NGF hydrogel can improve the recovery of facial nerve defects. Objective This study investigated the effects of chitosan-β-glycerophosphate-nerve growth factor (C/GP-NGF) hydrogel combined with autologous vein conduit on the recovery of damaged facial nerve in a rat model. Methods A 5 mm gap in the buccal branch of a rat facial nerve was reconstructed with an autologous vein. Next, C/GP-NGF hydrogel was injected into the vein conduit. In negative control groups, NGF solution or phosphate-buffered saline (PBS) was injected into the vein conduits, respectively. Autologous implantation was used as a positive control group. Vibrissae movement, electrophysiological assessment, and morphological analysis of regenerated nerves were performed to assess nerve regeneration. Results NGF continuously released from C/GP-NGF hydrogel in vitro. The recovery rate of vibrissae movement and the compound muscle action potentials of regenerated facial nerve in the C/GP-NGF group were similar to those in the Auto group, and significantly better than those in the NGF group. Furthermore, larger regenerated axons and thicker myelin sheaths were obtained in the C/GP-NGF group than those in the NGF group.
Collapse
Affiliation(s)
- Xiuhua Chao
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China
- Shandong Institute of Otolaryngology, Jinan, PR China
| | - Lei Xu
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China
- Shandong Institute of Otolaryngology, Jinan, PR China
| | - Jianfeng Li
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China
- Shandong Institute of Otolaryngology, Jinan, PR China
| | - Yuechen Han
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China
| | - Xiaofei Li
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China
| | - YanYan Mao
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China
| | - Haiqiong Shang
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China
- Shandong Institute of Otolaryngology, Jinan, PR China
| | - Zhaomin Fan
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China
- Shandong Institute of Otolaryngology, Jinan, PR China
| | - Haibo Wang
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China
- Shandong Institute of Otolaryngology, Jinan, PR China
| |
Collapse
|
21
|
Wasano K, Kawasaki T, Yamamoto S, Tomisato S, Shinden S, Ishikawa T, Minami S, Wakabayashi T, Ogawa K. Pretreatment Hematologic Findings as Novel Predictive Markers for Facial Palsy Prognosis. Otolaryngol Head Neck Surg 2016; 155:581-7. [PMID: 27165675 DOI: 10.1177/0194599816646552] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 04/06/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the relationship between prognosis of 2 different facial palsies and pretreatment hematologic laboratory values. STUDY DESIGN Multicenter case series with chart review. SETTING Three tertiary care hospitals. SUBJECTS AND METHODS We examined the clinical records of 468 facial palsy patients who were treated with an antiviral drug in combination with either oral or intravenous corticosteroids in participating hospitals between 2010 and 2014. Patients were divided into a Bell's palsy group or a Hunt's palsy group. We used the Yanagihara facial nerve grading system to grade the severity of facial palsy. "Recovery" from facial palsy was defined as achieving a Yanagihara score ≥36 points within 6 months of onset and having no accompanying facial contracture or synkinesis. We collected information about pretreatment hematologic findings, demographic data, and electrophysiologic test results of the Bell and Hunt group patients who recovered and those who did not. We then compared these data across the 2 palsy groups. RESULTS In the Bell's palsy group, recovered and unrecovered patients differed significantly in age, sex, electroneuronography score, stapedial muscle reflex, neutrophil rate, lymphocyte rate, neutrophil-to-lymphocyte ratio, and initial Yanagihara score. In the Hunt's palsy group, recovered and unrecovered patients differed in age, electroneuronography score, stapedial muscle reflex, monocyte rate, platelet count, mean corpuscular volume, and initial Yanagihara score. CONCLUSIONS Pretreatment hematologic findings, which reflect the severity of inflammation and bone marrow dysfunction caused by a virus infection, are useful for predicting the prognosis of facial palsy.
Collapse
Affiliation(s)
- Koichiro Wasano
- Department of Otolaryngology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Taiji Kawasaki
- Department of Otolaryngology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
| | - Sayuri Yamamoto
- Department of Otolaryngology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
| | - Shuta Tomisato
- Department of Otolaryngology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
| | - Seiichi Shinden
- Department of Otolaryngology, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Toru Ishikawa
- Department of Otolaryngology, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Shujiro Minami
- Department of Otolaryngology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Takeshi Wakabayashi
- Department of Otolaryngology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Kaoru Ogawa
- Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
22
|
Lee S, Seol HJ, Park K, Lee JI, Nam DH, Kong DS, Cho YS. Functional Outcome of the Facial Nerve After Surgery for Vestibular Schwannoma: Prediction of Acceptable Long-Term Facial Nerve Function Based on Immediate Postoperative Facial Palsy. World Neurosurg 2016; 89:215-22. [PMID: 26826537 DOI: 10.1016/j.wneu.2016.01.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 01/18/2016] [Accepted: 01/19/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the relationship between immediate postoperative facial palsy and long-term facial palsy and identify a treatment strategy for vestibular schwannoma considering long-term outcomes of facial nerve function and tumor control. METHODS Patients (N = 385) who underwent surgery in a single institution were reviewed retrospectively; 12 patients with neurofibromatosis, 6 with preoperative radiosurgery, and 14 with multiple surgeries were excluded. The generalized estimating equation method was used to show the correlation between immediate and later postoperative facial palsy and to identify the cutoff grade of immediate postoperative facial palsy. RESULTS The tumor control rates for 1 year, 3 years, and 5 years were 88.7%, 83.9%, and 80.0%. Preservation of facial function above House-Brackmann (H-B) grades 1 and 2 was achieved in 47.9% of patients immediately postoperatively, in 50.1% after 1 month, and in 74.5% after >2 years. The immediate postoperative facial palsy grade showed a statistically significant relationship with the facial palsy grade on long-term follow-up (P < 0.001). H-B grade 3 immediate postoperative facial palsy was identified as the cutoff grade that showed the most significant relationship between the grade of immediate postoperative facial palsy and the grades above the cutoff (H-B grade 1-3) on long-term follow-up (P < 0.001). CONCLUSIONS H-B grade of immediate postoperative facial palsy can predict facial palsy at long-term follow-up. H-B grade 3 immediate postoperative facial palsy is the lowest tolerable grade that guarantees functional improvement on long-term follow-up. Planned facial nerve preservation surgery followed by radiosurgery is thought to be optimal treatment in patients with vestibular schwannoma for both tumor control and facial nerve function.
Collapse
Affiliation(s)
- Seunghoon Lee
- Department of Neurosurgery-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ho Jun Seol
- Department of Neurosurgery-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Kwan Park
- Department of Neurosurgery-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung-Il Lee
- Department of Neurosurgery-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Do-Hyun Nam
- Department of Neurosurgery-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Doo-Sik Kong
- Department of Neurosurgery-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yang-Sun Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
23
|
Haginomori SI, Ichihara T, Mori A, Kanazawa A, Kawata R, Tang H, Mori Y. Varicella-zoster virus-specific cell-mediated immunity in Ramsay Hunt syndrome. Laryngoscope 2015; 126:E35-9. [DOI: 10.1002/lary.25441] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 05/13/2015] [Accepted: 05/22/2015] [Indexed: 11/05/2022]
Affiliation(s)
- Shin-Ichi Haginomori
- Department of Otolaryngology-Head and Neck Surgery; Osaka Medical College; Takatsuki Japan
| | - Takahiro Ichihara
- Department of Otolaryngology-Head and Neck Surgery; Osaka Medical College; Takatsuki Japan
| | - Atsuko Mori
- Department of Otolaryngology-Head and Neck Surgery; Osaka Medical College; Takatsuki Japan
| | - Atsuko Kanazawa
- Department of Otolaryngology-Head and Neck Surgery; Osaka Medical College; Takatsuki Japan
| | - Ryo Kawata
- Department of Otolaryngology-Head and Neck Surgery; Osaka Medical College; Takatsuki Japan
| | - Huamin Tang
- Division of Clinical Virology; Department of Microbiology and Infectious Disease; Kobe University Graduate School of Medicine; Kobe Japan
| | - Yasuko Mori
- Division of Clinical Virology; Department of Microbiology and Infectious Disease; Kobe University Graduate School of Medicine; Kobe Japan
| |
Collapse
|
24
|
Mancini P, De Seta D, Prosperini L, Nicastri M, Gabriele M, Ceccanti M, Sementilli G, Terella M, Bertoli GA, Filipo R, Inghilleri M. Prognostic factors of Bell's palsy: Multivariate analysis of electrophysiological findings. Laryngoscope 2014; 124:2598-605. [DOI: 10.1002/lary.24764] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 05/06/2014] [Accepted: 05/07/2014] [Indexed: 11/07/2022]
Affiliation(s)
| | | | - Luca Prosperini
- Department of Neurology and Psychiatry; University Sapienza; Rome Italy
| | - Maria Nicastri
- Department of Sense Organs; University Sapienza; Rome Italy
| | - Maria Gabriele
- Department of Neurology and Psychiatry; University Sapienza; Rome Italy
| | - Marco Ceccanti
- Department of Neurology and Psychiatry; University Sapienza; Rome Italy
| | | | - Maria Terella
- Department of Sense Organs; University Sapienza; Rome Italy
| | | | | | | |
Collapse
|
25
|
Prognostic factors of synkinesis after Bell's palsy and Ramsay Hunt syndrome. Auris Nasus Larynx 2013; 40:431-4. [DOI: 10.1016/j.anl.2013.01.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 01/22/2013] [Accepted: 01/24/2013] [Indexed: 11/18/2022]
|
26
|
Byun H, Cho YS, Jang JY, Chung KW, Hwang S, Chung WH, Hong SH. Value of electroneurography as a prognostic indicator for recovery in acute severe inflammatory facial paralysis: a prospective study of Bell's palsy and Ramsay Hunt syndrome. Laryngoscope 2013; 123:2526-32. [PMID: 23918352 DOI: 10.1002/lary.23988] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/18/2012] [Accepted: 12/18/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS To evaluate the prognostic and predictive value of electroneuronography (ENoG) in acute severe inflammatory facial paralysis, including Bell's palsy and Ramsay Hunt syndrome (RHS). STUDY DESIGN Prospective observational study. METHODS Patients with acute severe facial paralysis of House-Brackmann (H-B) grade IV or worse and diagnosed with Bell's palsy or RHS were enrolled from August 2007 to July 2011. After treatment with oral corticosteroid, antiviral agent, and protective eye care, patients were followed up until recovery or 12 months from onset. RESULTS Sixty-six patients with Bell's palsy and 22 with RHS were included. Multiple logistic regression analysis showed significant effect of ENoG value on recovery in both Bell's palsy and RHS. Values of ENoG were significantly worse in RHS than Bell's palsy. Chance of early recovery within 6 weeks after correction of ENoG effect was still significantly worse in RHS. Logistic regression analysis showed 90% chance of recovery within 6 months, expected with ENoG values of 69.2% degeneration (Bell's palsy) and 59.3% (RHS). The receiver operating characteristics (ROC) curves showed ENoG values of 82.5% (Bell's palsy) and 78.0% (RHS) as a critical cutoff value of nonrecovery until 1 year, with the best sensitivity and specificity. CONCLUSIONS A higher chance of recovery was expected with better ENoG in Bell's palsy and RHS. Based on our data, nonrecovery is predicted in patients with ENoG value greater than 82.5% in Bell's palsy, and 78% in RHS. LEVEL OF EVIDENCE 4.
Collapse
Affiliation(s)
- Hayoung Byun
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; and the
| | | | | | | | | | | | | |
Collapse
|
27
|
Kato Y, Kamo H, Kobayashi A, Abe S, Okada-Ogawa A, Noma N, Kukimoto N, Omori H, Nakazato H, Kishi H, Ikeda M, Imamura Y. Quantitative evaluation of oral function in acute and recovery phase of idiopathic facial palsy; a preliminary controlled study. Clin Otolaryngol 2013; 38:231-6. [DOI: 10.1111/coa.12118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Y. Kato
- Department of Oral Diagnostic Sciences; Nihon University School of Dentistry; Tokyo; Japan
| | - H. Kamo
- Department of Oral Diagnostic Sciences; Nihon University School of Dentistry; Tokyo; Japan
| | - A. Kobayashi
- Department of Oral Diagnostic Sciences; Nihon University School of Dentistry; Tokyo; Japan
| | - S. Abe
- Department of Oral Diagnostic Sciences; Nihon University School of Dentistry; Tokyo; Japan
| | | | | | - N. Kukimoto
- Department of Otorhinolaryngology-Head and Neck Surgery; Nihon University School of Medicine; Tokyo; Japan
| | - H. Omori
- Department of Otorhinolaryngology-Head and Neck Surgery; Nihon University School of Medicine; Tokyo; Japan
| | - H. Nakazato
- Department of Otorhinolaryngology-Head and Neck Surgery; Nihon University School of Medicine; Tokyo; Japan
| | - H. Kishi
- Department of Otorhinolaryngology-Head and Neck Surgery; Nihon University School of Medicine; Tokyo; Japan
| | - M. Ikeda
- Department of Otorhinolaryngology-Head and Neck Surgery; Nihon University School of Medicine; Tokyo; Japan
| | | |
Collapse
|
28
|
|
29
|
Marsk E, Bylund N, Jonsson L, Hammarstedt L, Engström M, Hadziosmanovic N, Berg T, Hultcrantz M. Prediction of nonrecovery in Bell's palsy using Sunnybrook grading. Laryngoscope 2012; 122:901-6. [PMID: 22374870 DOI: 10.1002/lary.23210] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 12/22/2011] [Accepted: 12/29/2011] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS To develop a clinical prognostic model to identify Bell's palsy patients with risk for nonrecovery at 12 months. STUDY DESIGN Data from a prospective, randomized, double-blind, placebo-controlled, multicenter study. METHODS There were 829 patients with Bell's palsy randomized in a factorial fashion to treatment with prednisolone or no prednisolone. Facial function was assessed with the Sunnybrook grading scale. Univariate and multivariate logistic regression analyses at different time points were used to identify factors predicting nonrecovery, defined as Sunnybrook <70 at 12 months. Variables studied were age, gender, time to inclusion, prednisolone treatment, side of palsy, pain at inclusion, and Sunnybrook scores. Factors of predictable significance were used to construct prognostic models at baseline, days 11 to 17, and at 1 month. Receiver operating characteristics curves were created to test the predictive capacity of the models. RESULTS At baseline, treatment with prednisolone or no prednisolone (P = .0005), age (P = .04) and the Sunnybrook score (P = .0002) were significant factors for predicting nonrecovery. The receiver operating characteristics area under the curve at baseline for these three variables was 0.74 (sensitivity 0.83, specificity 0.57). At days 11 to 17 and at 1 month, the Sunnybrook score was the only significant predictive variable. The respective areas under the curves for the Sunnybrook score at these time points were 0.83 (sensitivity 0.81, specificity 0.75) and 0.94 (sensitivity 0.91, specificity 0.85). CONCLUSIONS Sunnybrook grading at 1 month most accurately predicts nonrecovery at 12 months in Bell's palsy.
Collapse
Affiliation(s)
- Elin Marsk
- Department of Otorhinolaryngology and Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden.
| | | | | | | | | | | | | | | |
Collapse
|
30
|
Takemoto N, Horii A, Sakata Y, Inohara H. Prognostic factors of peripheral facial palsy: multivariate analysis followed by receiver operating characteristic and Kaplan-Meier analyses. Otol Neurotol 2011; 32:1031-6. [PMID: 21725266 DOI: 10.1097/mao.0b013e31822558de] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To search for prognostic predictors and reexamine the usefulness of electroneurography (ENoG) in predicting the prognosis of peripheral facial palsy using statistical methods. STUDY DESIGN Prospective study. SETTING Tertiary referral center. PATIENTS Consecutive 142 patients with Bell's palsy and 26 with Ramsay Hunt syndrome treated with steroid plus antiviral agents. INTERVENTIONS Multivariate analysis was used to identify which factors, including Yanagihara grading score and ENoG, predict better recovery. Receiver operating characteristic (ROC) curves were constructed for ENoG and grading score. The cumulative recovery rate by ENoG was calculated using Kaplan-Meier analysis. Recovery was defined as the improvement of grading score to 36 points or more (full score, 40) without synkinesis. RESULTS Multivariate analysis revealed that Ramsay Hunt syndrome, the worst grading score and ENoG were the significant prognostic predictors. The area under the ROC curve for ENoG was broader than those for grading score, indicating that ENoG was superior to grading score in terms of accuracy for prognosis prediction. The ROC curve revealed that more than 85% degeneration on ENoG had the best specificity (77.8%) and sensitivity (71.4%) to predict nonrecovery. When ENoG was subjected to the analysis of cumulative recovery rate using Kaplan-Meier plots, patients with more than 85% degeneration on ENoG had significantly poorer prognosis. CONCLUSION ENoG was the most effective factor for prediction of the prognosis of peripheral facial palsy, and more than 85% degeneration had the best specificity and sensitivity to predict nonrecovery.
Collapse
Affiliation(s)
- Norihiko Takemoto
- Department of Otolaryngology, Suita Municipal Hospital, 2-13-20 Katayama-cho, Suita City, Osaka 564-0082, Japan
| | | | | | | |
Collapse
|
31
|
Arana-Alonso E, Contín-Pescacen M, Guillermo-Ruberte A, Morea Colmenares E. Síndrome de Ramsay-Hunt: ¿qué tratamiento precisa? Semergen 2011. [DOI: 10.1016/j.semerg.2011.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
32
|
|
33
|
Jenke AC, Stoek LM, Zilbauer M, Wirth S, Borusiak P. Facial palsy: etiology, outcome and management in children. Eur J Paediatr Neurol 2011; 15:209-13. [PMID: 21159531 DOI: 10.1016/j.ejpn.2010.11.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 10/25/2010] [Accepted: 11/13/2010] [Indexed: 11/28/2022]
Abstract
BACKGROUND Currently there is much controversy whether to treat idiopathic facial palsy with corticosteroids with sparse data on the natural course of the disease in children. METHODS We performed a prospective study on all children <15 years of age who were admitted to our unit for facial palsy between 1st July 1998 to 30th June 2008. All patients received a standardized work-up and follow-up. Therapy consisted of symptomatic treatment either with (in case of neuroborreliosis) or without a 14 day course of intravenous antibiotics. FINDINGS 106 patients were included in our study. The calculated incidence for facial palsy was 21.1/100000/year for children <15 years. The incidence for neuroborreliosis (NB) in this age group was calculated to be 4.9/100000/year. The overall rate of complete recovery was 97.6% with significantly faster recovery in younger children and in patients with NB as compared to idiopathic facial palsy. Both patients with incomplete recovery were at least 14 years old and presented late in the course of the disease. CONCLUSION Based on the rate of 97.6% spontaneous complete recovery we believe that the routine use of corticosteroids in children with facial palsy is not justified, unless there is new data from controlled trials in children.
Collapse
Affiliation(s)
- Andreas Christoph Jenke
- Children's Hospital, HELIOS Klinikum Wuppertal, Witten-Herdecke University, Heusnerstr. 40, D-42283 Wuppertal, Germany.
| | | | | | | | | |
Collapse
|
34
|
Abstract
OBJECTIVE To evaluate if treatment start and age are related to the outcome in Bell's palsy patients treated with prednisolone. STUDY DESIGN Prospective, randomized, double-blind, placebo-controlled, multicenter trial. SETTING Sixteen otorhinolaryngologic centers in Sweden and 1 in Finland. PATIENTS Data were collected from the Scandinavian Bell's palsy study. A total of 829 patients were treated within 72 hours of onset of palsy. Follow-up was 12 months. INTERVENTION Patients were randomly assigned to treatment with placebo plus placebo (n = 206), prednisolone plus placebo (n = 210), valacyclovir plus placebo (n = 207), or prednisolone plus valacyclovir (n = 206). MAIN OUTCOME MEASURES Facial function was assessed with the Sunnybrook grading system, and complete recovery was defined as Sunnybrook = 100. Time from onset of palsy to treatment start was registered. RESULTS Patients treated with prednisolone within 24 hours and 25 to 48 hours had significantly higher complete recovery rates, 66% (103/156) and 76% (128/168), than patients given no prednisolone, 51% (77/152) and 58% (102/177) (p = 0.008 and p = 0.0003, respectively). For patients treated within 49 to 72 hours of palsy onset, there were no significant differences. Patients aged 40 years or older had significantly higher complete recovery rates if treated with prednisolone, whereas patients aged younger than 40 years did not differ with respect to prednisolone treatment. However, synkinesis was significantly less in patients younger than 40 years given prednisolone (p = 0.002). CONCLUSION Treatment with prednisolone within 48 hours of onset of palsy resulted in significantly higher complete recovery rates and less synkinesis compared with no prednisolone.
Collapse
|
35
|
Hsieh RL, Wu CW, Wang LY, Lee WC. Correlates of degree of nerve involvement in early Bell's palsy. BMC Neurol 2009; 9:22. [PMID: 19500424 PMCID: PMC2701406 DOI: 10.1186/1471-2377-9-22] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Accepted: 06/07/2009] [Indexed: 11/23/2022] Open
Abstract
Background This study aimed to evaluate the still unknown factors correlating with the degree of nerve involvement in early Bell's palsy. Methods This retrospective chart review study of newly diagnosed cases of Bell's palsy was conducted over a three-year period. Information on age, sex, day of onset, comorbidities, corticosteroid use, and electroneurographic test results were collected. The electroneurographic quotient (amplitude of compound muscle action potential on the affected side divided by that on the healthy side and expressed in percent) was used as an index of nerve involvement, with lower quotient indicating more severe disease. Results Data were collected on 563 patients. The mean electroneurographic quotient varied inversely with age (p < 0.001) and was higher in patients who used corticosteroids than those who did not (47.1% vs. 40.3%; p = 0.002). There was no correlation between the degree of nerve involvement and sex, season of onset, hypertension, or diabetes. Conclusion The degree of nerve involvement in early Bell's palsy correlates positively with age and negatively with corticosteroid use.
Collapse
Affiliation(s)
- Ru-Lan Hsieh
- Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan.
| | | | | | | |
Collapse
|
36
|
Kossowski M, Bordure P, Darrouzet V, Dubreuil C, Tran Ba Huy P. [Bell's palsy]. ANNALES D'OTO-LARYNGOLOGIE ET DE CHIRURGIE CERVICO FACIALE : BULLETIN DE LA SOCIETE D'OTO-LARYNGOLOGIE DES HOPITAUX DE PARIS 2008; 125:323-327. [PMID: 18842253 DOI: 10.1016/j.aorl.2008.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2008] [Accepted: 06/24/2008] [Indexed: 05/26/2023]
Affiliation(s)
- M Kossowski
- Service d'ORL et de chirurgie cervicofaciale, hôpital d'Instruction des Armées-Percy, 101, avenue Henri-Barbusse, 92141 Clamart cedex, France.
| | | | | | | | | |
Collapse
|
37
|
Abstract
PURPOSE Facial nerve injury can occur in the regions ranging from the cerebral cortex to the motor end plate in the face, and from many causes including trauma, viral infection, and idiopathic factors. Facial nerve paralysis in children, however, may differ from that in adults. We, therefore, evaluated its etiology and recovery rate in children and adults. MATERIALS AND METHODS We retrospectively evaluated the records of 975 patients, ranging in age from 0 to 88 years, who displayed facial palsy at Kyung Hee Medical Center between January 1986 and July 2005. RESULTS The most frequent causes of facial palsy in adults were Bell's palsy (54.9%), infection (26.8%), trauma (5.9%), iatrogenic (2.0%), and tumors (1.8%), whereas the most frequent causes of facial palsy in children were Bell's palsy (66.2%), infection (14.6%), trauma (13.4%), birth trauma (3.2%), and leukemia (1.3%). Recovery rates in adults were 91.4% for Bell's palsy, 89.0% for infection, and 64.3% for trauma, whereas recovery rates in children were 93.1% for Bell's palsy, 90.9% for infection, and 42.9% for trauma. CONCLUSION These results show that causes of facial palsy are similar in adults and children, and recovery rates in adults and children are not significantly different.
Collapse
Affiliation(s)
- Chang Il Cha
- Department of Otolaryngology, The College of Medicine, Kyung Hee University, Seoul, Korea
| | - Chang Kee Hong
- Department of Otolaryngology, The College of Medicine, Kyung Hee University, Seoul, Korea
| | - Moon Suh Park
- Department of Otolaryngology, The College of Medicine, Kyung Hee University, Seoul, Korea
| | - Seung Geun Yeo
- Department of Otolaryngology, The College of Medicine, Kyung Hee University, Seoul, Korea
| |
Collapse
|
38
|
Veronezi RJB, Fernandes YB, Borges G, Ramina R. Long-term facial nerve clinical evaluation following vestibular schwannoma surgery. ARQUIVOS DE NEURO-PSIQUIATRIA 2008; 66:194-8. [DOI: 10.1590/s0004-282x2008000200010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2007] [Accepted: 02/21/2008] [Indexed: 11/22/2022]
Abstract
BACKGROUND: Facial function is important in accompaniment of patients operated on vestibular schwannoma (VS). OBJETIVE: To evaluate long term facial nerve function in patients undergoing VS resection and to correlate tumor size and facial function in a long-term follow-up. METHOD: Transversal study of 20 patients with VS operated by the retrosigmoid approach. House-Brackmann Scale was used preoperatively, immediately after surgery and in a long-term follow-up. Student t test was applied for statistic analysis. RESULTS: In the immediate postoperative evaluation, 65% of patients presented FP of different grades. Improvement of facial nerve function (at least of one grade) occurred in 53% in the long-term follow-up. There was statistically significant difference in facial nerve outcome in long-term follow-up when tumor size was considered (p<0.05). Conclusion: The majority of patients had improvement of FP in a long-term follow-up and tumor size was detected to be a factor associated with the postoperative prognostic.
Collapse
|
39
|
Abstract
BACKGROUND In this retrospective study, we assessed the long-term prognostic value of the minimal nerve excitability test (NET) by comparing the results it yielded with the House-Brackmann (HB) index in patients with the most common types of facial paralysis, Bell's palsy and traumatic facial palsy. PATIENTS AND METHODS Three hundred and fifty patients aged 9-85 years (mean age 42.4 years; 156 male and 194 female), all of whom were treated initially with the same steroid therapy, entered on study. Patients in whom decompression surgery had been performed were excluded so as to avoid falsely optimistic prognoses. The 350 study patients were divided into two groups: group 1 was made up of 250 with Bell's palsy and group 2, of 100 with nonpenetrating traumatic facial palsy following temporal bone fracture. The NET was conducted repeatedly in all patients for 3 weeks from the start of day 3 of treatment, the value recorded on day 14 being used in the evaluation. For each patient, the result of the NET was recorded as 'normal', 'diminished' or 'without response' according to the difference between the two sides of the face. The final HB grading was determined after 1 year to check for the agreement between the electrical prognosis and the clinical outcome and thus the reliability of the prognosis indicated by the NET. RESULTS The results indicate that a normal NET forecast a satisfactory outcome that could be classed as HB I-II in almost all the patients in both groups. Among patients who had no response on NET, 85% of those with Bell's palsy and 90% of those with traumatic facial palsy failed to recover nerve function. Diminished nerve excitability proved to be a sign of a relatively favourable prognosis: 74% of patients in each group recovered normal facial function. CONCLUSION The NET is a method of investigation that is easily applied and can make a positive contribution to the assessment of prognosis in Bell's palsy and in traumatic facial palsy, reflecting the functional state of the facial nerve reliably in most of cases.
Collapse
Affiliation(s)
- G Psillas
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, AHEPA-Hospital, Aristoteles-Universität, 54006, Thessaloniki, Griechenland
| | | | | | | |
Collapse
|