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Endoscopic vs microscopic facial nerve decompression for traumatic facial nerve palsy: a randomized controlled trial
Purpose
To explore a minimally invasive trans-canal endoscopic facial nerve decompression for traumatic facial nerve palsy and compare it with microscopic facial nerve decompression.
Methods
35 and 38 patients underwent endoscopic and microscopic facial nerve decompression, respectively, for traumatic facial nerve palsy. Onset of symptoms, type of temporal bone fracture, day of surgical intervention following trauma, ossicular chain status and nature of insult to facial nerve were observed. Time period for recovery (House Brackmann grade ≤ 3), long term recovery rates, pre- and post-operative hearing status, surgical time and post-operative pain were compared between groups.
Results
Maximum patients in endoscopic and microscopic groups (77.1% and 76.3%, respectively) had acute onset of symptoms. 57.1% (20/35) had longitudinal, 17.1% (6/35) had transverse and 25.7% (9/35) had mixed fractures in endoscopic group. In the microscopic group, 57.9% (22/38) had longitudinal, 18.4% (7/38) had transverse and 23.7% (9/38) had mixed fractures. The mean (± S.D.) post-operative air–bone gap in endoscopic and microscopic group were 16.47 ± 4.5 dB and 19.4 ± 5.2 dB, respectively, which was statistically significant. The mean (± S.D.) time period for recovery of endoscopic and microscopic groups were 14.4 ± 5 days and 22.5 ± 7 days, respectively (
p
value < 0.05). The difference in post-operative pain between the two groups was also statistically significant. The difference in long term recovery rates was not statistically significant (
p
> 0.05).
Conclusions
Endoscopic facial nerve decompression results in early recovery, less post-operative pain and better post-operative air–bone gap closure when compared to conventional microscopic technique.
Journal Article
Make a face
Make a Face is a very fun interactive, concept driven-picture book that shows how different facial expressions connect with different emotions by pairing them with corresponding animals who \"come to life\" as children make different faces on cue.
Book
Intraoperative facial nerve monitoring in parotidectomy: A systematic review of its predictive value
Objective
The purpose of this study was to investigate the relationship between intraoperative facial nerve monitoring parameters and postoperative facial nerve function during parotid surgeries.
Methods
Registered in PROSPERO, a comprehensive search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library for literature published between 1990 and 2024. Studies reporting the relationship between intraoperative facial nerve monitoring parameters and facial nerve outcomes following parotidectomy were included. Owing to the limited number of studies and heterogeneity, the findings were summarized using a narrative synthesis.
Results
A total of 8 studies, involving 632 participants, were included, among whom 193 developed postoperative facial palsy. Five studies reported that a reduction in amplitude or an increase in threshold was associated with postoperative facial dysfunction.
Conclusion
Current evidence does not provide conclusive support for the predictive value of intraoperative facial nerve monitoring parameters in postoperative facial nerve function. However, given its established protective role and some reported findings (e.g. >50% amplitude drop associated with severe palsy), continued use of intraoperative facial nerve monitoring appears reasonable.
Journal Article
Read the face : face reading for success in your career, relationships, and health
\"Relearn the intuitive language of face reading From birth, face is our first language. We are born face readers-knowing to seek out human features and faces from the moment our eyes open. We all have the intuitive ability to read and interpret the feelings and expressions of those around us. In Read the Face, master face reader Eric Standop unlocks the power of this innate human ability, sharing his own journey to become a face reading master, along with stories that illustrate the power of this unique language. Using a combination of three different schools of face reading, along with a scientific accuracy to detect the most fleeting microexpressions, Standop is able to read personality, character, emotions, and even the state of a person's health-all from simply glancing at their face. The book is divided into sections focusing on specific ways that face reading can offer insight, such as Health, Love, Communication, Work and Success. The stories are accompanied by detailed black and white illustrations of faces, allowing readers to observe the same features that Standop interpreted. The final section of the book outlines the meanings of dozens of facial features and face shapes, so that readers can recognize their own innate intuitive powers and develop them. Read the Face is a guide to using the ancient art and science of face reading to go beyond the surface and create the boldest life possible\"-- Provided by publisher.
Book
Acquired bilateral facial palsy: a systematic review on aetiologies and management
Objective
To systematically review the published cases of bilateral facial palsy (BFP) to gather evidence on the clinical assessment and management of this pathology.
Methods
Following PRISMA statement recommendations, 338 abstracts were screened independently by two authors. Inclusion criteria were research articles of human patients affected by BFP, either central or peripheral; English, Italian, French or Spanish language; availability of the abstract, while exclusion criteria were topics unrelated to FP, and mention of unilateral or congenital FP. Only full-text articles reporting the diagnostic work-up, the management, and the prognosis of the BFP considered for further specific data analysis.
Results
A total of 143 articles were included, resulting a total of 326 patients with a mean age of 36 years. The most common type of the paralysis was peripheral (91.7%), and the autoimmune disease was the most frequent aetiology (31.3%). The mean time of onset after first symptoms was 12 days and most patients presented with a grade higher than III. Associated symptoms in idiopathic BFP were mostly non-specific. The most frequently positive laboratory exams were cerebrospinal fluid analysis, autoimmune screening and peripheral blood smear, and the most performed imaging was MRI. Most patients (74%) underwent exclusive medical treatment, while a minority were selected for a surgical or combined approach. Finally, in more than half of cases a complete bilateral recovery (60.3%) was achieved.
Conclusions
BFP is a disabling condition. If a correct diagnosis is formulated, possibilities to recover are elevated and directly correlated to the administration of an adequate treatment.
Journal Article
A face like glass
When Neverfell, who has no memory, arrives in Caverna, her facial expressions make her very dangerous to the people who live with blank faces or pay dearly to learn to simulate emotions.
Book
Effectiveness of Low-frequency Pulse Electrical Stimulation Combined with Dexamethasone in Treating Facial Nerve Paralysis and Its Impact on Facial Nerve Function and Electromyography
This study aimed to evaluate the efficacy of adjunct low-frequency pulse electrical stimulation alongside dexamethasone in the treatment of facial nerve paralysis and its subsequent effects on facial nerve function and electromyographic parameters. With the aim of addressing a knowledge gap in the field, this research provides valuable insights into the potential benefits of combining these treatments and their impact on clinical outcomes, facial nerve functionality, and electromyographic dynamics.
A cohort of 66 patients with facial nerve paralysis treated at our institution between April 2018 and November 2021 were randomly assigned to either an observation (n=33) or an experimental group (n=33). The observation group received standard pharmacotherapy, including Western medications and Daqinjiao decoction, along with dexamethasone. The experimental group was administered low-frequency pulse electrical stimulation in addition to the observation group's regimen. Outcomes assessed were clinical efficacy, facial nerve paralysis scoring, facial nerve functional scoring and indices, electromyographic latency, amplitude ratios between affected and unaffected sides, as well as any adverse events.
The experimental group demonstrated a significant improvement over the observation group in clinical treatment outcomes, facial nerve paralysis scores, and facial nerve function scores (P < .05 for all). Furthermore, electromyographic analysis revealed shorter latency periods and greater amplitude ratios in the experimental group's facial muscles post-treatment (P < .05). No significant difference was observed in the incidence of adverse reactions between the two groups (P > .05).
The integration of low-frequency pulse electrical stimulation with dexamethasone therapy significantly ameliorates the severity of facial nerve paralysis, enhances facial nerve function, and improves electromyographic signals in facial muscles without increasing adverse effects. These findings support the clinical value and safety of this combined treatment approach for facial nerve paralysis, suggesting its suitability for broader clinical application. These results suggest that this combined treatment approach holds promise for broader clinical application, potentially providing a more effective and safer therapeutic option for patients with facial nerve paralysis. Implementing this approach in clinical practice may lead to improved treatment outcomes, better functional recovery, and enhanced quality of life for affected individuals.
Journal Article
Basic fibroblast growth factor helps protect facial nerve cells in a freeze-induced paralysis model
Severe axonal damage in the peripheral nerves results in retrograde degeneration towards the central side, leading to neuronal cell death, eventually resulting in incomplete axonal regeneration and functional recovery. Therefore, it is necessary to evaluate the facial nerve nucleus in models of facial paralysis, and investigate the efficacy of treatments, to identify treatment options for severe paralysis. Consequently, we aimed to examine the percentage of facial nerve cell reduction and the extent to which intratympanic administration of a basic fibroblast growth factor (bFGF) inhibits neuronal cell death in a model of severe facial paralysis. A severe facial paralysis model was induced in Hartley guinea pigs by freezing the facial canal. Animals were divided into two groups: one group was treated with gelatin hydrogel impregnated with bFGF (bFGF group) and the other was treated with gelatin hydrogel impregnated with saline (control group). Facial movement scoring, electrophysiological testing, and histological assessment of facial neurons were performed. The freezing-induced facial paralysis model showed a facial neuronal cell death rate of 29.0%; however, bFGF administration reduced neuronal cell death to 15.8%. Facial movement scores improved in the bFGF group compared with those in the control group. Intratympanic bFGF administration has a protective effect on facial neurons in a model of severe facial paralysis. These findings suggest a potential therapeutic approach for treating patients with refractory facial paralysis. Further studies are required to explore the clinical applicability of this treatment.
Journal Article