Facial Nerve


A cutaneous scar and temporary paralysis of the facial nerve are not infrequent complications associated with the open approach.  

Three patients recovered glossopharyngeal nerve function, 2 recovered vagus nerve function, and 1 recovered facial nerve function.  

There were no statistically significant differences (p < 0.05) observed between the two groups with respect to major or minor hematoma, seroma, infection, sensory nerve injury, facial nerve injury, hypertrophic scarring, dehiscence, skin sloughing, or revision.  

Diabetes was present in 51 per cent of patients (19/37), facial nerve palsy in 40 per cent (15/37) and multiple cranial nerve palsy in 24 per cent (9/37).  

Among subjects, 25 underwent surgical resection, with the facial nerve preserved in 15 of 29.  

Sensation on the face is innervated by the trigeminal nerves (V) as are the muscles of mastication, but the muscles of facial expression are innervated mainly by the facial nerve (VII) as is the sensation of taste.  

OBJECTIVE: Damage to the facial nerve during surgery in the cerebellopontine angle is indicated by A-trains, a specific electromyogram pattern. METHODS: A dedicated hardware and software platform for automated continuous analysis of the intraoperative facial nerve electromyogram was specifically designed. CONCLUSION: Automated real-time analysis of the intraoperative facial nerve electromyogram is the first technique capable of reliable continuous real-time monitoring.  

RESULTS: The parotid gland usually covered compartments I and II, and the marginal mandibular branch of the facial nerve was located a mean of 7.4 mm above the inferior mandibular margin.  

Abstract Conclusion: For otologic revision surgery, the advantage of the piezoelectric device appears real because it is possible to perform a 'blind' cutting of bone with fewer precautions necessary for soft tissues such as the facial nerve, lateral sinus, and dura mater. Results: The piezoelectric device provided effective cutting, with excellent control and without side effects on the adjacent structures of the middle and inner ear (lateral sinus, facial nerve, and/or dura mater).  

Results: Among 262 patients, 4 cases (1.5%) had 1 or more major complications requiring substantial medical or nursing interventions, including 1 case of cerebrospinal fluid (CSF) otorrhoea accompanied by meningitis, 2 cases of facial nerve paresis and 1 case of perforation of tympanic membrane. Forty cases (15.3%) had some form of minor complication that settled spontaneously or easily with conventional treatments and nursing, of which dizziness and vomiting was the most frequent (4.2%), followed by CSF gusher without otorrhoea and/or induced meningitis (2.7%), tinnitus (1.9%) and facial nerve partially exposed without paralysis (1.5%).  

We describe a 78-year-old woman who presented with a two-day history of progressive generalised weakness and left facial nerve palsy, preceded by a flu-like illness lasting for one week.  

OBJECTIVE: To revaluate the value and the methods of intraoperative facial nerve monitoring in parotid gland surgery. METHODS: Sixty-five cases received intraoperative facial nerve monitoring in parotidectomy (test group) since 2000 - 2008. The facial nerve was identified through central trunk method (n = 18), branch method (n = 35) and mixed method (n = 12). facial nerve was identified though branch method (n = 44) and no intraoperative facial nerve monitoring was performed in parotidectomy (control group). RESULTS: There were four cases (6.1%) of mild temporary paralysis and no permanent post-operative paralysis of facial nerve in the test group. While there were nine cases (20.5%) of mild temporary paralysis and two cases (4.5%) of permanent post-operative paralysis of facial nerve in the control group and the average operating duration was 3.0 hours. CONCLUSION: Intraoperative facial nerve monitoring (IFNM) in parotidectomy can assist a surgeon to confirm and identify the facial nerve and exercise precautions so as to shorten operating duration and prevent potential surgical complications..  

Temporary facial nerve deficit was observed exclusively in the case of extraoral approach.  

OBJECTIVE: To investigate the diagnostic value of high resolution CT for temporal bone traumatic facial nerve paralysis and the guidance significance for surgery. METHOD: Twenty-nine patients of traumatic facial nerve paralysis were investigated. The direct CT signs of facial nerve injury include the bone fracture line went through the tube, bone tube rupture or continuity interruption, while the indirect CT signs include local incrassation of the facial nerve, lower bone density of the tube, geniculate fossa expansion, oppressed facial nerve, et al. CONCLUSION: High resolution CT could localize the trend of temporal bone fracture,and is helpful to estimate the extent of facial nerve injury and other complications.  

The scores were evaluated with Sunnybrook facial nerve Evaluation System and Facial Disability Index Questionnaire (FDI).  

INTERVENTION:: Observation or surgical intervention using the middle fossa or translabyrinthine craniotomy for decompression or excision of the hemangioma with or without facial nerve resection and grafting. facial nerve function was House-Brackmann grade I/II in 7(38%), III/IV in 5 (28%), and V/VI in 6 (34%) patients, respectively. The facial nerve was preserved in 11 (73%) of 15 patients and was excised and grafted in 4 (27%) of 15. Recovery to a House-Brackmann grade I/II was seen in 8 (72%) of 11 patients in whom the integrity of the facial nerve was preserved.  

These unintentional movements are caused by an undifferentiated regeneration of the facial nerve that occurs after being compressed or partially damaged. OBJECTIVE:: This study aims to describe the frequency and location of synkinesis in patients with peripheral facial nerve paresis. RESULTS:: Patients with a facial nerve paresis (n = 103) were observed, and all showed synkineses. These are important facts for rehabilitation of facial nerve pareses, to refine and intensify the inhibition and control of synkineses so that facial symmetry and expressions may improve..  

Vibrissal paralysis was induced by crushing the buccal and mandibular branches of the facial nerve.  

Recovery from surgery was uneventful, except for transient facial nerve paralysis in 2 dogs.  

Penetrating keratoplasty was required to improve corneal clarity in the left eye, which had suffered chronic exposure keratopathy following a cerebellopontine angle tumor with facial nerve involvement.  

OBJECTIVE: To investigate the role of p75 neurotrophin receptor (p75NTR) in the regeneration of facial nerve crush injury. METHODS: In p75NTR knockout mice and wild type mice, the regenerating fibres in the facial nerve were also labelled by an anterograde tracer cholera toxin B (CTB). The next day after injury of facial nerve, CTB was injected into the trunk of the nerve in the proximal side of the crush, and then anterograde tracing and immunohistochemistry were used to examine the regeneration of axons after facial nerve crush injury. In p75NTR knockout mice and wild type mice, the facial nerves on one side were crushed and regenerating neurons in the facial nerve nucleus were labelled by Fast Blue. The facial nerve trunk was cut in the bifurcated region in the 4th day after injury and the stump was inserted into a small polymer tube containing Fast Blue. Retrograde tracing and labling motoneuron counting were used to examine the survival of motoneurons in the facial nerve nucleus after facial nerve crush injury. RESULTS: The results showed that the axonal growth of injured axons in the facial nerve of p75NTR knockout mice was significantly retarded. The number of regenerated neurons in the facial nerve nucleus in p75NTR knockout mice was significantly reduced (P < 0.05).  

This anatomical study defines the depth and fascial boundaries of the frontal branch of the facial nerve over the zygomatic arch. METHODS: Eight fresh cadaver heads were included in the study, with bilateral facial nerves studied (n = 16). RESULTS: The frontal branch of the facial nerve was identified in each tissue section and its fascial boundaries were easily identified using epidermis and periosteum as reference points. CONCLUSIONS: The frontal branch of the facial nerve is protected by a deep layer of fascia, termed the parotid-temporal fascia, which is separate from the SMAS as it travels over the zygomatic arch.  

dysarthria and weakness of the buccal branch of the facial nerve.  

OBJECTIVE: In this case report, delayed facial palsy developed in a patient without any direct manipulation of the main part of the facial nerve during an anterior petrosal approach. Exposure of the intracranial or intracanalicular segment of the facial nerve is not necessary for delayed facial palsy to develop.  

RESULTS: The anatomical study showed that the feasibility of the flap was good, the surface of the flap was 12x12 centimetres, and the temporal ramus of the facial nerve was easy to preserve if the dissection was prudent in the anterior part of the flap.  

OBJECTIVES/HYPOTHESIS:: The anatomical configuration of the facial nerve differs greatly between the intratemporal and extratemporal portions. The purpose of this study was to investigate the incidence of facial synkinesis and misdirection on clamping the facial nerve at the intratemporal or extratemporal portion of the facial nerve in guinea pigs. METHODS:: In 16 guinea pigs, the facial nerve was clamped with microsurgical needle forceps at either the extratemporal (group A) or intratemporal (group B) segment. facial nerve function was evaluated 1 week postoperatively using electroneurography (ENoG), and the incidence of facial synkinesis was evaluated 15 weeks postoperatively using an evoked blink reflex test. CONCLUSIONS:: A lack of funicular structure within the intratemporal facial nerve increases the possibility of misdirected regenerating axons and synkinesis.  

DATA EXTRACTION/SYNTHESIS:: Data included type of study, number of subjects, demographics, follow-up times, type of radiation, tumor size, tumor control definition, control rates, facial nerve function measure and outcome, type of hearing and vestibular testing and outcomes, and complications. facial nerve outcome was reported as House-Brackmann (64.4%), normal/abnormal (11.9%), other (1.7%), or was not reported (22%).  

BACKGROUND: Inflammation and oedema of the facial nerve are implicated in causing Bell's palsy.  

Fourth day onwards his neurologic status started deteriorating with development of behavioral abnormalities, hemi-spatial neglect of left upper limb, paralysis of left facial nerve, left upper limb, and right lower limb.  

OBJECTIVE: To analyze the clinical manifestations and the diagnosis of the facial nerve tumor according to the clinical information, and evaluate the different surgical approaches depending on tumor location. METHOD: Twenty-seven cases of facial nerve tumors with general clinical informations available from 1999.9 to 2006.12 in the Shanghai EENT Hospital were reviewed retrospectively. CT or/and MRI results in 24 cases indicated that the tumors originated from the facial nerve. Intra-operative findings showed that 24 (88.9%) cases involved no less than 2 segments of the facial nerve, of these 24 cases 87.5% (21/24) involved the mastoid protion, 70.8% (17/24) involved the tympanic protion, 62.5% (15/24) involved the geniculate ganglion, only 4.2% (1/24) involved the internal acoustic canal (IAC), and 3 cases (11.1%) had only one segments involved. In all of these 27 cases, the tumors were completely excised, of which 13 were resected followed by an immediate facial nerve reconstruction, including 11 sural nerve cable graft, 1 facial nerve end-to-end anastomosis and 1 hypoglossal-facial nerve end-to-end anastomosis. Tumors were removed with preservation of facial nerve continuity in 2 cases. CONCLUSION: facial nerve tumor is a rare and benign lesion, and has numerous clinical manifestations.  

At this time, a working diagnosis of facial nerve neuroma was made.  

Postoperative follow-up showed good, stable occlusion, excellent mouth opening, and no facial nerve weakness even for a temporary period.  

Case 1: A 73-year-old man treated for 3 months for bilateral otitis media with effusion had left facial nerve palsy and deteriorated bone conduction hearing in both ears. Case 2: A 66-year-old woman treated for about one year for bilateral otitis media with effusion and fluctuating mixed hearing loss had bilateral facial nerve palsy and a blood test positive for MPO-ANCA at 67 EU. Both recovered almost completely from facial nerve palsy and bone conductive hearing loss partially improved except in one hearing-impaired ear.  

The peri-operative complications were paralyses of mandibular branch of facial nerve, Horner's syndrome, secondary hemorrhage, fluid collection at resection site, local infection and parotid fistula in 1 case respectively.  

We present the surgical techniques and results of cross-facial nerve grafting that have been developed in the repair of ocular-oral synkinesis after facial paralysis. Eleven patients with ocular-oral synkinesis after facial paralysis underwent the cross-facial nerve grafting with facial nerve transposition at a tertiary academic hospital between 2003 and 2009. We concluded that cross-facial nerve grafting with facial nerve branch transposition is effective and can be considered as an option for the repair of ocular-oral synkinesis after facial paralysis in select patients..  

The most frequently applied treatment algorithm is a two-stage approach with placement of a cross-facial nerve graft (CFNG) initially and subsequent free functional muscle transfer.  

All tumors were found to compress the root exit zone (REZ) of the facial nerve to different extents, but concomitant vascular compression of the facial nerve was observed in a majority of cases, and microvascular decompression of the facial nerve at REZ was conducted in 43 of 55 patients (78.2%) by displacing the co-compressing vasculature away from the REZ and retaining it using a Teflon pad.  

The change of facial nerve function score was observed to choose the best acupuncture treatment program for facial paralysis from factor A (acupuncture opportunity), B (acupoints prescription), C (quantity of stimulus), D (time of electroacupuncture) and their 3 levels in each factor.  

When the facial nerve is involved by the tumor at the time of the operation, the surgical approach requires careful evaluation. In three cases the tumor affected the facial nerve itself and in the remaining ones it originated from intraparotid nonfacial peripheral nerves. When the facial nerve is involved by the tumor a conservative approach should always be considered.  

This approach is a safer and less invasive procedure to totally decompress the facial nerve compared with conventional middle fossa approach. BACKGROUND: If performed within 2 weeks after the onset of facial palsy, total decompression of the facial nerve enhances the chance of normal or near-normal facial function recovery in cases with massive nerve degeneration. The transmastoid approach and middle fossa approach are usually combined to totally expose the intratemporal facial nerve. SURGICAL PROCEDURE: The meatal and labyrinthine segments of the facial nerve are exposed by the superior route via the superior prelabyrinthine cell tracts.  

CONCLUSION: The antidromic facial nerve response (AFNR) revealed that the initial lesion in both Bell's palsy and Hunt syndrome was mainly located around the geniculate ganglion within 1 week after onset of paralysis. The AFNR monitoring was performed at the posterosuperior part of the anulus tympanicus preoperatively and at 4 points of the facial nerve during surgery. The latencies of the preoperative responses corresponded to those recorded intraoperatively around the pyramidal segment of the facial nerve..  

CONCLUSION: The antidromic facial nerve response (AFNR) is recommended as a monitoring method to detect cases resulting in facial nerve degeneration within 1 week after onset in patients with Bell's palsy and Hunt syndrome.  

CONCLUSION: An assessment of facial nerve (FN) damage on the basis of antidromic facial nerve response (AFNR) was established by computer simulation analysis.  

CONCLUSION: The present animal experiment supported that the antidromically evoked facial nerve response (AFNR) was useful for the early diagnosis of facial palsy and for assessing its recovery course. OBJECTIVE: Chronological changes of AFNR latencies after nerve damage were investigated to examine whether or not AFNR latency was suitable as a parameter for the assessment of facial nerve function. MATERIALS AND METHODS: AFNR were recorded in guinea pigs with and without the total or partial transection of the facial nerve. Chronological changes of AFNR after facial nerve transection were investigated.  

She had trigeminal nerve and facial nerve palsy after combined spinal-epidural anesthesia for cesarean section..  

RESULTS: Frey's syndrome occurred in 63.4%, and temporary facial nerve palsy in 32.7% of all cases. Permanent facial nerve paresis was observed in 2.3% of the cases, but in no case after PSP. Scores regarding Frey's syndrome and facial nerve paresis showed a significant positive correlation with extent of surgery.  

No major difficulties in exposing the facial nerve and its branches were observed.  

BACKGROUND: facial nerve explorations and microstimulation of distal nerve branches during facial reanimation procedures by the senior author (J.K.T.) have yielded various observations. The facial nerve branches were traced distally under the operating microscope and mapped with India ink. A number of nerve branches exited the parotid at approximately 9 +/- 0.85 cm from the facial nerve trunk division, and their distribution was noted. CONCLUSIONS: Diversity of facial nerve anatomy is recognized and documented.  

Kaplan-Meier and log-rank analysis indicated that age, tumor size, distant metastasis, postoperative radiotherapy, facial nerve dysfunction, neck dissection, skin invasion, and surgical margins were prognosis-related factors. Cox analysis showed that age, facial nerve dysfunction, distant metastasis and surgical margins were the important factors that influenced the prognosis.  

We summarized the microsurgical removal experience in a recent series of vestibular schwannomas and presented the operative technique and cranial nerve preservation in order to improve the rates of total tumor removal and facial nerve preservation. The anatomical integrity of the facial nerve was preserved in 91.0% (132/145) of the cases. Intracranial end-to-end anastomosis of the facial nerve was performed in 7 cases. Functional preservation of the facial nerve was achieved in 115 patients (Grade I and Grade II, 79.3%). Knowing the microanatomy of the cerebellopontine angle and internal auditory meatus, intraoperating neurophysiological monitoring of the facial nerve function, and the microsurgical techniques of the surgeons are all important factors for improving total tumor removal and preserving facial nerve function..  

We found that CHARGE individuals with CHD7 mutations more commonly have ocular colobomas, temporal bone anomalies (semicircular canal hypoplasia/dysplasia), and facial nerve paralysis compared with mutation negative individuals.  

There were no severe complications such as hematoma, facial nerve injury, and postoperative scar.  

The most common postoperative complications were lower cranial nerve paresis and facial nerve paresis.  

At this level, dissection proceeds in the subcutaneous plane to protect the frontal branch of the facial nerve and to keep the flap thin. (The key to the modified scalp flap is the dissection plane change that protects the frontal branch of the facial nerve.) The extent of posterior subgaleal dissection is dictated by the amount of anterior rotation necessary. This novel modified scalp flap prevents eyebrow/hairline distortion and avoids facial nerve injury..  

Immediate neuromuscular reconstruction of mimic function is favourable by nerve suture or nerve grafting of the facial nerve, or by using the contralateral healthy facial nerve via cross-face nerve grafting as long as the time since onset of the irreversible palsy is short enough that the paralysed mimic muscles can still be reinnervated. Functional upgrading in incomplete lesions is achieved by cross-face nerve grafting with distal end-to-side neurorrhaphy or by functional muscle transplantation with ipsilateral facial nerve supply..  

Brissaud already suggested several possible etiologies for the involuntary movements of his patient, including the possibility of arterial malformations compressing the origin of the facial nerve.  

SUBJECTS AND METHODS: An inpatient database was queried for the following diagnostic codes from 2000 to 2008: [ 383.2] petrositis, [ 383] acute mastoiditis, [ 386.3] labyrinthitis, [ 351.0] facial paralysis (Bell's palsy), [ 351.9] facial nerve disorder unspecified, [ 351.8] other facial nerve disorders, [ 383.01] subperiosteal abscess, [ 383.02] Gradenigo's syndrome, [ 320] meningitis, [ 324.9] extradural or subdural abscess, [ 324.0] intracranial abscess, [ 325] thrombosis of intracranial venous sinus, and [ 348.2] otic hydrocephalus.  

RESULTS: In all six specimens, we drilled successfully to the cochlea, preserving the facial nerve and ossicles. The closest distances of the mid-axis of the drilled path to structures were 1.28 +/- 0.17 mm to the facial nerve, 1.31 +/- 0.36 mm to the chorda tympani, and 1.59 +/- 0.43 mm to the ossicles.  

RESULTS: None of our patients had problems with wound healing; 2 patients developed a fistula of the parotid gland; and 4 patients developed palsy of the facial nerve that was completely reversible after 6 weeks.  

In two cases round window was placed in deep niche and was partly covered by facial nerve.  

Abstract Most cases of facial nerve paresis are idiopathic (Bell's palsy). We report 2 children presenting with unilateral lower motor neuron facial nerve palsy and hypertension. A diagnosis of Guillain-Barre syndrome was made in both; literature linking facial nerve palsy in childhood with hypertension and Guillain-Barre syndrome is reviewed..  

Introduction: Bell's palsy is a commonly encountered paralysis of the facial nerve occurring worldwide.  

The underlying causes of lower eyelid retraction included congenital retraction (seven eyelids), congenital fibrosis of the extraocular muscles (CFEOM; seven eyelids), TAO (seven eyelids), post-operative cicatricial retraction (five eyelids), and facial nerve palsy (one eyelid).  

Surgical removal was accomplished without occurrence of facial nerve dysfunction or other morbidity.  

To assess the effect and efficacy of botulinum toxin type A (BTX-A) in reducing synkinesis in aberrant facial nerve regeneration (following facial paralysis).  

Two cases of cranial nerves palsies have been described in children in the literature, including one case of peripheral facial nerve palsy and one case of velopalatine hemiparalysis.  

Finally, we discuss the role of surgical management in terms of preserving facial nerve integrity and preventing recurrence..  

Gadolinium enhancement was seen over the right facial nerve. These lesions suggest a possibility of transaxonal spread of the varicella zoster virus between the trigeminal nerve, the facial nerve, and the spinal trigeminal nucleus and tract..  

The article describes our results of surgical treatment of 37 patients with hemifacial spasm (HS) as well as results of morphological studies of facial nerve root exit zone (REZ). This zone did not exceed 1.1 diameter of facial nerve. In 35 patients complete decompression of facial nerve REZ was achieved. HS results from compression of central myelinated zone of facial nerve thus surgical decompression should be preformed close to REZ at the brainstem..  

Principal elements of the technique were: partial resection of the parotid gland without rerouting of the facial nerve; luxation of mandibula; drilling of the bone. There were no post-operative deaths, one TIA, 13 transient palsies of the lower facial nerve, and one transient palsy of accessory nerve.  

Although facial nerve palsy occurs less frequently in children than in adults, the condition is deeply concerning to the patient and family. Whereas facial nerve palsy is most often idiopathic in the adult population, a secondary cause can now be identified in the majority of pediatric cases. This review provides an overview of the anatomical and pathophysiological considerations in facial nerve palsy and describes the current management principles to assist pediatricians in the diagnosis and treatment of this condition..  

Five of 17 patients suffered permanent new facial nerve dysfunction. The actuarial 5-year facial nerve preservation probability was 80%.  

Sir Charles Bell is better known among neurologists for his descriptions of the clinical consequences of facial nerve lesions.  

OBJECTIVES/HYPOTHESIS: Determine outcomes associated with nerve grafting versus static repair following facial nerve resection. METHODS: Charts from 105 patients who underwent facial nerve reconstruction between January 1999 and January 2009 were reviewed. facial nerve function was measured using the House-Brackmann (H-B) scale. CONCLUSIONS: Where possible, nerve grafting is the preferred method of facial nerve reconstruction. Although elderly patients with parotid malignancy have traditionally been considered poor candidates for nerve grafting, we demonstrate good results within 9 months of facial nerve repair even with radiotherapy, the use of long grafts (>6 cm), and prolonged preoperative dysfunction..  

This report describes an exceptional case of a "nondestructive" translabyrinthine surgical approach to a large congenital petrosal cholesteatoma that threatened the vestibulum, superior semicircular canal, facial nerve, and internal auditory canal.  

Group A (n = 42) included patients who underwent nerve transfers: cross-facial nerve grafting and subsequent microcoaptations, mini-hypoglossal nerve transfers, and direct orbicularis oculi neurotization.  

BACKGROUND: Despite a wealth of literature describing the anatomy of the temporal region, controversy still exists over the depth of the frontal branch of the facial nerve as it travels over the zygomatic arch.  

Other potential causes of ulceration are trauma or underlying eyelid abnormalities (entropion, ectropion, agenesis, dermoids, neoplasia), lash abnormalities (ectopic cilia, trichiasis), tear film abnormalities or neurological deficiencies (trigeminal nerve paralysis, facial nerve paralysis).  

On electrophysiological studies, the right facial nerve was not excitable. The left facial nerve compound muscle action potential (CMAP) amplitude was severely dispersed and latency was mildly prolonged, consistent with demyelination.  

Hypoglossal-facial nerve anastomosis is a time-proven technique for the repair of facial nerve palsy. A re-routing technique of the temporal facial nerve is also performed to allow a direct anastomosis to the hypoglossal nerve without the need for a jump graft.  

The evidence obtained from laboratory studies of animals and humans that HSV-1 may be linked to facial nerve paralysis is first outlined.  

Superficial or total parotidectomy as a standard procedure is often said to be the gold standard; however, with it the risk of intraoperative damage to the facial nerve cannot be ignored. For some time now, extracapsular dissection without exposure of the main trunk of the facial nerve has been favored as an alternative for the treatment of discrete parotid tumors. Data on the incidence of facial nerve lesions and other acute postoperative complications of extracapsular dissection have been lacking until now. METHODS: We performed a retrospective analysis of the data from patients in whom extracapsular dissection of a benign parotid tumor had been performed under facial nerve monitoring and as a primary intervention in our department between 2000 and 2008. In 346 patients (92%) facial nerve function was normal (House-Brackmann grade I) in the immediate postoperative period, whereas 23 patients (6%) showed temporary facial nerve paresis (House-Brackmann grade II or III) and eight patients (2%) developed permanent facial nerve paresis (seven patients House-Brackmann grade II, one patient House-Brackmann grade III).  

Impairment of the peripheral or central part of the facial nerve causes an ipsilateral peripheral facial nerve paresis.  

Background and Objective: During the resection of jugular foramen tumors via the basic far lateral approach, the jugular foramen tumor area as well as its adjacent structures, especially the intracranial part, can be better exposed, which avoids stripping of the petrous part of temporal bone and displacement of facial nerve, and protects the patient's hearing from damage. It has a higher rate of total resection, preoperative cranial nerve function impairment is expected to restore, and also has the advantage of protecting the facial nerve, labyrinth and vertebral artery structure from unnecessary damage..  

Hypothesis/Objectives: We hypothesized associations between temporal bone fracture location and orientation in horses detected during computed tomography (CT) and frequency of facial nerve (CN7) deficit, vestibulocochlear nerve (CN8) deficit, or temporohyoid osteoarthropathy (THO).  

Forty-five case series were disaggregated to formulate microsurgery facial nerve and hearing preservation outcomes expectations models.  

All of the surgical procedures from April 2005 onwards were performed with electrophysiological monitoring of the facial nerve. CONCLUSIONS: The controversial issues identified, due either to discrepancies or lack of enough evidence, were: the diagnostic role of MRI, the validity and usefulness of FNAB, the indications of surgical treatment, the need for facial nerve monitoring and the consideration of cosmetic aspects, in particular the indications of rhytidectomy incision..  

RESULTS: Patients in both groups had temporary facial nerve injury that was primarily related to retraction of the nerve.  

OBJECTIVE: The retrosigmoid and middle fossa approaches to acoustic tumor excision allow for hearing preservation but differ in the angle of approach to the facial nerve. The authors comparatively examined facial nerve results of each approach. SUBJECTS AND METHODS: The authors reviewed facial nerve outcomes of patients undergoing acoustic tumor excision at a single subspecialty practice that had used a hearing preservation approach for the past 15 years.  

OBJECTIVE: To reclassify facial nerve hemangiomas in the context of presently accepted vascular lesion nomenclature by examining histology and immunohistochemical markers. STUDY DESIGN: Cohort analysis of patients diagnosed with a facial nerve hemangioma between 1990 and 2008. We propose that these lesions be classified as "venous vascular malformations of the facial nerve." This nomenclature should more accurately predict clinical behavior and guide therapeutic interventions..  

All patients were submitted to a clinical examination to identify TMJ disorders and determine facial nerve function, and they all answered the University of Washington QOL (UW-QOL) questionnaire (version 4). Neither facial nerve palsy nor TMJ disorders affected QOL.  

METHODS: This was a retrospective cohort study of children who presented to an ED with facial nerve paralysis (FNP).  

A 2-year-old, female German Shepherd Dog with facial nerve paralysis was diagnosed with acute myelomonocytic leukemia based on clinical, cytologic, and immunologic findings.  

BACKGROUND: The Facial Grading Scale (FGS) is a quantitative instrument used to evaluate facial function after facial nerve injury. OBJECTIVE: The objectives of this study were to use the FGS in a large series of consecutive subjects with facial paralysis to quantitatively evaluate improvements in facial function after facial nerve rehabilitation and to describe the management of chronic facial paralysis. METHODS: A total of 303 individuals with facial paralysis were evaluated by 1 physical therapist at a tertiary care facial nerve center during a 5-year period.  

Abstract Conclusion: Chronic suppurative otitis media causes some disturbance to the chorda tympani nerve (CTN), which may affect the facial nerve. It is not possible to perform a biopsy of the main truncus of the facial nerve, therefore studies of the CTN might show possible pathologic or physiologic changes of the facial nerve in the future.  

The aims of this study were (1) to evaluate the effect of high-dose erythropoietin (EPO; 5000 U/kg) on expression of inducible nitric oxide synthase (iNOS) in the facial nucleus after facial nerve transection; and (2) to explore whether this effect is relevant to facial motor neuron survival. The right facial nerves of 40 rats were transected at the level of the stylomastoid foramen, with the left sides left untreated. These results indicate that a high dose of EPO attenuates the increase in iNOS expression in the facial nucleus after facial nerve transection, and thus may enhance the survival of facial motor neurons..  

Introduction There are no established doctrines for treating Bells facial nerve paralysis (Bell's palsy), as there are still controversies in relation to the etiology of the disease.  

INTRODUCTION: This study aims to review the management and discuss the outcome of patients with iatrogenic facial nerve palsy. METHODS: 11 patients with iatrogenic facial nerve palsy (FNP) were evaluated retrospectively in a tertiary centre between June 1995 and September 2008. Ten patients underwent facial nerve exploration and one patient was managed conservatively. facial nerve recoveries were achieved to Grade I House Brackmann classification in five cases, Grade II in two cases and Grade III in two cases postoperatively. CONCLUSION: Mistakes that most likely occurred during mastoid surgery are drilling towards the antrum, causing injury to the facial nerve at the second genu. Early facial nerve exploration and neurolysis resulted in good facial nerve recovery..  

OBJECTIVE: To establish whether nimodipine, a calcium channel blocker, accelerates or otherwise improves functional recovery of whisking after facial nerve crush injury in the rat. METHODS: Thirty rats underwent exposure of the left main trunk of the facial nerve followed by a standard crush injury and subsequent quantitative facial movement testing. Four days prior to facial nerve manipulation, experimental animals underwent subcutaneous implantation of a nimodipine-secreting pellet. CONCLUSIONS: We demonstrate that nimodipine improves recovery of whisking after facial nerve crush. Given the low adverse effect profile of nimodipine, there may be clinical implications in its administration in patients experiencing facial nerve injury..  

OBJECTIVES: To eliminate the inconsistency in the nomenclature, to anatomically and definitively describe the topographic relationship of the temporal branch of the facial nerve to the fascial layers and the fat pads, and to create an effective algorithm to define the safest approaches and planes for surgical procedures in this area. RESULTS: The temporal branch of the facial nerve that traversed inside the deep layers of the temporoparietal fascia and the superficial musculoaponeurotic system coursed along the zygomatic arch as 1 (14.3%), 2 (57.1%), 3 (14.3%), and 4 (14.3%) twigs in the specimens.  

At final follow-up, the patient complained of a grade 4/5 hemiparesis, facial nerve palsy, and hearing loss in his left ear.  

To our knowledge it is the largest reported encapsulation of a prosthetic temporomandibular joint that incorporated the facial nerve..  

Separately, a review was performed on the facial nerve outcomes of 30 patients who underwent plasma knife parotidectomy. In 30 patients undergoing plasma knife-parotidectomy, 10 (33%) had mild weakness of 1 or 2 preserved facial nerve branch postoperatively (House-Brackmann 2) that resolved within 1 month, whereas 2 (7%) had visible weakness in 1 branch (HB 3) that normalized after 3 months of follow-up.  

Facial lacerations may damage underlying structures, including the lacrimal system, facial nerve, or parotid duct.  

The authors report the case of a 35-year-old Arab man who presented with unilateral facial nerve palsy in the presence of an infected lower third molar. Surgical removal of the tooth and drainage of the abscess produced significant improvement in facial nerve function, and total resolution occurred prior to clinical follow-up 10 days later.  

Recently, we showed that manual stimulation (MS) of denervated vibrissal muscles enhanced functional recovery following facial nerve cut and suture (FFA) by reducing poly-innervation at the neuro-muscular junctions (NMJ).  

On examination the positive findings were reduced sensation by 25% over the left side of face with House and Brackman grade II facial nerve palsy.  

The facial nerve was preserved in all of the patients.  

facial nerve palsy with a parotid mass is usually associated with malignant neoplasm of parotid gland. A literature review revealed only 16 cases of facial nerve palsy associated with suppurative parotitis or parotid abscess were reported. We present a case of deep parotid abscess which is complicated by facial nerve dysfunction.  

The objective of this study is to review the factors influencing the outcome of treatment for the patients presented with idiopathic facial nerve paralysis. The demographic data, clinical presentation and management of 84 patients with idiopathic facial nerve paralysis (Bell's palsy) were collected from the medical record office, reviewed and analyzed from 2000 to 2005. The patients who were treated after three days of clinical presentation, who were more than 50 years of age, who had concurrent chronic medical illness and facial nerve paralysis HB Grade IV to VI during initial presentation have reduced chance of full recovery of facial nerve paralysis..  

The standard superficial parotidectomy approach was modified to dissect facial nerve branches selectively to obtain a symmetric facial contour. The parotid gland was fully bisected along the course of the zygomatic and buccal branches of the facial nerve to provide access to the midcheek mass. The parotidotomy approach was accomplished in two cases with a malignant tumor (one acinic cell carcinoma, one low-grade mucoepidermoid carcinoma), four with a benign tumor (two pleomorphic adenoma, one basal cell adenoma, one facial nerve schwannoma), and in one case with a chronic inflammatory lesion (chronic sialadenitis). In no case was facial nerve paralysis or Frey's syndrome noticed after this approach.  

We have previously demonstrated that CD4(+) Th2 lymphocytes are required to rescue facial motoneuron (FMN) survival after facial nerve axotomy through interaction with peripheral antigen presenting cells, as well as CNS resident microglia. The role of TLR2 in the FMN response to axotomy was explored in this study, using a model of facial nerve axotomy at the stylomastoid foramen in the mouse, in which blood-brain-barrier (BBB) permeability does not occur. After facial nerve axotomy, TLR2 mRNA was significantly upregulated in the facial motor nucleus and co-immunofluorescence localized TLR2 to CD68(+) microglia, but not GFAP(+) astrocytes.  

Fifteen percent had transient damage to the facial nerve.  

Ramsay Hunt syndrome (RHS) is defined as a peripheral facial nerve palsy accompanied by an erythematous vesicular rash on the ear (zoster oticus) and hard palate.  

BACKGROUND: Measuring rodent facial movements is a reliable method for studying recovery from facial nerve manipulation and for examining the behavioral correlates of aberrant regeneration. METHODS: One hundred seventy-eight adult rats underwent facial nerve manipulation and testing. In the experimental groups, the left facial nerve was either crushed, transected, and repaired epineurially, or transected and the stumps suture-secured into a tube with a 2-mm gap between them. Markers of potential synkinesis increased in selected groups following facial nerve injury. Generalized co-contraction of the upper and midfacial zones emerges following facial nerve manipulation, possibly related to aberrant regeneration, polyterminal axons, or hypersensitivity of the rodent to sensory stimuli following nerve manipulation..  

METHODS: Following a facial nerve crush axotomy in gonadectomized adult male rats, testosterone propionate (TP), dihydrotestosterone (DHT), or estradiol (E(2)) was systemically administered with/without daily electrical stimulation of the proximal nerve stump. facial nerve outgrowth was assessed at 4 and 7 days post-axotomy using radioactive labeling.  

Surgery by trans-labyrinth approach paves way for removing cholesteatoma thoroughly, dealing with facial nerve and repairing cerebrospinal fluid leakage.  

The inferior margin of infratemporal tumor could be accessed via the transcranial route with zygomatic or orbitozygomatic osteotomy without complications including facial nerve injury in nine cases, and the lowest level of the infratemporal tumors was approximately 4.5 cm below the outer surface of the middle cranial base.  

In the current study, we examined the appearance, composition and effects of gene deletions on intrabrainstem sprouts following peripheral facial nerve axotomy. Strong immunoreactivity for vesicular acetylcholine transporter (VAChT) and retrogradely transported MiniRuby following its application on freshly cut proximal facial nerve stump confirmed their axotomized motoneuron origin; the sprouts expressed CD44 and alpha7beta1 integrin adhesion molecules and grew apparently unhindered along neighboring central white matter tracts.  

No violation of the facial nerve took place, although the chorda tympani nerve was violated in one case and the stapes in two. It was obvious during preoperative planning that these structures would be violated, but this was accepted in order to maintain a safety margin from the facial nerve.  

A clinical-electroneuromyographical study of 40 children (32 (80%) of them aged from 12 to 17 years, mean age 13,9+/-1,8 years, and 8 (20%) - from 1 to 8 years, mean age 4,4+/-2,1 years) were studied in the acute period of facial nerve paralysis (FNP). An electroneuromyographical analysis of motor ortho- and antidromic response to the facial nerve stimulation on the side of paresis and on the contralateral side in patients and controls revealed the presence of proximal axon- and myelinopathy of facial nerve with the involvement of its own motorneurons and brain stem interneurons.  

This article reviews the final outcomes of facial function in patients with traumatic intratemporal facial nerve injury according to the timing of surgical exploration. METHODS: We performed a retrospective review of 58 patients with complete facial nerve paralysis caused by temporal bone fractures as a result of head trauma between 1998 and 2007. Characteristics assessed in the study included type of trauma, location of facial nerve injury, timing of surgical intervention, audiometric findings, surgical approach, and long-term follow-up of recovery of facial nerve function, as assessed by two facial nerve grading systems. CONCLUSION: This study demonstrated that some patients with traumatic facial nerve paralysis who had nerve conduction studies consistent with a poor prognosis regained considerable facial function after early surgical intervention. However, late exploration after facial nerve paralysis did not result in positive outcomes, regardless of the type of temporal bone fracture or the site of injury, and no difference was observed compared with conservative treatment..  

Summary In this study, we extended application of face transplantation model in rat by incorporation of vascularized premaxilla, and nose with infraorbital and facial nerves for evaluation of allotransplanted sensory and motor nerve functional recovery. Infraorbital nerve and facial nerve were included into the transplant. SSEP and MEP confirmed recovery of motor and sensory functions and latencies reached 67% of normal infraorbital nerve value and 70% of normal facial nerve value at 100 days post-transplant.  

OBJECTIVES: To evaluate the causes, treatment modalities and recovery rate of paediatric facial nerve paralysis. MATERIALS AND METHODS: We analysed 24 cases of paediatric facial nerve paralysis diagnosed in the otolaryngology department of Gachon University Gil Medical Center between January 2001 and June 2006. The most common degree of facial nerve paralysis on first presentation was House-Brackmann grade IV (15 of 24 cases). One of the 24 cases was also treated surgically with facial nerve decompression. CONCLUSION: facial nerve paralysis in children can generally be successfully treated with conservative measures.  

Avoiding injuries to the semicircular canals (SCCs) and facial canal is mandatory, and there is need to find a way to recognize the facial nerve and SCCs for safe performance of mastoidectomy. The sigmoid sinus alongside the facial nerve and SCCs was skeletonized using the drilling guidance provided by the fluorescence. CONCLUSION: With this novel technique, it is possible to perfectly skeletonize the facial nerve and the SCCs in the cadaver.  

The mean +/- SD distance was 1.20 +/- 0.36 mm from midportion of the drill to the facial nerve and 1.25 +/- 0.33 mm from the chorda tympani.  

The buccal and mandibular branches of the facial nerve were evaluated for this study.  

MATERIAL/METHODS: Retrospective chart review was performed on all patients treated in a multidisciplinary facial nerve center with lower lip asymmetry over an eighteen month period.  

We report on a patient with cutaneous squamous cell carcinoma invading the parotid gland with clinical evidence of facial nerve weakness. On standard 1.5 Tesla (T) magnetic resonance imaging (MRI), bilateral parotid glands were symmetric; however, a second high-field 3-T MRI revealed asymmetric enhancement of the left facial nerve at the stylomastoid foramen and extending throughout the left parotid gland.  

In all 4 experimental rats, HRP reaction product labeled a small number of ganglion cells in the VG adjacent to the nervus intermedius and facial nerve.  

BACKGROUND: To improve the ability to prognosticate the final surgery outcomes, this study was carried out to explore the correlation between the number of motor axons given to cross-facial nerve grafts for smile restoration and the aesthetic and functional outcomes.  

CONCLUSION: The time course for improvement and the extent of recovery is significantly different in patients presenting with an incomplete facial nerve paresis compared with patients with a total paralysis.  

RESULTS: Twenty-nine patients underwent bilateral radiofrequency ablation of temporal branches of the facial nerve and the angular nerves.  

METHODS: In three cases of hemifacial spasm refractory to drugs and botulinum toxin treatment, the authors used a virtual reality workstation (Dextroscope) to develop an interactive simulation of craniotomy, approach, and Gore-Tex implant optimal size and position in order to reach vascular decompression of facial nerve. During surgical procedures, facial nerve vascular compressions were exposed and Gore-Tex grafts were successfully placed as it was virtually planned.  

In treating reversible facial paralysis, cross-facial nerve grafting offers voluntary and emotional reanimation. In contrast, rapid re-innervation and strong neural stimulation can be obtained with hypoglossal-facial nerve crossover. One branch was anastomosed to the contralateral facial nerve, and the other branch was used for hypoglossal-facial nerve crossover, followed by connecting the proximal stump of the graft to the trunk of the paralysed facial nerve in an end-to-end fashion. Since our method can efficiently gather neural inputs from the contralateral facial nerve and the ipsilateral hypoglossal nerve, it may become a good alternative for reanimation of reversible facial paralysis when the ipsilateral facial nerve is not available..  

The evaluation of facial nerve function was performed by using House-Brackmann (HB) classification. Integrity of the facial nerve was achieved via re-routing and end-to-end anastomosis or n. The cases were evaluated regarding complications and facial nerve function postoperatively. facial nerve function was HB stage V in all cases. facial nerve function was HB stage II in three cases (re-routing) and HB stage III in two cases (graft).  

Conditions such as temporomandibular joint disorders, sialorrhea, headache and neuropathic facial pain, muscle movement disorders, and facial nerve palsy could also be treated with this drug.  

BACKGROUND: The cervical branch of the facial nerve and the muscles it supplies play a role in perioral function and neck aesthetics. It is unclear whether this is the result of platysmal weakness alone, or attributable to coinnervation of the lip depressor muscles by the cervical and marginal mandibular branches of the facial nerve.  

Twenty patients had transfer of the mini-hypoglossal to the cervicofacial branch of the facial nerve and nine had direct depressor muscle neurotization. In late cases, the facial nerve was in-continuity, and preoperative needle electromyographs of depressors showed at least fibrillations.  

Twelve hours after the procedure, left-sided hemiparesis and right-sided facial nerve paresis developed, followed by ulceration and necrosis of the soft palate, diaphragm, and right nasal ala.  

The left (67 episodes; 50.0%) and right (64 episodes; 47.8%) facial nerves were involved with similar frequency.  

Complications included 1 case of a partial distally necrotic flap that resolved after local debridement and did not require further flap manipulation and 1 case of transient, spontaneously resolved facial nerve (temporal branch) palsy and limited mouth opening (<20 mm), which also resolved after judicious physiotherapy.  

The contralateral facial nerve was used as a motor donor nerve in 4 procedures, the motor nerve to the masseter muscle was used in 8 patients, and the gracilis muscle was used in all operations, with a total of 17 free-muscle transplantations.  

Patients were assessed weekly by blinded assessors, using the House-Brackmann facial nerve grading system.  

INTRODUCTION AND OBJECTIVES: The purpose of this work is to study the functional sequelae after peripheral facial palsy (PFP) to analyze its impact and relationship with the degree of facial nerve dysfunction, from the neurophysiological point of view.  

Two patients experienced early complications: One had a transient facial nerve palsy, and the other had sialadenitis treated with antibiotics.  

BACKGROUND: The "babysitter" procedure combines cross-facial nerve grafting with segmental transfer of the hypoglossal to the affected facial nerve.  

BACKGROUND:: A variety of microorganisms have been shown to cause peripheral facial nerve palsy (PFNP) and/or aseptic meningitis in children.  

General somatic afferents of facial nerve innervate skin of the concha, the posterior external ear canal and a small area behind the ear. But pain around the ear that precedes or develops at the same time as Bell's palsy frequently is beyond the territory of sensory innervations of facial nerve. So, stimulation of nervi nervorum dominating facial nerve trunk can be transmitted to trigeminocervical nuclear complex and make referred pain on the craniofacial region segmentally. The reason why referred pain of facial nerve origin develops around the ear is that facial nerve and its ensheathing connective tissue are derivatives of second branchial arch which is homologous to the somites of body..  

age>60 years, male gender, facial palsy, hardness of the tumour, clinical stage, tumour grade, facial nerve invasion and lymph node metastases.  

OBJECTIVE: To study the changes in facial nerve function, morphology and neurotrophic factor 3 expression in response to three types of nerve injury. MATERIALS AND METHODS: Changes in facial nerve function (in terms of blink reflex, vibrissae movement and position of nasal tip) were assessed in 45 rats in response to three types of nerve injury: partial section of the extratemporal segment (group one); partial section of the facial canal segment (group two); and complete transection of the facial canal segment (group three). All facial nerves were then dissected out from the sacrificed animals, on the first, seventh or 21st post-operative day, and the injured segment bisected for subsequent analysis. Morphological change and neurotrophic factor 3 expression in these facial nerve segments were evaluated by means of improved trichrome staining and immunohistochemical analysis, respectively. RESULTS: facial nerve function was more severely damaged and recovery was slower in group two compared with group one, although the facial nerve injury had been identical at the two sites involved. CONCLUSIONS: The facial palsy of the group two rats was more severe than that of group one rats, although their facial nerve function had partly recovered on the 21st post-operative day. Neurotrophic factor 3 immunoreactivity increased in facial nerve fibres after partial transection..  

43 patients had bilateral browlift, 3 patients had unilateral browlift, 2 of whom had underlying facial nerve palsy and one had involutional brow ptosis. Encountered complications included: undercorrection 6 (12%), segmental facial nerve palsy 1(2%), visible scar 2 (5%), paraesthesia 2 (5%), suture granuloma 1 (2%).  

Preoperative and postoperative assessment included a thorough history and physical examination to determine the maximal mouth opening, presence of pain and sounds, frequency of dislocations, recurrence rate, and presence of facial nerve paralysis. There was no facial nerve paralysis after either treatment.  

We have previously demonstrated a neuroprotective mechanism of FMN (facial motoneuron) survival after facial nerve axotomy that is dependent on CD4(+) Th2 cell interaction with peripheral antigen-presenting cells, as well as CNS (central nervous system)-resident microglia. In the present study, we tested the hypothesis that Th2-associated chemokine receptors increase in the facial motor nucleus after facial nerve axotomy at timepoints consistent with significant T-cell infiltration. Microarray analysis of Th2-associated chemokine receptors was followed up with real-time PCR for CCR3, which indicated that facial nerve injury increases CCR3 mRNA levels in mouse facial motor nucleus. Unexpectedly, quantitative- and co-immunofluorescence revealed increased CCR3 expression localizing to FMN in the facial motor nucleus after facial nerve axotomy.  

The transverse facial artery (TFA) is found in the lateral face and supplies the parotid gland and duct, facial nerve, facial muscles, and skin. The TFA originated from the superficial temporal artery at or above the level of crossing by the temporofacial trunk of the facial nerve in the parotid gland (57.6%).  

Although resembling Ramsay Hunt syndrome with presence of facial nerve paralysis and accompanying vesicles, involvement of cervical dermatomes is not a feature of the classic Ramsay Hunt syndrome..  

Conclusion: Among patients with facial nerve paralysis, significant difference was observed on three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI) between those with and without audio-vestibular disturbance. Objective: To evaluate the 3D-FLAIR MRI findings in patients who have facial nerve paralysis with and without audio-vestibular disturbance. Methods: 3D-FLAIR MRI was performed with and without gadolinium enhancement in 15 patients (5 men and 10 women) with unilateral facial nerve paralysis: 3 patients with Ramsay Hunt syndrome, 3 patients having facial nerve paralysis with hearing loss or vertigo without vesicles, and 9 patients with Bell's palsy.  

The 18 ossicular malformations were well analyzed on the images obtained, which also provided better visualization of the abnormalities and associated lesions (particularly the anomalies in facial nerve position), thus providing quality surgical planning as judged by the surgeon.  

Although they may play different roles in the remodeling mechanism of facial nucleus during facial nerve injury and regeneration, comprehensive gene profiling analysis of these two neuron types has never been performed due to the difficulty in isolating specific neuron populations and extracting sufficient amount of RNAs from the heterogeneous facial nucleus.  

facial nerve axotomy is a well-described injury paradigm for peripheral nerve regeneration and facial motoneuron (FMN) survival.  

Complications included failure to thrive, scarring, facial nerve palsy, and death.  

The facial nerve exhibited consistent planar arrangement and diameters in the intraparotid and proximal extraparotid regions, but less so in the distal nerve course.  

A 56-year-old male patient, with this relatively rare parotid gland lipoma is reported in this article; it was managed by conservative superficial parotidectomy preserving facial nerve that, if performed correctly, excludes the possibility of any second attack..  

In recent years, many anatomical researches have showed that there are common and extensive connections between the trigeminal nerve and the facial nerve.They are briefly outlined as follows: (1) The infraorbital nerve communicates with buccal branch of the facial nerve. (2) The auriculotemporal nerve of the trigeminal nerve communicates with the buccal, zygomatic,temporal branches and the upper divisions of the facial nerve. (3) The supraorbital nerve communicates with the zygomatic and temporal branches of the facial nerve. (4) The mental nerve communicates with the marginal mandibular branch of the facial nerve. These communications between the trigeminal nerve and facial nerve are probably related to several clinical signs, for example,some trigeminal neuralgia patients are complicated by facial spasm, some patients appeared spontaneous partial functional recovery of mimetic muscles following surgical resection of a considerable segment of the facial nerve (including a portion of its main trunk and the peripheral plexus), etc. The purpose of this article was to review the anatomical features and clinical significance of the communications between the trigeminal nerve and the facial nerve..  

CONCLUSIONS: The application of lateral brow incision by the guide of sphenozygomatic suture and rigid fixation for zygomatic complex fracture approach leaves minimal scar and injury to the facial nerve,with better esthetic and functional outcome..  

The stapedius muscle was formed by two anlagen, one for the tendon, which derives from the internal segment of the interhyale and another for the belly, located in the second pharyngeal arch, medially to the facial nerve and near the interhyale.  

There were no cases of facial nerve weakness or salivary fistula.  

Putative sympathetic premotor neurons controlling cutaneous vasomotion are contained within the rostral ventromedial medulla (RVMM) between levels corresponding, rostrally, to the rostral portion of the nucleus of the facial nerve (RVMM(fn)) and, caudally, to the rostral pole of the inferior olive (RVMM(io)).  

Along the intracranial facial nerve, we classified the compression sites into the transitional zone (TRZ), the central nervous system (CNS) segment and the peripheral nervous system (PNS) segment.  

This is a rare case of a young male with biopsy proven adenoid cystic carcinoma of the external auditory canal who underwent excision of the lesion with superficial parotidectomy sparing the facial nerve.  

The subset who had tinnitus in addition to hearing loss had similar results, with the only significant association being found between loops running between the facial nerve and the vestibulocochlear nerve, and a p value of 0.0433 was obtained.  

First of all, we have studied on CT scan the positional relationship between the facial nerve and other structures of the cadaveric TBs and prototyped bones. Classic mastoid surgical procedures were performed in the Anatomy Department: exposing sigmoid sinus, facial nerve, labyrinth, dura mater, jugular bulb, and internal carotid artery.  

OBJECTIVE: To analyze the influence of the topical use of basic fibroblast growth factor (bFGF) in the regeneration of the facial nerve in rats. MATERIALS AND METHODS: Twenty-eight Wistar adult male rats underwent complete section of the facial nerve trunk, followed by end-to-end anastomosis with epineural sutures. To evaluate facial nerve regeneration, the number of myelinated fibers evident on histologic sections was counted on the 14th (7 experimental and 8 control animals) and the 28th days (7 experimental and 6 control animals) after surgery, and the facial movements of vibrissae and the blink reflex were evaluated on alternate days until the 28th day. CONCLUSION: This study showed that the regeneration of the facial nerve occurred earlier and resulted in significantly more myelinated nerve fibers in the animals that received topical bFGF..  

Surgical resection should be performed with special attention to preserving facial nerve function..  

Occasionally, patients with KFS may also show signs of deafness, intellectual disability, cardiac malformation, palpebral ptosis, facial nerve paralysis, cleft palate, and scoliosis.  

In addition to using intra-operative facial nerve monitoring in helping to locate the position of the facial nerve in anterograde parotidectomy, numerous soft tissue and bony landmarks have been proposed to assist the surgeon in the early identification of this nerve. The purpose of this study was to measure the distance (in twenty-six embalmed cadavers) from four of the most commonly used surgical landmarks to the main trunk of the facial nerve-the posterior belly of digastric muscle (PBDM), the tragal pointer (TP), the junction between the bony and cartilaginous ear canal (EAM) and the tympanomastoid suture (TMS). The main trunk of the facial nerve was found 5.5+/-2.1mm from the PBDM, 6.9+/-1.8 mm from the TP, 10.9+/-1.7 mm from the EAM and 2.5+/-0.4 mm from the TMS. From this, the TMS can be used as a reliable indicator for locating the main trunk of the facial nerve. In addition, this study also demonstrated a statistically significant difference between the sexes in relation to the two bony landmarks used here, the EAM and the TMS, with the facial nerve found further away from those landmarks in females compared to males. With the advent of 3D construction and reformatting of images, these values may come to the forefront in pre-operative planning for locating the facial nerve in anterograde parotidectomy..  


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