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OBJECTIVE: To evaluate the clinical, macroscopic and histological changes and in the expression of myelin basic protein and glial fibrillary acidic protein postneurorraphy of the facial nerve combined with the application of brain derived neurotrophic factor or placement of a sural nerve graft in guinea pigs. MATERIALS AND METHODS: An experimental, prospective, longitudinal and comparative study was done at Unit of Experimental Lung Transplant of National Institute of Respiratory Diseases Ismael Cosio Villegas, Mexico City. In 18 guinea pigs, divided into 3 groups of 6 each one, neurorraphy of the left facial nerve was performed and they were treated as follows: Group I: Facial nerve neurorraphy without treatment. Group II: sural nerve graft placement without treatment. Group III: Facial nerve neurorraphy and brain derived neurotrophic factor. The study lasted 12 weeks and eyelid closure, vibrissa movements, infection, necrosis, adhesions and fibrosis of the anastomosis were evaluated. Study was done from January 1st, 2022 to January 31, 2023. RESULTS: Group III showed better clinical evolution in a shorter time, less macroscopic and microscopic fibrosis, better axonal regeneration and neovascularization. The 3 groups showed similar expression of myelin basic protein and glial fibrillary acidic protein. CONCLUSIONS: Facial nerve neurorraphy in guinea pigs combined with the application of brain derived neurotrophic factor reduces the degree of facial paralysis in a shorter time and favors the healing of the neurorraphy with less fibrosis and better axonal regeneration than the neurorraphy without treatment and sural graft placement without treatment, but it does not originate changes in the production of basic protein and glial fibrillary acidic protein. [ABSTRACT FROM AUTHOR]

Introduction: Facial synkinesis are one of the chronic consequences of facial paralysis with significant functional, psychological, and social limitations. They are defined as involuntary movements accompanying voluntary movements in another muscle group. Despite the existence of various treatments for facial synkinesis, evaluating their outcomes is challenging due to the limited universality of grading scales for synkinesis assessment. The Synkinesis Assessment Questionnaire (SAQ) has proven to be a simple, reliable, and valid tool for self-reported synkinesis severity. Objective: To perform linguistic and cross-cultural validation of the SAQ into Chilean Spanish, making it applicable to the Chilean population. Materials and Methods: Using the Guillemin methodology, the instrument was translated into Spanish by certified independent translators and then adapted to our population. It was subsequently back-translated into English to determine its concordance with the original questionnaire. The translated and adapted instrument was utilized with a sample of 10 patients to assess comprehension difficulty and applicability. Results: All participants understood the instrument and responded to the questionnaire without language difficulties. There were no major suggestions regarding the adaptation. Conclusion: A Chilean Spanishadapted translation of the SAQ scale to evaluate facial synkinesis in patients with facial paralysis was obtained, making it applicable to Chilean patients. [ABSTRACT FROM AUTHOR]

Moebius syndrome (MBS) is a non-progressive congenital condition involving palsies of the facial (VII) and abducens (VI) cranial nerves, characterized by bilateral facial paralysis and convergent strabismus. The exact cause of MBS remains unknown, with an approximate incidence of 0.002% among newborns. This condition in notable in the first days of life and most of the people with MBS cannot show any type of facial expression such as smiling, frowning or raising their eyebrows. We present the case of a patient with MBS who, despite having bilateral facial paralysis, regains movement of all the branches of the facial nerve after 5 applications of platelet-rich plasma (PRP) in positive sites for the scratch-collapse test. Thanks to this, a symmetrical smile, absence of hypersalivation, and normal speech were observed, which led to a significant improvement in her social interaction and self-esteem. [ABSTRACT FROM AUTHOR]

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Resumen Introducción y objetivo. En el abordaje clínico de la parálisis facial periférica existen opciones terapéuticas enfocadas a restaurar la función motora facial, como son las cirugías estáticas y dinámicas; sin embargo, la asimetría facial es un problema persistente. La neurectomía selectiva del nervio facial (NSNF) es una cirugía utilizada recientemente para el manejo de las sincinesias e hipercinesias producidas como secuela en parálisis facial. El objetivo del presente trabajo es analizar los resultados en la mejoría de la asimetría facial de nuestros pacientes sometidos a NSNF para el tratamiento de la hipercinesia contralateral de la parálisis facial mediante la implementación de la escala Sunnybrook Facial Grading Scale (SFGS). Material y método. Estudio prospectivo observacional descriptivo analizando una muestra de 100 pacientes con diagnóstico de parálisis facial periférica atendidos en el Hospital de San José, Bogotá, Colombia. Describimos variables demográficas, y una vez identificados los pacientes sometidos a NSNF, utilizamos la historia clínica para hacer la estadificación de la escala descrita y comparamos los resultados en el pre y postoperatorio. Describimos también la técnica quirúrgica utilizada. Resultados. Evidenciamos una diferencia en la puntuación de la escala SFGS dada por un incremento en la puntuación en 4 pacientes sometidos al procedimiento, con diferencias estadísticamente significativas. Conclusiones. En nuestra experiencia, La NSNF es útil en el manejo de la asimetría facial persistente como secuela de parálisis facial. Nivel de evidencia científica 4c Terapéutico

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: las complicaciones por otitis media aguda tienen una incidencia menor a un 1%. Aun así, se describe en literatura una mortalidad de un 5%. Actualmente existe escasa evidencia sobre estas complicaciones en nuestra realidad local. Objetivo: describir las de complicaciones de otitis media aguda según tipo, sexo, síntomas de ingreso, exámenes solicitados y tratamiento. Material y Métodos: estudio descriptivo retrospectivo de revisión de fichas clínicas que incluyó pacientes que ingresaron al Hospital Clínico de la Pontificia Universidad Católica de Chile con diagnóstico de otitis media aguda entre el 1 enero de 2000 hasta el 30 de julio de 2022. Resultados: se obtuvieron 71 pacientes ingresados por complicación de otitis media aguda. La edad media fue de 26,79 años, con 46 mujeres y 25 hombres. Se observaron complicaciones extracraneales, intracraneales y complicaciones simultáneas. Las complicaciones más frecuentes fueron la laberintitis y mastoiditis sin reportar casos de mortalidad. Discusión: actualmente existe escasa información sobre complicaciones de otitis media aguda y su epidemiología a nivel local. Las complicaciones extracraneales fueron más frecuentes: de ellas, la laberintitis y la mastoiditis agudas. El diagnóstico es clínico con apoyo de exámenes tanto de laboratorio, audiovestibulares e imágenes. Con respecto al tratamiento quirúrgico, se debe evaluar caso a caso y debe incluir miringotomía con o sin instalación de tubo de ventilación y mastoidectomía en casos refractarios. Es importante la sospecha y la derivación precoz.

Background and objective. In the clinical approach of the peripheral facial paralysis there are therapeutic options focused on restoring facial motor function, such as static and dynamic surgeries; however, facial asymmetry is a persistent problem. Selective facial nerve neurectomy (SFNN) is a widely used surgery for the management of synkinesias and hyperkinesias as sequelae of pasalysis. Our objective is to analyze the results in the improvement of facial asymmetry of patients undergoing SFNN for the treatment of contralateral hyperkinesia of facial paralysis through the implementation of the Sunnybrook Facial Grading Scale (SFGS). Methods. A prospective observational descriptive study is designed for a sample of 100 patients diagnosed with peripheral facial paralysis treated at the Hospital de San José, Bogotá, Colombia. Demographic variables were described, and once the patients undergoing SFNN were identified, the clinical history is used to carry out the staging of the scale described and the results are compared in the pre and postoperative period. A description of the surgical technique used was made. Results. A difference in the SFGS scale classification score was identified due to an increase in the score in the postoperative period of 4 patients that were treated with SFNN with statistically significant differences. Conclusions. In our experience, SFNN is useful in the management of persistent facial asymmetry as a consequence of facial palsy. [ABSTRACT FROM AUTHOR]

En las últimas décadas, se ha incrementado el reporte de manifestaciones neurológicas asociadas con la infección por el virus de chikunguña. Se informa el caso de un adulto joven previamente sano que presentó parálisis facial izquierda aislada después de una infección reciente por el virus de chikunguña en el trópico colombiano. Se describen aspectos importantes de la fisiopatología del virus y su tropismo por el sistema nervioso central y periférico, y se sugiere considerar este virus en el diagnóstico diferencial de la parálisis facial en pacientes con infección confirmada por el virus de chikunguña en regiones tropicales endémicas o en aquellos con antecedente de viajes recientes a dichas regiones.

Como los otros herpesvirus alfa, el virus de la varicela-zóster (VZV) permanece en estado de latencia en los ganglios neurales después de la infección primaria (varicela). La reactivación de una infección latente por VZV en los ganglios de la raíz dorsal, produce el herpes zóster. La erupción que este provoca se caracteriza por lesiones cutáneas metaméricas que se acompañan de dolor neurítico y comprometen con mayor frecuencia a ancianos y sujetos inmunocomprometidos, en especial, aquellos infectados con el virus de la inmunodeficiencia humana (HIV). Las complicaciones que se observan en esta población de pacientes incluyen neumonía, hepatitis y compromiso del sistema nervioso central (meningitis y encefalitis). Varios síndromes clínicos se asocian con el herpes zóster de localización craneal, incluida la parálisis facial periférica y el síndrome de Ramsay-Hunt, el cual constituye la segunda causa de parálisis facial periférica y tiene una gran variedad de presentaciones clínicas. La parálisis facial se presenta en 60 a 90 % de los casos de síndrome de Ramsay-Hunt, puede preceder o aparecer después de las lesiones cutáneas y tiene peor pronóstico que la parálisis de Bell. Se describen aquí dos casos de herpes zóster del ganglio geniculado, con parálisis facial periférica que coincidió con la aparición de las lesiones cutáneas vesiculosas en el conducto auditivo externo y el pabellón auricular (síndrome de Ramsay-Hunt multimetamérico). En ambos casos, se identificó el genoma del VZV mediante PCR en el líquido cefalorraquídeo (LCR).

Introduction: During the COVID-19 pandemic, neurological manifestations affect at least 36% of patients. Cases of Guillain-Barré syndrome have been reported with coinfection by SARS-CoV-2 or with onset of symptoms days after infection by this agent. Objective: To describe a case of a patient with facial diplegia as a clinical form of postcovid-19 Guillain-Barré syndrome. Clinical case report: A 37-year-old female patient who in the first days of October 2021 had high respiratory condition with positive antigen test and polymerase chain reaction for COVID-19. Two weeks later, she began with paresthesias in her lower limbs and hands, difficulty speaking and closing both eyes. On neurological physical examination, she presented bilateral Bell's sign, effacement of the bilateral frontal and nasolabial furrows, deviation of the labial commissure to the right, and generalized areflexia. The nerve conduction study showed axonomyelinic damage of motor fibers of nerves explored bilaterally. The cerebrospinal fluid study was normal. Facial diplegia was considered as clinical presentation of post-covid-19 Guillain-Barré syndrome. She underwent treatment with immunoglobulin, vitamin therapy and rehabilitation, achieving her satisfactory clinical evolution. Conclusions: Facial diplegia is not the most frequent clinical form of Guillain-Barré syndrome, but it should alert to early diagnosis in patients with history of COVID-19. There is good clinical response after treatment with intravenous immunoglobulin. [ABSTRACT FROM AUTHOR]

A significant raise in the reports of neurological manifestations due to Chikungunya virus has been described worldwide. Here, we describe a case report of a previously healthy young adult who developed isolated left facial palsy after a confirmed Chikungunya virus infection in the Colombian tropics. We suggest considering this virus as a differential diagnosis for facial palsy in patients with confirmed Chikungunya virus infection who live in endemic regions or report a history of recent travel to these regions. [ABSTRACT FROM AUTHOR]

Resumen Introducción y Objetivo: El síndrome de Möbius es un trastorno congénito que afecta al nervio facial y al abducens, provocando parálisis facial uni o bilateral y estrabismo. Su tratamiento consiste en lograr la reanimación facial con la transferencia de un músculo funcional libre. Típicamente, se ha realizado en dos o más etapas, siendo controvertido el tiempo entre las cirugías, así como el nervio donador ideal para el colgajo (rama maseterina del trigémino o espinal accesorio). Describimos nuestra cirugía de reanimación facial en Síndrome de Möbius completo mediante transferencia en un solo tiempo de gracilis libre bilateral, usando como nervio donador la rama maseterina del trigémino o el nervio espinal accesorio. Evaluamos resultados y determinamos si es un procedimiento efectivo y seguro. Material y Método: Entre marzo de 2014 y octubre de 2016, sometimos a transferencia en un solo tiempo de gracilis libre bilateral a 4 pacientes con Síndrome de Möbius. Realizamos exploración física y neurológica detallada para determinar los nervios donadores. Tradicionalmente nuestra primera elección es el trigémino, sin embargo estaba afectado en 2 pacientes, por lo que en ellos utilizamos el nervio espinal accesorio. El seguimiento promedio fue de 17 meses Hicimos la evaluación postoperatoria utilizando la escala de valoración estética y funcional de Terzis, la escala de excursión de la sonrisa de Chuang, y una escala de satisfacción postoperatoria. Resultados: De los 4 pacientes operados 2 eran varones y 2 mujeres. Realizamos 8 transferencias musculares libres en 4 tiempos quirúrgicos. Utilizamos los vasos faciales como receptores en todos los casos. Empleamos el nervio trigémino como donador en 2 pacientes y en los otros 2 el nervio espinal accesorio. No hubo complicaciones ni pérdidas de colgajos. Todos los pacientes lograron un mínimo de III en la escala de valoración estética y funcional de Terzis, y de IV en los que usamos el espinal accesorio como donador. El resultado mínimo utilizando la escala de excursión de la sonrisa de Chuang fue de 2, pero mejorando a 3 en los que usamos el espinal accesorio. El promedio en la escala de satisfacción postoperatoria fue de 3, pero en el paciente con mayor tiempo de seguimiento fue de 4. Conclusiones: La cirugía de reanimación facial en pacientes con síndrome de Möbius completo mediante transferencia en un solo tiempo quirúrgico de gracilis libre bilateral es un procedimiento seguro y efectivo. La selección cuidadosa de los pacientes, una exploración física completa cuidadosa, la selección de nervios motores donadores, la realización impecable de la cirugía y un programa de rehabilitación postoperatoria correcto, son indispensables para tener éxito.

Background: BNT162b2 (Pfizer-BioNTech) is a nucleosidemodified mRNA vaccine formulated with lipid nanoparticles for the prevention of COVID-19 disease caused by SARSCoV-2 infection. In early December 2020, BNT162b2 received an emergency use authorization, initial efficacy and safety data have been released, consumer / patient information sheets for vaccines distributed in North America do not warn of Bell's palsy as a possible adverse effect. We reported the case of a patient who developed Bell's palsy on the right side in less than 3 hours after the application of the first dose of the Pfizer-BioNTech COVID-19 vaccine. Clinical case: 32-year-old latina woman who developed right facial paralysis after receiving the first dose of the BNT162b2 mRNA vaccine on April 7, 2021; with right facial paresis, absence of forehead wrinkles, lip-buccal sulcus and nasolabial fold; spasms of the facial and periorbital muscles, laterocervical pain; possible etiologies were ruled out, prednisone, gabapentin and topiramate. CT without alterations, achieving gradual improvement; until full functional recovery after 15 days. With benign evolution, congruent with the natural history of the disease, classifying it as idiopathic Bell's palsy. Conclusions: Although a causal relationship cannot be established, the time and mode of appearance of the paralysis suggested a relationship with the application of the BNT162b2 vaccine. Given the recommendation of the health authorities to monitor the cases of Bell's palsy, and the surveillance of events supposedly attributable to vaccination (ESAVI) and as it is the first case reported in the literature, in the mexican population, we believe that this case should be shared with the scientific community in a timely manner. [ABSTRACT FROM AUTHOR]

Like other alpha-herpesviruses, the varicella-zoster virus (VZV) remains latent In the neural ganglia following the primary varicella Infection. The reactivation of the VZV In the dorsal root ganglia results In herpes zoster. Herpes zoster eruption Is characterized by localized cutaneous lesions and neuralgic pain mostly In older and immunocompromised persons, especially those living with the human Immunodeficiency virus (HIV). The most commonly reported complications include VZV pneumonia, meningitis, encephalitis, and hepatitis. Several neurologic syndromes have been described associated with herpes zoster localized in cranial areas Including peripheral nerve palsies and the Ramsay-Hunt syndrome, which has a varied clinical presentation and Is the second most common cause of peripheral facial paralysis. Facial paralysis In this syndrome occurs In 60 to 90% of cases and it may precede or appear after the cutaneous lesions with a worse prognosis than Idiopathic Bell paralysis. Here we present two cases of herpes zoster from the geniculate ganglia with peripheral facial paralysis that appeared simultaneously with vesicular herpetic otic lesions (multimetamerlc Ramsay-Hunt syndrome). In the two cases, ampllfiable varicella-zoster viral DNA was found In the cerebrospinal fluid by RT-PCR Multiplex. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

It was reported a 68 year old male patient with a personal pathological history of post- ischemic stroke Parkinson's syndrome and systemic arterial hypertension and with the intention of describing the experience of diagnosis and treatment of Ramsay Hunt syndrome. Patient presented to his primary health physician at the Univirsity Clinic “Omar Ranedo Pubillones” in Guantanamo, presenting pain in right side of the face and earache, headache and fever. Then, he presented vesicular lesions with a herpetic appearance. It was concluded the definitive diagnosis of Ramsay Hunt syndrome type II and it was referred to Otolaryngology consultation, where the diagnosis was confirmed. After treatment patient’s improvement was good. Although Ramsay Hunt syndrome is not a health problem, shows the need for primary care physicians to become familiar with the theoretical basis for its diagnosis and the importance of interdisciplinary evaluation for this purpose.

Resumen Introducción y objetivo. El Espectro Óculo Aurículo Vertebral (EOAV) es un conjunto de malformaciones congénitas que incluye malformaciones orbitarias, mandibulares, auriculares, de tejidos blandos, del nervio facial y malformaciones vertebrales. El compromiso de los pares craneales, y más específicamente del nervio facial, se presenta en un 10 a un 45% de los casos. La clasificación de OMENS evalúa la función del nervio facial con parámetros anatómo-clínicos, a diferencia de la escala eFACE que permite determinar la función del nervio facial y la simetría del rostro en reposo y en movimiento. Los estudios electrofisiológicos son los más útiles y objetivos para valorar la función del nervio facial y de sus músculos diana. El objetivo de este estudio es realizar una caracterización electrofisiológica y una evaluación con la escala eFACE de la parálisis facial en el EOAV. Material y Método. Estudio observacional descriptivo, prolectivo y transversal que incluye todos los pacientes de nuestra institución con compromiso del nervio facial asociado a EOAV excluyendo aquellos expedientes sin estudios electrofisiológicos. Resultados. Evaluamos 32 pacientes que cumplían criterios de inclusión: 12 varones y 20 mujeres, con edad media de 11.46 años, de los que 17 presentaron parálisis facial izquierda, 14 derecha y 1 bilateral. Según la clasificación de OMENS las ramas superiores del nervio facial estaban comprometidas en 6 pacientes, las inferiores en 3 y todas en 23. En la escala de eFACE obtuvimos un puntaje (score) de reposo promedio de 74, dinámico promedio de 56, periocular promedio de 72, de tercio medio facial y de la sonrisa promedio de 68 y de tercio inferior promedio de 79. Los estudios de neuroconducción del nervio facial reportaron axonopatia motora mixta con compromiso de 3 ramas en 23 pacientes, 2 ramas en 5 y 1 rama en 4 casos; 13 pacientes presentaron compromiso en la rama maseterina del nervio trigémino y 4 en el nervio hipogloso. En la electromiografía 5 pacientes tuvieron ausencia de respuesta en tercio superior, 3 en los músculos de la sonrisa y 7 en los depresores del labio inferior. Conclusiones. La evaluación clínica funcional con la escala de eFACE y la caracterización electrofisiológica de los pacientes con parálisis facial del desarrollo asociada al EOAV permiten determinar el compromiso de las distintas ramas del nervio facial, el estado de la musculatura facial y el compromiso de otros pares craneales.

Introducción: Desde que se inició la pandemia por el SARS-CoV-2, se han descrito numerosos casos de síndrome de Guillain-Barré secundario a la COVID-19. Su presentación típica es la triada de parestesias, debilidad muscular ascendente y arreflexia, aunque hay diversas variantes regionales como la diplejía facial. Presentación del caso: Mujer de 35 años que, dos semanas después de un contacto estrecho con un caso confirmado de COVID-19, ingresa por miopericarditis probablemente viral, con estudio de autoinmunidad negativo, múltiples serologías virales negativas y positividad para IgG anti-SARS-CoV-2 con PCR negativa. Una semana tras el alta presenta paresia de ambos nervios faciales sin otras alteraciones neurológicas. Se realiza TAC craneal sin hallazgos y EMG que evidencia afectación bilateral de los nervios faciales. La paciente rechaza realización de punción lumbar Discusión: La diplejía facial puede ocurrir en el contexto de diversas patologías, como tumores meníngeos o troncoencefálicos, agentes infecciosos, síndrome de Guillain-Barré, patologías autoinmunes, traumatismos, causas metabólicas o causas congénitas. En el caso descrito tras descartar mediante pruebas de imagen y analíticamente el resto de etiologías, y dada la presentación clínica, permanece como causa más probable el síndrome de Guillain-Barré, posiblemente secundario a infección por SARS-CoV-2 dada la positividad de IgG anti-SARS-CoV-2 tras un contacto con un caso confirmado. Conclusión: Este caso apoya la hipótesis de que la COVID-19 puede desencadenar el síndrome de Guillain-Barré, específicamente en forma de diplejía facial, una variante atípica que se debe conocer para su identificación y manejo precoz como parte de este síndrome.

El síndrome de Miescher-Melkerson-Rosenthal es una condición clínica poco frecuente caracterizada por un edema orofacial episódico, paresia facial periférica recurrente, lengua geográfica (lingua plicata) y granulomas en biopsia de piel o labial. Se ha reportado más frecuentemente en mujeres, y su incidencia es probablemente subestimada por el desconocimiento del síndrome, su presentación clínica incompleta y la plétora de diagnósticos diferenciales. Se debe considerar en pacientes que presenten al menos dos de las cuatro características mencionadas. Su tratamiento, con esteroides vía oral, está dirigido a los episodios de edema orofacial y/o paresia facial. A continuación se describen tres casos del síndrome valorados en el servicio de neurología de la Fundación Cardioinfantil y se presenta una breve revisión de la literatura.

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Introduction: One of the most recurrent sequels in the neurological branch is the facial paralysis which not only affects the motor area, but also the psychological one, as the face is the person's representative image. Objective: To evaluate the influence of digitopuncture as therapeutic alternative in patients with facial paralysis, by using the photographic technique for measuring angles according to the proposed evaluation indicators. Methods: A panel experimental and longitudinal study was made, with a pretest and a posttest, in the Physiotherapy Service of Dr. Carlos Juan Finlay Hospital Central Military Clinical-surgical, in Marianao municipality, Havana, from May to July, 2016, for which two groups were formed: a control group, in which conventional treatment was applied (massage, exercises of the pantomime and physical agents), and an experiment group which received digitopuncture besides massage. Results: In the evaluation of both groups, it was obtained that in the control group the best results were in the central axis of the mouth, followed by the muscle contraction, while the whole experimental group showed remarkable changes in all the indicators, with prevalence of the muscle contraction. When comparing the results of both groups in the pretest and posttest, the incidence and effectiveness of the digitopuncture was evidenced in the experimental group. Conclusions: Digitopuncture, as part of the rehabilitation in patients affected due to facial paralysis, influenced in a better recovery and decreased the time of treatment considerably, which had a higher incidence in the female group.

Introduction: Peripheral Facial Palsy is defined as the weakness or paralysis of the musculature innervated by the facial nerve due to lesions of the seventh cranial nerve anywhere in its path from the nucleus of origin to the structures innervated by it. Objective: to assess the use of acupuncture and tuina massage in the treatment of patients with Bell's palsy. Methods: a prospective and longitudinal therapeutic clinical study of patients with Bell's peripheral facial palsy from January 2017 to January 2018, evaluated by questioning and neurological and traditional physical examination. At the beginning and end of the treatment the House-Brackmannc scale was applied as an instrument to evaluate the application of the treatment. Demographic, clinical and outcome variables were explored. Results: male gender predominated and the group from 30 to 50 years old, the most frequent traditional diagnosis was cold wind and in 84.6 % of patients the treatment applied was satisfactory, with an average recovery time of 38 days. Conclusions: the application of acupuncture and tuina massage is a successful traditional technique to treat Peripheral Facial Palsy.

Este estudio busca evidenciar la existencia del estrés térmico por calor y los cambios bruscos de temperatura en procesos manufactureros de la cerámica, y que son silenciados desde la misma identificación de la patología del trabajador. También pone de manifiesto la relación de causalidad entre los efectos en la salud y las condiciones de trabajo donde se realiza la labor. El diagnóstico de la enfermedad relacionado con el estrés térmico por calor o a los cambios bruscos de temperatura son ingenuamente enmascarados por la clasificación de enfermedades como de tipo común o general.

Antecedentes: El síndrome de Melkersson-Rosenthal es una entidad poco frecuente caracterizada, en su forma completa, por parálisis facial recurrente, lengua fisurada y edema orofacial. La mayoría de los casos se presentan como formas oligosintomáticas y monosintomáticas. Su etiología es aún desconocida y tiene un curso crónico que puede ser progresivo. Caso clínico: Presentamos el caso de una niña de nueve años de edad con episodios recurrentes de parálisis facial periférica. Durante su estudio se observó edema labial, glositis migratoria benigna y queilitis angular, por lo que se formuló el diagnóstico clínico de síndrome de Melkersson-Rosenthal. Conclusiones: Debemos considerar este síndrome dentro del diagnóstico diferencial ante la presencia de parálisis facial periférica recurrente o edema facial, debido a su comportamiento y evolución progresiva.

El síndrome de Möebius es una alteración congénita caracterizada por parálisis de los pares craneales debido a una atrofia de sus núcleos, principalmente se ven afectados el nervio facial y el nervio abducens causando parálisis facial y limitación del movimiento ocular. Otros nervios craneales también se ven afectados lo que trae anomalías dentales y esqueletales. Puede a su vez, estar asociado a malformaciones de las extremidades superiores e inferiores como sindactilia y pie equinovaro. Su etiología es aún desconocida, pero se relaciona a un problema vascular que afecta el desarrollo de los núcleos de los pares craneales. El objetivo de esta investigación es describir las característi as del Síndrome de Möebius y reportar 3 casos clínicos que acudieron a consulta odontológica.

Ramsay Hunt syndrome is defined as a vesicle and erythematous rash of the ear or mouth associated with peripheral facial nerve palsy in addition to other frequent signs and symptoms such as tinnitus, hearing loss, nausea, vomiting, vertigo and nystagmus. The above is explained by the proximity of the eighth pair of the geniculated cranial ganglion to the vestibulocochlear nerve within the bony facial canal. Currently, it is known that the pathogen responsible for Ramsay Hunt syndrome is a varicella-zoster virus, a difference from Bell's palsy, whose etiological agent is herpes simplex virus for which there is a mild paralysis and with a better prognosis compared to patients with Ramsay Hunt syndrome. However, the latter may be indistinguishable from Bell's palsy. On the other hand, a group of patients has been described as Ramsay Hunt syndrome but herpete that develops a peripheral facial paralysis without rash in the ear or mouth. This facial paralysis is associated with the antibody's four-time increase against varicella-zoster virus or the presence of varicella-zoster virus DNA in the atrial skin, mononuclear blood cells, middle ear fluid or saliva. This increase indicates that a proportion of patients with Bell's palsy have Ramsay Hunt syndrome. Studies have revealed that early treatment with acyclovir and prednisone improves the prognosis and recovery of these patients. [ABSTRACT FROM AUTHOR]

Introducción: el síndrome de Ramsay Hunt es un trastorno poco común causado por la activación del virus varicela zóster. Se manifiesta clínicamente por ampollas en el canal auditivo externo, dolor de oído, así como signos y síntomas de parálisis facial. Es un cuadro que suele ser más severo y con mayor potencialidad de complicaciones que la parálisis de Bell. Caso clínico: paciente femenina de 53 años de edad, con antecedentes de hipertensión arterial y diabetes mellitus tipo 2, quien consultó por presentar lesiones dolorosas en el pabellón auricular derecho y desviación de la comisura labial a la izquierda. Al examen físico se observaron lesiones sugestivas de infección por el virus de la varicela zóster. Se realizó manejo con corticoides y antivirales, con rápida y completa mejoría. Conclusión: la parálisis facial del síndrome de Ramsay Hunt, es usualmente severa. Se considera que el tratamiento temprano con corticosteroides más antivirales o con solo corticosteroides, evita el daño irreversible del nervio facial y posibles complicaciones. Rev.cienc.biomed. 2014;5(1):139-14

Background: Melkersson-Rosenthal syndrome is a rare disorder characterized, in its complete form, by recurrent facial nerve palsy, fissured tongue and oro-facial swelling. Most of the cases present with partial or monosymptomatic forms. The etiology is still unknown, and it is considered a chronic disease with progressive course. Case report: We present a nine-year-old girl with recurrent episodes of peripheral facial nerve palsy. Examination revealed lips swelling, fissured tongue and angular cheilitis. Clinical diagnosis of Melkersson-Rosenthal syndrome was made. Conclusions: We must consider this syndrome in the differential diagnosis in the presence of acute peripheral facial paralysis and/or facial swelling due to its behavior and progressive evolution. [ABSTRACT FROM AUTHOR]

Background and objective. The Oculo Auriculo Vertebral Spectre (OAVS) refers to a series of malformations in the orbit, mandible, ear, facial nerve as well as spine/vertebral defects. Facial nerve compromise is present in up to 10-45% of the cases. OMENS classification evaluates facial nerve function according to clinical parameters, whereas the eFACE scale system provides a graphic output, it evaluates 3 categories static, dynamic, and synkinetic. Further, eletrophysiological studies are currently one of the most useful and objective methods to evaluate nerve viability and target muscles. The aim of this investigation is to conduct an electrophysiological characterization and an evaluation with the eFACE scale in patients with facial palsy associated to OAVS. Methods. All cases of OAVS associated to facial palsy from our institution were included. Each patient was evaluated with the eFACE scale system. We excluded patients without electrophysiological studies. Results. A total of 32 patients were evaluated: 12 male and 20 female, with a mean age of 11.46 years old. Seventeen had a left facial palsy, 14 had right facial palsy and 1 had bilateral involvement. The superior facial nerve branches were affected in 6 patients, 3 had inferior nerve involvement and 23 had involvement of all of the facial nerve branches. According to the eFACE scale, the mean score was 74 (repose) and 56 (dynamic). The peri-ocular score was 72, a mean score of 68 for middle facial third (including smile) and an inferior score of 79. As for the neuroconduction studies, most of them reported a mixed axonopathy, with involvement of 3 branches in 23 patients, 2 branches in 5 and 1 branch in 4 cases. Thirteen patients had involvement of the masseteric nerve branch and 4 in the hypoglossal nerve. As for the electromyography, 5 patients had no activity in the upper third, 3 in the smile muscles and 7 in the depressors. Conclusions. The eFACE scale and electrophysiological characterization of patients with facial palsy associated to OAVS provides useful information regarding the facial nerve's branches involvement and the current state of muscular function, both of utmost importance when clinical evaluation is performed before any type of surgical procedure is planned in this patients. [ABSTRACT FROM AUTHOR]

Peripheral facial paralysis is a sudden onset disturbance, marked by weakening of the muscles on one side of the face. Objective: to review scientific publications those demonstrate the effects and results of the use of acupuncture in the treatment of peripheral facial paralysis. The search was done in the database websites: Pubmed, Medline, Scielo, Virtual Health Library, resulting in five randomized clinical trials. Acupuncture has demonstrated efficacy in relieving the symptoms of the disease: headache, trigeminal neuralgia and retro-auricular pain, as well as improving muscle recovery and quality of life of patients. The clinical trials did not demonstrate the efficacy of acupuncture in relation to other treatments. Acupuncture is a safe treatment option in patients with Peripheral Facial Paralysis, since there were no reports of serious adverse events in the studies and contributed satisfactorily to facial nerve recovery in both the acute and late phases of the disease. [ABSTRACT FROM AUTHOR]

The Ramsay Hunt syndrome (RHS) is caused by an acute form of herpes zoster. It is a serious and rare complication, due to a reactivation of varicella zoster virus. This syndrome is produced by a latent infection of the central nervous system, which is clinically presented as a peripheral facial paralysis with vesicular eruption on the ear or in the mouth. Diagnosis of RHS is made clinically and laboratory detection of the virus is mandatory. Earlier treatment improves the prognosis and decreases complications. Magnetic resonance imaging (MRI) with contrast frequently demonstrates facial nerve enhancement in RHS. Nonetheless, it could be also associated to an enhancement of the eighth pair, cochlea, vestibule and segments of the semi-circular canal. MRI is useful because it associates clinical manifestations with nerve affections. In addition, it corroborates multiple neural involvement, which helps to identify the extension of the disease. [ABSTRACT FROM AUTHOR]

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Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Acute peripheral facial paralysis may be diagnosed and treated by different specialists., Objective: The aim of this study was to explore the variability in the treatment of Bell's palsy (BP) and Ramsay Hunt Syndrome (RHS) among different medical specialties., Methods: An anonymous nationwide online survey was distributed among the Spanish Societies of Otorhinolaryngology (ORL), Neurology (NRL) and Family and Community Medicine (GP)., Results: 1039 responses were obtained. 98% agreed on using corticosteroids, ORL using higher doses than NRL and GP. Among all, only 13% prescribed antivirals in BP routinely, while 31% prescribed them occasionally. The percentage of specialists not using antivirals for RHS was 5% of ORL, 11% of NRL, and 23% of GP (GP vs. NRL p = 0.001; GP vs. ORL p < 0.0001; NRL vs. ORL p = 0,002). 99% recommended eye care. Exercises as chewing gum or blowing balloons were prescribed by 45% of the participants with statistically significant differences among the three specialties (GP vs. NRL p = 0.021; GP vs. ORL p < 0.0001; NRL vs. ORL p = 0.002)., Conclusion: There is general agreement in the use of corticosteroids and recommending eye care as part of the treatment of acute peripheral facial paralysis. Yet, there are discrepancies in corticosteroids dosage, use of antivirals and recommendation of facial exercises among specialties., (Copyright © 2023 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: One of the most recurrent sequels in the neurological branch is the facial paralysis which not only affects the motor area, but also the psychological one, as the face is the person's representative image. Objective: To evaluate the influence of digitopuncture as therapeutic alternative in patients with facial paralysis, by using the photographic technique for measuring angles according to the proposed evaluation indicators. Methods: A panel experimental and longitudinal study was made, with a pretest and a posttest, in the Physiotherapy Service of Dr. Carlos Juan Finlay Hospital Central Military Clinical-surgical, in Marianao municipality, Havana, from May to July, 2016, for which two groups were formed: a control group, in which conventional treatment was applied (massage, exercises of the pantomime and physical agents), and an experiment group which received digitopuncture besides massage. Results: In the evaluation of both groups, it was obtained that in the control group the best results were in the central axis of the mouth, followed by the muscle contraction, while the whole experimental group showed remarkable changes in all the indicators, with prevalence of the muscle contraction. When comparing the results of both groups in the pretest and posttest, the incidence and effectiveness of the digitopuncture was evidenced in the experimental group. Conclusions: Digitopuncture, as part of the rehabilitation in patients affected due to facial paralysis, influenced in a better recovery and decreased the time of treatment considerably, which had a higher incidence in the female group. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Oral y Maxilofacial is the property of Sociedad Espanola de Cirugia Oral y Maxilofacial (SECOM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El síndrome de Möebius es una alteración congénita caracterizada por parálisis de los pares craneales debido a una atrofia de sus núcleos, principalmente se ven afectados el nervio facial y el nervio abducens causando parálisis facial y limitación del movimiento ocular. Otros nervios craneales también se ven afectados lo que trae anomalías dentales y esqueletales. Puede a su vez, estar asociado a malformaciones de las extremidades superiores e inferiores como sindactilia y pie equinovaro. Su etiología es aún desconocida, pero se relaciona a un problema vascular que afecta el desarrollo de los núcleos de los pares craneales. El objetivo de esta investigación es describir las característi as del Síndrome de Möebius y reportar 3 casos clínicos que acudieron a consulta odontológica.

La parálisis facial afecta la musculatura de la mímica facial, generando alteraciones estéticas, funcionales y psicosociales. El manejo multidisciplinario es clave para lograr los mejores resultados, especialmente como apoyo a la cirugía reconstructiva. La estrategia de tratamiento está basada en un enfrentamiento sistemático de acuerdo a las características semiológicas y electromiográficas de cada paciente, lo que permite agruparlos de acuerdo a la reversibilidad y severidad de su patología. Los métodos de reconstrucción quirúrgica pueden ser estáticos o dinámicos (injerto cruzado de nervio sural, colgajo muscular libre con injerto de nervio sural ipsilateral o cruzado y colgajo mini-temporal). Incorporar la terapia física dentro del protocolo quirúrgico puede lograr mayor activación muscular, mayor simetría facial y reducir molestias postoperatorias como el edema facial, manejo de cicatrices, entre otros. Aunque existe reconocimiento sobre el impacto que posee el tratamiento de la parálisis facial, no existe a la fecha amplio consenso sobre cuál es el óptimo manejo de esta condición, y a pesar de los avances reportados durante los últimos años y la cantidad de técnicas propuestas en la literatura, la reanimación facial sigue siendo un desafío en cirugía reparadora.

In 1888 Dr. Paul Julius Möebius defined this syndrome as congenital facial paralysis of III, VI, VII and XII cranial nerves, associated with multiple malformations. Case report: female, 3 years old with corrected polydactyly at birth and language problems. Came to the hospital to assess bilateral palpebral ptosis and endotropia with limitation to abduction. The physical examination showed aphasia, dyslalia, sialorrea, microglossia, and polydactyly surgery scar on the 5th fingers of both hands. Incurable entity, with a large number of affectations and limitations in the quality of life of the patient and the people around him. This pathology could be suspected by the external habitus only; however, since its prevalence is low (1:50,000 live births) normally it is not the first differential. This is the reason of this case report. [ABSTRACT FROM AUTHOR]

Introduction: Facial paralysis involves the VII for cranial or facial and can be complete or partial presenting unilaterally. Signs and symptoms: The signs and symptoms are varied and is often related to exposure to a viral infection. Diagnosis: it is based on the existence of findings in three aspects: clinical, topographic and electrical. Treatment: it is based on: a) type of paralysis; b) etiology and nature of the causal lesion; c) place where the injury has occurred; d) intensity or magnitude of the lesion and paralysis; e) time elapsed between the initiation of paralysis and the examination of the patient. Conclusions: The physiotherapeutic treatment will take into account sensitivity, muscular strength and synkinesis. Among the treatment techniques used are: heat treatment, manual lymphatic drainage, acupuncture, electrotherapy, stretching, multisensory stimulation, neuromuscular bandage and muscle reeducation. [ABSTRACT FROM AUTHOR]

Background and Objective.Möbius syndrome is a congenital disorder that affects facial and abducens cranial nerves, resulting in uni or bilateral facial palsy and strabismus. The treatment is facial reanimation with free functional muscle transfer. Typically, facial reanimation has been realized in 2 or more stages with controversial issues, such as the amount of time between the stages and the ideal donor nerve (masseter or spinal accessory). We describe our one-stage facial reanimation surgery for complete Möbius Syndrome using 2 free gracilis muscle flaps, and bilateral trigeminal or spinal nerves as a donor. We evaluate our outcomes and determine if this is an effective and safe procedure. Methods. Between March 2014 and October 2016, 4 patients with complete Möbius Syndrome were operated using bilateral gracilis free muscle transfers in one surgical time. Detailed physical and neurologic examinations were performed with special emphasis on which cranial nerves were involved. Traditionally our first choice of nerve donor has been the trigeminal nerve, but it was involved in 2 patients, so in theme we used the spinal nerve as a donor to innervate 2 free gracilis flaps for smile reconstruction. The mean postoperative follow-up time was 17 months. Outcomes were assessed using the Terzis functional and aesthetic grading system, Chuang's smile excursion score, and a questionnaire to evaluate patient satisfaction. Results. A total of 4 patients were included: 2 male and 2 female. We performed 8 free gracilis muscle transfers in 4 surgical times. We used the facial vessels in every flap, and the trigeminal nerve as a donor in 2 patients and in the 2 remaining, the spinal nerve. We have no complications nor flap failures. All patients achieved at least score of III using the Terzis functional and aesthetic grading system, and IV in those with spinal nerve as a donor. Likewise, the minimum score using Chuang's smile excursion score was 2, but in those with spinal nerve as a donor we got a score of 3. Finally the mean satisfaction score was 3, but the patient with the longest follow-up time gave a 4. Conclusions. One-stage facial reanimation surgery for complete Möbius Syndrome using 2 free gracilis muscle flaps is an effective and safe procedure. Careful patient selection, adequate physical evaluation, motor nerve donor selection, flawless surgery performance, and adequate postoperative rehabilitation program, are mandatory in order to obtain success. [ABSTRACT FROM AUTHOR]