Flashcards in Facial paralysis Deck (23):
What are some causes of facial paralysis? (4)
4. tumors of pinna, parotid gland or skull base
Paralysis of (central/peripheral) portion of the facial nerve affects all divisions of the nerve
Paralysis of (central/peripheral) portion of the facial nerve spares the forehead
central - lesion of the supranuclear tracts
How is facial paralysis graded? What is considered normal vs flaccid complete paralysis?
1 = normal
6 = flaccid complete paralysis
What are the 6 major branches of the facial nerve?
6. Posterior Auricular
What is it called when a patient presents with unilateral facial nerve paralysis that is, by definition, idiopathic
PCR has shown Bell's palsy is related to what type of infection in most cases?
Is the onset and recovery of Bell's palsy fast or slow?
Onset fast (sudden)
Recovery = gradual, but spontaneous expected in >85%
What meds can inc freq of complete recovery in Bell's palsy?
Prednisone (oral steroid)
If facial paralysis has a gradual onset and does not begin to recover by 6-8 weeks, or recurrent symptoms on the same side occur, this suggests what? How can this be evaluated?
Tumor (e.g. facial nerve neuroma, parotid gland malignancy, cerebello-pontine angle tumor
What syndrome causes facial nerve paralysis and is accompanied by severe pain and a vesicular eruption in the external auditory canal and auricle in the distribution of the facial nerve
Which has a better prognosis, Bell's palsy or Ramsay-Hunt synd?
This syndrome is related to reactivation of herpes zoster in the geniculate ganglion. What's the std tx?
Ramsay Hunt's syndrome
Medical therapy with antiviral agents and oral steroids
Temporal bone fractures may injury (transect or stretch) what nerve?
If the facial nerve is not transected and the nerve swells, it can impeded ___ flow and create a conduction block. Facial paralysis can take up to ___ hrs to develop
What can be done to assess the facial nerve along its intratemporal course?
electrical testing and high-resolution CT scanning of the temporal bone
When would you reanastomose or use an interpositional graft with a greater auricular/sural nerve for the facial nerve transmastoid/intercranially?
If it's impaled by a bony spicule
If the cochlea or balance organs are injured in temporal bone trauma, what type of hearing problem would result?
If the middle ear or ear canal are injured in temporal bone trauma, what type of hearing problem would result?
conductive hearing loss may occur secondary to a middle ear blood collection (hemotympanum)
If the ossicular chain is discontinuous, or a TM perforation occurs, what type of hearing problem would result?
Conductive hearing loss
How does the facial nerve play a key role in the function of the eye?
Help with eyelid closure --> keeps cornea moist (blinks sweeps tears over the cornea, and eyelid closure at night prevents the cornea from drying)
Prevents foreign bodies from injuring the cornea
What is a consequence of dry corneas?
Corneal ulcerations, pain, scarring, permanent changes in vision