Limits...
Modern concepts in facial nerve reconstruction.

Volk GF, Pantel M, Guntinas-Lichius O - Head Face Med (2010)

Bottom Line: Reconstructive surgery of the facial nerve is not daily routine for most head and neck surgeons.The published experience on strategies to ensure optimal functional results for the patients are based on small case series with a large variety of surgical techniques.A step-by-step clinical examination, if necessary MRI imaging and electromyographic examination allow a classification of the palsy's aetiology as well as the determination of the severity of the palsy and the functional deficits.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Otorhinolarnygology, University Jena, Lessingstrasse 2, Jena, Germany.

ABSTRACT

Background: Reconstructive surgery of the facial nerve is not daily routine for most head and neck surgeons. The published experience on strategies to ensure optimal functional results for the patients are based on small case series with a large variety of surgical techniques. On this background it is worthwhile to develop a standardized approach for diagnosis and treatment of patients asking for facial rehabilitation.

Conclusion: A standardized approach is feasible: Patients with chronic facial palsy first need an exact classification of the palsy's aetiology. A step-by-step clinical examination, if necessary MRI imaging and electromyographic examination allow a classification of the palsy's aetiology as well as the determination of the severity of the palsy and the functional deficits. Considering the patient's desire, age and life expectancy, an individual surgical concept is applicable using three main approaches: a) early extratemporal reconstruction, b) early reconstruction of proximal lesions if extratemporal reconstruction is not possible, c) late reconstruction or in cases of congenital palsy. Twelve to 24 months after the last step of surgical reconstruction a standardized evaluation of the therapeutic results is recommended to evaluate the necessity for adjuvant surgical procedures or other adjuvant procedures, e.g. botulinum toxin application. Up to now controlled trials on the value of physiotherapy and other adjuvant measures are missing to give recommendation for optimal application of adjuvant therapies.

Show MeSH

Related in: MedlinePlus

Summarizing schematic algorithm of the different possibilities of facial nerve reconstruction.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2984557&req=5

Figure 5: Summarizing schematic algorithm of the different possibilities of facial nerve reconstruction.

Mentions: Head and neck surgeons faced with acute or chronic facial palsy demanding surgical repair need a broad spectrum of surgical tools in order to ensure optimal treatment of the patient. Following the diagnostic recommendations and the classification presented in this review may help to find the optimal strategy of modern facial nerve rehabilitation for the individual patient with severe facial palsy (Summary in Figure 5).


Modern concepts in facial nerve reconstruction.

Volk GF, Pantel M, Guntinas-Lichius O - Head Face Med (2010)

Summarizing schematic algorithm of the different possibilities of facial nerve reconstruction.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2984557&req=5

Figure 5: Summarizing schematic algorithm of the different possibilities of facial nerve reconstruction.
Mentions: Head and neck surgeons faced with acute or chronic facial palsy demanding surgical repair need a broad spectrum of surgical tools in order to ensure optimal treatment of the patient. Following the diagnostic recommendations and the classification presented in this review may help to find the optimal strategy of modern facial nerve rehabilitation for the individual patient with severe facial palsy (Summary in Figure 5).

Bottom Line: Reconstructive surgery of the facial nerve is not daily routine for most head and neck surgeons.The published experience on strategies to ensure optimal functional results for the patients are based on small case series with a large variety of surgical techniques.A step-by-step clinical examination, if necessary MRI imaging and electromyographic examination allow a classification of the palsy's aetiology as well as the determination of the severity of the palsy and the functional deficits.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Otorhinolarnygology, University Jena, Lessingstrasse 2, Jena, Germany.

ABSTRACT

Background: Reconstructive surgery of the facial nerve is not daily routine for most head and neck surgeons. The published experience on strategies to ensure optimal functional results for the patients are based on small case series with a large variety of surgical techniques. On this background it is worthwhile to develop a standardized approach for diagnosis and treatment of patients asking for facial rehabilitation.

Conclusion: A standardized approach is feasible: Patients with chronic facial palsy first need an exact classification of the palsy's aetiology. A step-by-step clinical examination, if necessary MRI imaging and electromyographic examination allow a classification of the palsy's aetiology as well as the determination of the severity of the palsy and the functional deficits. Considering the patient's desire, age and life expectancy, an individual surgical concept is applicable using three main approaches: a) early extratemporal reconstruction, b) early reconstruction of proximal lesions if extratemporal reconstruction is not possible, c) late reconstruction or in cases of congenital palsy. Twelve to 24 months after the last step of surgical reconstruction a standardized evaluation of the therapeutic results is recommended to evaluate the necessity for adjuvant surgical procedures or other adjuvant procedures, e.g. botulinum toxin application. Up to now controlled trials on the value of physiotherapy and other adjuvant measures are missing to give recommendation for optimal application of adjuvant therapies.

Show MeSH
Related in: MedlinePlus