Facial nerve and its dysfunction

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(ENT) Specials Fichas sobre Facial nerve and its dysfunction, creado por Liam Musselbrook el 06/12/2016.
Liam Musselbrook
Fichas por Liam Musselbrook, actualizado hace más de 1 año
Liam Musselbrook
Creado por Liam Musselbrook hace casi 8 años
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Pregunta Respuesta
Basic anatomy of the facial nerve in the ear Gives off the greater superficial petrosal n., nerve to stapediius and chordatympani Nerve emerges in the cerebellopontine angle
Facial nerve branches within parotid gland Two Zulus Bit My Cat Temporal, Zygomatic, Buccal, Mandibular, Cervical
Upper or lower motor neurone lesion? LMN: forehead (eyebrow raise) also affected UMN: lower face involved with preservation of bilateral eyebrow raise
History questions for facial nerve pathology Onset? Severity? Symptoms related to palsy? Otological symptoms? Neuro symptoms Parotid disease? Systemic illness? Trauma?
Examination for facial nerve pathology Expressions and facial movements Cranial nerve examination Ear examination Palpate parotid Inspect oral cavity
House Brackmann Scale I-VI Normal to worst
Congenital causes of facial nerve pathology Moebius Syndrome Hemifacial microsomia
Iatrogenic causes of facial nerve pathology Forceps delivery Parotid or submandibular gland surgery Mastoid surgery Skull base surgery
Infective causes of facial nerve pathology Cholesteatoma Acute otitis media Mastoiditis Herpes zoster (Ramsey Hunt syndrome)
Inflammatory causes of facial nerve pathology Inflammation of parotid (e.g. sarcoidosis)
Trauma causes of facial nerve pathology Penetrating injury Forceps delivery Transverse fractures of the skull
Tumours causing facial nerve pathology Malignant parotid tumours Middle ear - squamous, rhabdomyosarcoma, glomus jugulare/tympanicum Petrous apex cysts Acoustic and facial nerve neuromas Meningioma Carcinomatous meningitis
Bell's palsy Idiopathic lower motor palsy of VII nerve 20/100,000 Tavener's criteria: acute onset, hemi-facial, no CNS pathology, no ear pathology Signs of recovery within 2 months Oral sterioids speed recovery if given early
What is associated with poor prognosis in Bell's palsy? Increasing age Associated pain Complete palsy Increased latency to onset of recovery
Treatment of facial nerve palsy - General Oral steroids + aciclovir for Bell's Palsy and Ramsay Hunt Syndrome if severe facial weakness Permanent facial weakness -> facial slings made from fascia lata
Treatment of facial palsy - Eye care Reduced eye closure -> dryness + abrasions Artificial tear Eye patch at night Temporary lateral tarsorrhaphy or gold weight
Mostrar resumen completo Ocultar resumen completo

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