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Description
Flashcards by Liam Musselbrook, updated more than 1 year ago
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Created by Liam Musselbrook
about 9 years ago
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| Question | Answer |
| 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 |
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