1/65. Unilateral transient forehead paralysis following injury to the temporal branch of the facial nerve.BACKGROUND: Cutaneous surgery in the temporal region of the forehead can lead to injury to the superficial temporal branch of the facial nerve. A flattened forehead and with ipsilateral forehead paralysis can occur with damage to this nerve. methods: A case is presented of transient forehead paralysis resulting from Mohs' micrographic surgery with reconstruction of the defect. The paralysis resolved over a period of fifteen months. RESULTS: The anatomy of the nerve makes it susceptible to injury during cutaneous surgery. The area of danger is the area superior to the zygomatic arch and lateral to the lateral eyebrow where the nerve is closest to the skin. CONCLUSIONS: Restoration of motor function usually occurs without intervention, but may take several months. Should motor function not recur, nerve grafting of a repair of the ptotic brow may be needed. The anatomy of the nerve is reviewed and brow lifting options are discussed.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/65. Bilateral facial nerve paralysis after high voltage electrical injury.A case of bilateral facial nerve paralysis of a patient who received a high voltage electrical burn is presented. This is an extremely unusual neurologic condition and has not been previously reported in association with electrical injuries. The patient regained nearly complete neurologic function several months after the incident.- - - - - - - - - - ranking = 0.66666666666667keywords = injury (Clic here for more details about this article) |
3/65. facial nerve injury following superficial temporal artery biopsy.BACKGROUND: With proper training, superficial temporal artery biopsy is a safe office procedure with few complications. Surgeons from different disciplines, including ophthalmologists, dermatologists, general surgeons, and plastic surgeons may be called upon to perform this common procedure to confirm giant cell arteritis. OBJECTIVE: To emphasize the surgical anatomy of the scalp as it pertains to superficial temporal artery biopsy and to raise awareness that significant complications can occur after superficial temporal artery biopsy. METHOD: Case report. RESULTS: A 75-year-old woman with presumed giant cell arteritis developed frontalis muscle paralysis following a superficial temporal artery biopsy. biopsy selection site within the danger zone combined with deep dissection carries the greatest risk of injury to the temporal branches of the facial nerve. CONCLUSION: Any surgeon involved in the practice of performing superficial temporal artery biopsies should have a thorough understanding of proper surgical techniques and regional anatomy to avoid potential devastating complications.- - - - - - - - - - ranking = 0.83333333333333keywords = injury (Clic here for more details about this article) |
4/65. Otic capsule fracture with preservation of hearing and delayed-onset facial paralysis.The unusual occurrence of an otic capsule fracture with preservation of hearing is presented. In addition, the patient suffered facial paralysis beginning 6 days after the injury that rapidly recovered. Fifteen-month follow-up reveals stable hearing thresholds. The course of a fracture through the inner ear could be an important factor in determining the potential for hearing preservation.- - - - - - - - - - ranking = 0.16666666666667keywords = injury (Clic here for more details about this article) |
5/65. Injury to the facial nerve associated with the use of a disposable nerve stimulator.Clinical observations and experimental data from this study support the thesis that the disposable Weck nerve locator/stimulator may induce neural damage. This potential damage may cause at least a temporary paresis. Although more study is required to better document the method, degree, and factors influencing injury, we believe that enough evidence is present to induce caution and warrant further study. We recommend that the stimulators be used with caution on the lowest setting possible and with as little contact with the nerve as possible.- - - - - - - - - - ranking = 0.16666666666667keywords = injury (Clic here for more details about this article) |
6/65. Surgical management of the facial nerve in craniofacial trauma and long-standing facial paralysis: cadaver study and clinical presentations.BACKGROUND AND OBJECTIVES: Examination of the extratemporal branches of the facial nerve reveals several branching patterns of the facial nerve, indicating the variability in the course of the nerve. Due to such variance, injury to this nerve often accompanies facial trauma and surgical dissection for the repair of facial bone injuries, and it may result in high morbidity. methods AND MATERIALS: A study of 12 fresh cadavers was performed to 1) review the variability in location of the extratemporal branches of the facial nerve, 2) identify the soft tissue injuries in which the facial nerve is at risk, and 3) discuss surgical options for repair. The authors identified the zygomatic and buccal and the extratemporal branches of the facial nerve. Among the five extratemporal branches, there is a significant crossover between all, except the temporal and the mandibular branches. This indicates that dissection should proceed with great caution, since injury to the temporal and marginal mandibular branches is unlikely to resolve spontaneously. The management of injuries within one year and those of longer duration is discussed. RESULTS AND/OR CONCLUSIONS: Two of the 5 major branches of the extratemporal facial nerve have a high morbidity following injury. Repair should be performed within the first 72 hours. Graft, if required, should be placed in 9 to 12 months.- - - - - - - - - - ranking = 0.50360711802476keywords = injury, trauma (Clic here for more details about this article) |
7/65. Open reduction of subcondylar fractures via an anterior parotid approach.Visualization of subcondylar fractures is limited, and rigid fixation technically difficult, employing standard open surgical techniques--especially when the condyle is displaced out of the glenoid fossa. The majority of condylar neck fractures are treated by closed reduction with maxillomandibular fixation, to obviate the potential for permanent injury to the facial nerve. The technique described employs an anterior parotid, two-layer, sub-SMAS (superficial musculo-aponeurotic system) approach via a rhytidectomy incision that reliably identifies and preserves the neural elements and provides direct access to the pericondylar region. The thirteen patients presented here exhibited satisfactory functional and aesthetic results. Complications included temporary nerve palsies, plate fractures, and a hematoma.- - - - - - - - - - ranking = 0.16666666666667keywords = injury (Clic here for more details about this article) |
8/65. skull-base trauma: neurosurgical perspective.Trauma to the cranial base can complicate craniofacial injuries and lead to significant neurological morbidity, related to brain and/or cranial nerve injury. The optimal management involves a multidisciplinary effort. This article provides the neurosurgeon's perspective in management of such trauma using a 5-year retrospective analysis of patients sustaining skull-base trauma. The salient features of anterior and middle skull-base (temporal bone) trauma are summarized, and the importance of frontal basilar trauma as well as brain injury is evident. With these injuries, all cranial nerves (except 9 to 12) are at risk; the olfactory nerve and the facial nerve are the first and second, respectively, to sustain injuries. This retrospective analysis provides a better understanding of cranial base trauma and its management. It emphasizes the multifaceted nature of such trauma and the need to recognize anterior skull-base complications, including cerebrospinal fluid leak and brain injury.- - - - - - - - - - ranking = 0.50759292034917keywords = injury, trauma, brain (Clic here for more details about this article) |
9/65. Trauma to the temporal bone: diagnosis and management of complications.The temporal bone contains important sensory and neural structures that may be damaged in patients who experience craniofacial trauma. The most serious complications of temporal bone trauma include facial nerve paralysis, cerebrospinal fluid leak, and hearing loss. Injury to the temporal bone often presents with subtle signs and symptoms, such as otorrhea, facial palsy, and hemotympanum. A high index of suspicion and a thorough knowledge of how to diagnose injury to the temporal bone are paramount in treating patients who present to the emergency room with craniofacial trauma. This article provides an overview of temporal bone trauma, outlines a methodical approach to the patient with temporal bone trauma, details four cases, and describes the treatment of complications.- - - - - - - - - - ranking = 0.17027378469142keywords = injury, trauma (Clic here for more details about this article) |
10/65. The bicoronal flap approach in craniofacial trauma.The utilization of the bicoronal scalp flap in craniofacial trauma has proved indispensable in the management of severe craniofacial injuries. It provides vast exposure of such critical structures as the cranium, frontal sinus, orbit and upper midface, compared with that for previous techniques of facial fracture reduction. Although the flap has great utility, severe complications, such as facial nerve injury, diplopia, telecanthus, and scalp necrosis, can occur. This article reviews the surgical anatomy, technique, and indications for the safe utilization of the bicoronal scalp flap approach in the management of craniofacial trauma.- - - - - - - - - - ranking = 0.17099520829637keywords = injury, trauma (Clic here for more details about this article) |
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