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Facial nerve grafting – what’s the wait?

An uninterrupted facial nerve after resection of cerebellopontine angle (CPA) tumour does not always translate into preserved facial animation. Fortunately there is a high probability spontaneous recovery may occur and hence patients are typically observed for 12 months postoperatively. However,...

3D ultrasonography for evaluation of muscles following facial palsy

Reconstructive surgery for facial nerve palsies is not recommended beyond two to three years after a degenerative facial nerve lesion. Since the time course of muscle atrophy is variable, this timeline is a rough guideline. The only assessment method currently...

Efficacy of stereotactic radiosurgery for facial nerve schwannoma

This international multicentre study reviewed the results of stereotactic radiosurgery (SRS) in 63 patients with facial nerve schwannoma over three decades. The facial nerve schwannoma were distinguished from vestibular schwannoma based on intraoperative findings or typical temporal or extra temporal...

The middle way: treating idiopathic facial nerve palsy

Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...

How the world sees facial palsy patients

This paper from Australia gives an insightful perspective on the impact of facial paralysis on patients, and may explain the well-documented poor quality of life scores in this patient group, particularly those ‘successfully reconstructed’ with surgery. It explores how the...

Facial Plastic and Reconstructive Surgery – Clinical Reference Guide

This book is an excellent pocket guide encompassing a wide range of facial plastic and reconstructive surgery. It is formatted in a very similar way to the well-known Otolaryngology and Head and Neck Surgery by Pasha. The book is organised...

Delayed facial palsy post vestibular schwannoma resection

This article presents findings of a retrospective evaluation of 489 patients who underwent vestibular schwannoma surgery and developed delayed facial palsy. The authors define delayed facial palsy as deterioration of at least two HB grades between postoperative days five and...

Facial paralysis risk factors in benign parotid surgery

The literature shows that the risk of facial paralysis following benign parotid surgery can be as high as 57% for temporary weakness and 7% for permanent facial nerve damage. It is generally thought that the factors involved may be related...

Does Koos classification predict facial nerve dysfunction?

The Koos classification is a grading system used often for preoperative evaluation of acoustic tumours on imaging studies. It indirectly correlates to the size of the tumour. Size of the vestibular schwannoma is often considered the main determinant for hearing...

Facial Landmark localisation by curvature maps and profile analysis

The detection of three dimensional (3D) landmarks by scanning surfaces is a well established method in medical science. Anatomical landmarks are visually or palpably detectable and act as reference points for clinical measurements. When measuring these landmarks with a sliding...

Indication and timing of electrodiagnostic tests in facial palsy

This excellent review describes the benefits and limitations of electrodiagnostic testing for patients with facial paralysis. Tests such as Schirmer, stapedial reflex and electrogustometry have been largely replaced by neurophysiologic tests like nerve excitability test (NET), electroneuronography (ENoG), surface electromyography...

Is there a role for facial nerve decompression in Ramsay Hunt syndrome?

This is an interesting paper. The authors recommend a transmastoid facial decompression for patients with complete facial nerve paralysis with House Brackman HB 5/6 who do not show any sign of recovery after two weeks of treatment following a diagnosis...