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Surgical Repair Versus Expectant Treatment in Traumatic Facial Palsy

Surgical Repair Versus Expectant Treatment in Traumatic Facial Palsy Abstract When the facial nerve is paralyzed, the patient loses what Ballance and Duel have so aptly named "the language of facial expression." Emotional movements and the power of voluntary movement are both destroyed. Only when absolutely symmetrical impulses reach the facial muscles on both sides at exactly the same moment will a patient exposed to emotional stimulation be able to react normally. Such impulses can only originate in the facial nuclei, because the symmetry and synchronism of the emotional movements of the face are dependent on the close cooperation of the cortical facial centers of both hemispheres. Voluntary movements on the other hand can be performed if only nervous impulses from any suitable center in the brain reach the muscles concerned. This is illustrated in Figure 1. During a mastoidectomy performed elsewhere, the facial nerve had been cut and the distal end of the facial nerve had been anastomosed to References 1. Ballance, C., and Duel, A. B.: The Operative Treatment of Facial Palsy , Arch. Otolaryng. 15:1, 1932.Crossref 2. Bunnell, S.: Suture of the Facial Nerve Within the Temporal Bone , Surg., Gynec. & Obst. 45:7, 1927. 3. Surgical Repair of the Facial Nerve , Arch. Otolaryng. 25:235, 1937. 4. Jongkees, L. B. W.: Les Operations plastiques de nerf facial dans le cas de traumatisme endotemporal , Acta oto-rhino-laryng. belg. 10:36, 1956. 5. Kettel, K.: 35 Tilfælde af otogen Facialisparese opereret a.m. Ballance & Duel og Bunnell , Nord. med. 24:1783, 1944. 6. The Prognosis of Nerve Grafting and Nerve Suture in Peripheral Facial Palsies , Acta otolaryng. (Supp.) 74:180, 1948. 7. Nerve Grafting and Nerve Suture in Postoperative Facial Palsies, in Proceedings of the Fourth International Congress of Otolaryngology, 1949, p. 355. 8. Nerve Grafting and Nerve Suture in Postoperative Facial Palsies: A Report of 69 Cases , Arq. neuro-psiquiat. 12:415, 1954. 9. Repair of the Facial Nerve in Traumatic Facial Palsies , A.M.A. Arch. Otolaryng. 66:634, 1957. 10. Peripheral Facial Palsy, Pathology and Surgery , Copenhagen; Munksgaard, Charles C Thomas, Springfield, Ill. 1959. 11. Martin, H., and Helsper, J. T.: Spontaneous Return of Function Following Surgical Section or Excision of the Seventh Cranial Nerve in the Surgery of Parotid Tumors , Ann. Surg. 146:715, 1957. 12. Martin, R. C.: Intratemporal Suture of the Facial Nerve , Tr. Pacific Coast Oto-Opht. Soc. Sept. , 1930, p. 119. 13. Intratemporal Suture of the Facial Nerve , Arch. Otolaryng. 13:259, 1931. 14. Surgical Repair of the Facial Nerve , Arch. Otolaryng. 23:458, 1936. 15. Repair of Peripheral Injuries of the Facial Nerve , J. Nerv. & Ment. Dis. 99:755, 1944. 16. Maxwell, J. H.: Extra-Temporal Repair of the Facial Nerve: Case Reports , Ann. Otol. Rhin. & Laryng. 60:1114, 1951. 17. Repair of the Facial Nerve After Facial Lacerations , Tr. Am. Acad. Ophth. ( (Sept.) -Oct.) 1954, p. 733. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Otolaryngology American Medical Association

Surgical Repair Versus Expectant Treatment in Traumatic Facial Palsy

KETTEL, KARSTEN
A.M.A. Archives of Otolaryngology , Volume 71 (4) – Apr 1, 1960
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References (17)

Publisher
American Medical Association
Copyright
Copyright © 1960 American Medical Association. All Rights Reserved.
ISSN
0096-6894
DOI
10.1001/archotol.1960.03770040023004
Publisher site
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Abstract

Abstract When the facial nerve is paralyzed, the patient loses what Ballance and Duel have so aptly named "the language of facial expression." Emotional movements and the power of voluntary movement are both destroyed. Only when absolutely symmetrical impulses reach the facial muscles on both sides at exactly the same moment will a patient exposed to emotional stimulation be able to react normally. Such impulses can only originate in the facial nuclei, because the symmetry and synchronism of the emotional movements of the face are dependent on the close cooperation of the cortical facial centers of both hemispheres. Voluntary movements on the other hand can be performed if only nervous impulses from any suitable center in the brain reach the muscles concerned. This is illustrated in Figure 1. During a mastoidectomy performed elsewhere, the facial nerve had been cut and the distal end of the facial nerve had been anastomosed to References 1. Ballance, C., and Duel, A. B.: The Operative Treatment of Facial Palsy , Arch. Otolaryng. 15:1, 1932.Crossref 2. Bunnell, S.: Suture of the Facial Nerve Within the Temporal Bone , Surg., Gynec. & Obst. 45:7, 1927. 3. Surgical Repair of the Facial Nerve , Arch. Otolaryng. 25:235, 1937. 4. Jongkees, L. B. W.: Les Operations plastiques de nerf facial dans le cas de traumatisme endotemporal , Acta oto-rhino-laryng. belg. 10:36, 1956. 5. Kettel, K.: 35 Tilfælde af otogen Facialisparese opereret a.m. Ballance & Duel og Bunnell , Nord. med. 24:1783, 1944. 6. The Prognosis of Nerve Grafting and Nerve Suture in Peripheral Facial Palsies , Acta otolaryng. (Supp.) 74:180, 1948. 7. Nerve Grafting and Nerve Suture in Postoperative Facial Palsies, in Proceedings of the Fourth International Congress of Otolaryngology, 1949, p. 355. 8. Nerve Grafting and Nerve Suture in Postoperative Facial Palsies: A Report of 69 Cases , Arq. neuro-psiquiat. 12:415, 1954. 9. Repair of the Facial Nerve in Traumatic Facial Palsies , A.M.A. Arch. Otolaryng. 66:634, 1957. 10. Peripheral Facial Palsy, Pathology and Surgery , Copenhagen; Munksgaard, Charles C Thomas, Springfield, Ill. 1959. 11. Martin, H., and Helsper, J. T.: Spontaneous Return of Function Following Surgical Section or Excision of the Seventh Cranial Nerve in the Surgery of Parotid Tumors , Ann. Surg. 146:715, 1957. 12. Martin, R. C.: Intratemporal Suture of the Facial Nerve , Tr. Pacific Coast Oto-Opht. Soc. Sept. , 1930, p. 119. 13. Intratemporal Suture of the Facial Nerve , Arch. Otolaryng. 13:259, 1931. 14. Surgical Repair of the Facial Nerve , Arch. Otolaryng. 23:458, 1936. 15. Repair of Peripheral Injuries of the Facial Nerve , J. Nerv. & Ment. Dis. 99:755, 1944. 16. Maxwell, J. H.: Extra-Temporal Repair of the Facial Nerve: Case Reports , Ann. Otol. Rhin. & Laryng. 60:1114, 1951. 17. Repair of the Facial Nerve After Facial Lacerations , Tr. Am. Acad. Ophth. ( (Sept.) -Oct.) 1954, p. 733.

Journal

A.M.A. Archives of Otolaryngology – American Medical Association

Published: Apr 1, 1960

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