Post Temporal Bone Fracture Facial Paralysis: Strategies in Decision Making and Analysis of Efficacy of Surgical Treatment

AbstractManagement of traumatic facial nerve injuries after temporal bone fractures is both challenging and controversial. The dilemma is whether to operate or not and if operating, when to operate and how much of the nerve to decompress. The aim of this study is to review our criteria for decision making in management of patients with temporal bone fracture induced facial nerve palsy, and analyze outcome of patients selected for surgical management. Review of 28 cases of temporal bone fracture between 2012 and 2016 was carried out. Patient assessment included clinical, audiological, computer tomography scans and electromyography (EMG) examinations. All 28 cases were initially started on conservative medical treatment. Based on criteria of complete clinical paralysis at onset, no improvement with conservative treatment and fibrillation potential in EMG, 10 cases underwent surgical decompression through the transmastoid approach. Among the 10 surgically-treated patients, lesions were predominantly found in geniculate ganglion area. Analysis of results after 12  months revealed 70% of cases who underwent surgery had House Brackmann (HB) Grade I–II recovery. Good recovery was achieved in all 18 medically treated patients (HB Grade I–II). Candidate selection based on accurate clinical judgment and judicious use of electrodiagnostic tests plays a vital r ole in outcomes in the treatment of post traumatic facial injury. Early surgical intervention gave better resul...
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research

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Anyone else have experience with these? I've done 3-5 patient for a psychiatrist friend. 2 were clear home runs. The others were lost to follow-up (I just do straight to injection referral). Cash pay. The two who benefited, it was a very rewarding experience. Could a simple shot be a breakthrough treatment for PTSD? Stellate ganglion block therapy has helped a number of soldiers deal with PTSD and now they're calling for it to be used more widely. Bill Whitaker reports, Sunday on 60 Minutes. www.cbsnews.com
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
In this study, we explored the effect of vitamin B12 on nerve regeneration after TBI both in vivo and in vitro. Meanwhile, we investigated the role of ER stress during the vitamin B12 treatment for TBI by inspecting changes in neuronal apoptosis, microtubule, myelin regeneration, and axonal growth. Materials and Methods Animals Adult C57BL/6 male mice aged 6–8 weeks and weighing 20–26 g were purchased from the Animal Center of the Chinese Academy of Sciences (Shanghai, China). Animals were housed under a 12-h light/dark cycle at 21–23°C and provided access to food and water ad libitum. The care and...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Authors: Buisset A, Leruez S Abstract Homonymous lateral hemianopia follows an attack on the contralateral retrochiasmal visual pathways. In three patients with post-traumatic homonymous hemianopia, optical coherence tomographic (OCT) study of the ganglion cell layer thickness showed hemiretinal thinning contralateral to the visual field defect. This involvement could be explained by trans-synaptic degeneration of the pre-geniculate visual pathways, whose cell nuclei correspond to ganglion cells, which synapse with the damaged retrogeniculate visual pathways. PMID: 30449646 [PubMed - as supplied by publisher]
Source: Journal Francais d Ophtalmologie - Category: Opthalmology Tags: J Fr Ophtalmol Source Type: research
Publication date: 1 February 2018 Source:Colloids and Surfaces B: Biointerfaces, Volume 162 Author(s): Yu-Ting Lau, Lam-Fung Kwok, Kin-Wai Tam, Ying-Shing Chan, Daisy Kwok-Yan Shum, Graham Ka-Hon Shea Schwann cell-seeded nerve guidance channels are designed to assist post-traumatic nerve regeneration in the PNS. Chitosan is a natural polymer well suited for tissue engineering as it is biocompatible, non-immunogenic, and biodegradable. Electrospun chitosan nanofibers utilized in nerve guidance channels have the capacity for guiding axonal growth within the channel lumen yet are limited in their capacity to maintain structu...
Source: Colloids and Surfaces B: Biointerfaces - Category: Biochemistry Source Type: research
Abstract Schwann cell-seeded nerve guidance channels are designed to assist post-traumatic nerve regeneration in the PNS. Chitosan is a natural polymer well suited for tissue engineering as it is biocompatible, non-immunogenic, and biodegradable. Electrospun chitosan nanofibers utilized in nerve guidance channels have the capacity for guiding axonal growth within the channel lumen yet are limited in their capacity to maintain structural integrity within physiological environments. To address this, we attempted genipin crosslinking of chitosan nanofibers. Compared to neat chitosan nanofibers, genipin-treated nanofi...
Source: Colloids and Surfaces - Category: Biotechnology Authors: Tags: Colloids Surf B Biointerfaces Source Type: research
The PTSD Psychopharmacology Working Group appreciates the opportunity to respond to the correspondence from Dr. Lipov and his colleagues regarding the potential application of thoracic and cervical ( “stellate”) ganglion blockade to the treatment of PTSD. The Consensus Statement focused on the unmet need for effective pharmacotherapies for the treatment of PTSD (1), but it was not intended to in any way to suggest that advances in other forms of effective treatment for PTSD would not be welc omed.
Source: Biological Psychiatry - Category: Psychiatry Authors: Tags: Correspondence Source Type: research
The Posttraumatic Stress Disorder (PTSD) Psychopharmacology Working Group appreciates the opportunity to respond to the letter to the editor from Lipov et  al. (1) regarding the potential application of thoracic and cervical (“stellate”) ganglion blockade to the treatment of PTSD. The Consensus Statement focused on the unmet need for effective pharmacotherapies for the treatment of PTSD (2), but it was not intended to in any way to suggest that a dvances in other forms of effective treatment for PTSD would not be welcomed.
Source: Biological Psychiatry - Category: Psychiatry Authors: Tags: Correspondence Source Type: research
AbstractPurpose of ReviewExternal nasal neuralgia is a rare syndrome of atypical facial pain for which there is limited reports in the scientific literature. We aim to review diagnosis and provide an update on treatments for this rare condition.Recent FindingsEtiology has been documented as post-traumatic due to direct trauma to the nose area and in few case reports, idiopathic. Sensory innervation of the nose arises from the ophthalmic and maxillary divisions of the trigeminal nerve. Direct injury to the nerve appears to be the etiology of post-traumatic external nasal neuralgia. Pathophysiology for idiopathic nasal neura...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
Publication date: Available online 7 September 2017 Source:Stem Cell Reports Author(s): Sa Cai, Yat-Ping Tsui, Kin-Wai Tam, Graham Ka-Hon Shea, Richard Shek-Kwan Chang, Qiang Ao, Daisy Kwok-Yan Shum, Ying-Shing Chan Our ultimate goal of in vitro derivation of Schwann cells (SCs) from adult bone marrow stromal cells (BMSCs) is such that they may be used autologously to assist post-traumatic nerve regeneration. Existing protocols for derivation of SC-like cells from BMSCs fall short in the stability of the acquired phenotype and the functional capacity to myelinate axons. Our experiments indicated that neuro-ectodermal...
Source: Stem Cell Reports - Category: Stem Cells Source Type: research
Numerous military doctors around the world use stellate ganglion block injections to 'reset' the nervous system in soldiers tormented by past trauma. Now the Pentagon is backing US research on it.
Source: the Mail online | Health - Category: Consumer Health News Source Type: news
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