 |
 |
There are many causes for disorders of the facial nerve, and these often result in significant disfigurement and impaired function. Patients coming to the Center present with a variety of concerns regarding their facial paralysis, in addition to wanting to be sure about a proper diagnosis. Patients may experience difficulties with speech and eating, facial asymmetry, drooling, and an inability to close the eye on the paralyzed side. A less obvious but often grave concern is the inability to express emotion on the affected side. This loss of ability to communicate non-verbally can be extremely bothersome. Many patients also experience a reluctance to appear in public, and refrain from simple pleasures such as dining out.
To address the need for services for this problem, the Massachusetts Eye and Ear Infirmary's Facial Nerve Center was established in 1989. The center provides the experience and expertise of a team of medical specialists skilled in the evaluation and treatment of facial nerve disorders.
The Facial Nerve Center is a fully equipped otolaryngology office at Massachusetts Eye and Ear Infirmary. There is a facility for testing facial nerve function electrophysiologically. Additionally, muscular function measurements can be performed in conjunction with the neurology department at Massachusetts General Hospital. There is equipment in the center for photo and video documentation of facial movement, and an outcomes research center to track outcomes through the Facial Nerve Center.
The facial nerve carries impulses from the brain to the facial muscles, allowing facial expression and movement. In addition, portions of the facial nerve activate the tear glands, the salivary glands, and tiny ear muscles, as well as carry taste sensations from the tongue back to the brain. When the nerve impulses to the facial nerve are interrupted, any or all of these functions may be affected.
Common causes of facial nerve problems can include:
Bell's palsy is a rapid onset of facial paralysis on one side of the face, without an apparent cause. It ordinarily affects all branches of the nerve, from the forehead to the neck. A viral illness preceding the paralysis, ear pain, changes in taste, facial numbness, and tongue numbness are commonly associated symptoms.
The cause of Bell's palsy is uncertain, as its other name, idiopathic facial paralysis, reflects. There is evidence to suggest a viral cause, with most data pointing to infection with herpes simplex virus (HSV). While it is difficult to prove this cause and effect relationship conclusively, the fact that Bell's palsy appears to respond to antiviral and anti-inflammatory medications further supports the relationship between HSV and Bell's palsy. For additional information
Sometimes removal of an acoustic neuroma, or other skull base tumor in a similar location, results in postoperative facial paralysis. This is related to manipulation of the facial nerve during tumor removal. Nerves are extremely sensitive to any manipulation, and can be either temporarily or permanently altered by any surgical procedure around them.
There are different phases of recovery phases that follow different degrees of neural injury that result in facial paralysis. These can be followed when the status of the nerve is known, though occasionally the status of the nerve is not known at the conclusion of surgery, making management of the resulting facial paralysis difficult. For additional information
When facial nerve function is abnormal following parotid surgery, it is important to distinguish the cause of the weakness. The most common cause is nerve stretching that occurs during tumor removal. In that situation, complete recovery is likely. The degree of nerve weakness appears at the time of recovery. Complete facial paralysis takes longer to recover from than mild facial weakness. For additional information
Melkersson Rosenthal syndrome is characterized by a triad of symptoms, including relapsing facial paralysis, facial edema, and a fissured tongue. It appears to have a familial inheritance pattern, though the specific mode of inheritance has not been established. With repeated episodes of facial paralysis, recovery can diminish. For this reason, some doctors feel that facial nerve decompression is indicated since it appears to decrease the severity of the facial paralysis in subsequent episodes. This approach is generally reserved for severe cases with impending long term facial paralysis. For additional information
Facial paralysis that occurs following head trauma can be due to several different injuries. The most common are fractures of the temporal bone through which the facial nerve travels.These are also called Skull Base Fractures. For additional information
Many infectious and inflammatory processes can result in facial paralysis. This occurs either through direct effects on the nerve, or because generalized inflammation causes swelling in the tight bony canal through which the facial nerve runs. This chokes the nerve of its blood supply, and causes it to malfunction from lack of nutrition. Some diseases and conditions that result in facial paralysis include Lyme disease, Multiple Sclerosis and Diabetes. For additional information
There are several causes of congenital facial paralysis. These include genetic problems, in utero problems that develop during pregnancy, or paralysis resulting from trauma at delivery. For additional information
Facial paralysis can be seen in patients suffering from acute and/or chronic otitis media. There are a number of ways that the nerve can be affected. Usually the state of nerve function and the likelihood of full recovery are dependent on the time of onset of facial nerve symptoms during the course of the ear disease, and the facial nerve paralysis. For additional information
Synkinesis and facial spasms are facial syndromes that involve involuntary muscle contraction. For additional information
There are currently three main treatments for facial nerve disorders:
The Facial Nerve Center at Massachusetts Eye and Ear Infirmary has been in existence since 1989. It is staffed by a group of dedicated health care professionals with a special interest in facial nerve disorders. The group consists of neuro-otologists, facial plastic surgeons, ophthalmologist/oculoplastic surgeons, audiologists, nurses, and physical therapists.
There are a number of active areas of investigation related to facial nerve disorders. Click for a sampling of publications that have emerged from individuals involved with the center over the past decade.
 | We comply with the HONcode standard for
health trustworthy information: Verify here. |
|
|
|