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The Facial Nerve

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The Facial Nerve – PowerPoint PPT presentation

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Title: The Facial Nerve


1
The Facial Nerve
  • Ali Sepehr

2
50 y/o male with 2 month h/o unintentional right
eye closure after a 1 yr h/o hemifacial paralysis.
3
Differential Diagnosis
4
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5
History
  • Approximately 1 yr prior he fell from a ladder on
    his head at work and had a 2-3 day delayed
    hemifacial paralysis and R SNHL
  • Denies any h/o infections, otalgia, vertigo,
    changes in vision or taste

6
Physical Exam
  • TMs C,D,I,M
  • Positive hemotympanum and Battles sign
  • No parotid masses
  • No aphasia or paralysis or paresis of trunk or
    extremities

7
House-Brackmann System
8
  • PMHx HTN, hypercholestrolemia
  • PSHx R canthoplasty
  • Meds Atacand and Atenolol
  • All NKDA
  • SHx social ETOh and 1 pipe/day for 10 yrs, quit
    15 yrs ago.

9
CT
10
Anatomy
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12
Segments
13
Extratemporal segments
14
Tympanomastoid suture
15
Nerve Fiber Components
16
EMG and ENoG
17
Schirmer test
18
Trigeminofacial (Blink) Reflex
19
Bells Palsy, trauma
20
Congenital facial palsy
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Neoplasms
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Hyperthyroidism
34
Stroke
35
Myasthenia Gravis
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Neurorrhaphy
38
Hypoglossal-Facial Crossover
39
Cross face nerve graft
40
Static Procedures
41
Temporalis Transposition
42
Masseter Transposition
43
Gold Weight
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