Treatment Of Facial Nerve Injury Research Articles

Delivery of neurotrophin-3 by RVG-Lamp2b-modified mesenchymal stem cell-derived exosomes alleviates facial nerve injury.

We aim to investigate the effect of RVG-Lamp2b-modified exosomes (exos) loaded with neurotrophin-3 (NT-3) on facial nerve injury. Exos were collected from control cells (Ctrl Exo) or bone marrow mesenchymal stem cells co-transfected with RVG-Lamp2b and NT-3 plasmids (RVG-NT-3 Exo) by gradient centrifugation and identified by western blotting, transmission electron microscopy, and nanoparticle tracking analysis. Effect of RVG-NT-3 Exo on oxidative stress damage was determined by analysis of the morphology, viability, and ROS production of neurons. Effect of RVG-NT-3 Exo on facial nerve axotomy (FNA) was determined by detecting ROS production, neuroinflammatory reaction, microglia activation, facial motor neuron (FMN) death, and myelin sheath repair. Loading NT-3 and modifying with RVG-Lamp2b did not alter the properties of the exos. Moreover, RVG-NT-3 Exo could effectively target neurons to deliver NT-3. Treatment with RVG-NT-3 Exo lowered H2O2-induced oxidative stress damage in primary neurons and Nsc-34 cells. RVG-NT-3 Exo treatment significantly decreased ROS production, neuroinflammatory response, FMN death, and elevated microglia activation and myelin sheath repair in FNA rat models. Our findings suggested that RVG-NT-3 Exo-mediated delivery of NT-3 is effective for the treatment of facial nerve injury.

Clinical analysis of transcranial facial nerve bridging with interpositional graft for the treatment of facial nerve injury

Objective:To retrospectively analyze the effectiveness of transcranial facial nerve bridging in the treatment of facial nerve dysfunction. Methods:A retrospective analysis was conducted on 27 patients with facial nerve dysfunction who underwent transcranial facial nerve bridging at the Eye, Ear, Nose, and Throat Hospital affiliated with Fudan University from 2017 to 2022. The main collected data includes the patient's age, gender, primary lesion, damaged location, interval from facial paralysis to surgery, and preoperative and postoperative House-Brackmann（HB） scale for facial nerve function. Statistical comparisons were made between the average HB level of patients before and after surgery. Results:A total of 27 patients included 17 males and 10 females. The average age of patients during surgery is（42.50±3.38） years old. Primary lateral skull base diseases include trauma（n=3）, tumors（n=22）, and infections（n=2）. The duration of facial paralysis varies from 6 months to 5 years. Statistics analysis has found that the average postoperative HB score of patients who underwent transcranial facial nerve bridging was significantly lower at（3.750 ± 0.183） compared to preoperative（4.875±0.168）. The proportion of patients with good facial nerve function increased significantly from 7.4% before surgery to 42.9% after surgery. Conclusion:Transcranial facial nerve bridging surgery with interpositional graft has a significant effect on improving facial nerve function in patients with facial nerve injury. Further research is still needed to evaluate the long-term effectiveness of this surgery, to determine the optimal patient selection criteria and postoperative rehabilitation strategies.

Facial palsy reconstruction.

The facial nerve stimulates the muscles of facial expression and the parasympathetic nerves of the face. Consequently, facial nerve paralysis can lead to facial asymmetry, deformation, and functional impairment. Facial nerve palsy is most commonly idiopathic, as with Bell palsy, but it can also result from a tumor or trauma. In this article, we discuss traumatic facial nerve injury. To identify the cause of the injury, it is important to first determine its location. The location and extent of the damage inform the treatment method, with options including primary repair, nerve graft, cross-face nerve graft, nerve crossover, and muscle transfer. Intracranial proximal facial nerve injuries present a challenge to surgical approaches due to the complexity of the temporal bone. Surgical intervention in these cases requires a collaborative approach between neurosurgery and otolaryngology, and nerve repair or grafting is difficult. This article describes the treatment of peripheral facial nerve injury. Primary repair generally offers the best prognosis. If primary repair is not feasible within 6 months of injury, nerve grafting should be attempted, and if more than 12 months have elapsed, functional muscle transfer should be performed. If the affected nerve cannot be utilized at that time, the contralateral facial nerve, ipsilateral masseter nerve, or hypoglossal nerve can serve as the donor nerve. Other accompanying symptoms, such as lagophthalmos or midface ptosis, must also be considered for the successful treatment of facial nerve injury.

Professor LI De-hua's experience in treating facial nerve injury after total parotidectomy with blade needle based on jingjin theory

The paper summarizes the academic thought and clinical experience of professor LI De-hua in treatment of facial nerve injury after total parotidectomy with blade needle based on jingjin (muscle region of meridian, sinew/fascia) theory. This disease is located at muscle regions of hand-/foot-three yang meridians; and the sinew/fascia adhesion is its basic pathogenesis, manifested by "transversely-distributed collaterals" and "knotted tendons". In treatment, the knotted tendons are taken as the points. Using the relaxation technique of blade needle, the lesions of sinews/fascia are dissected and removed to release the stimulation or compression to the nerves and vessels so that the normal function of sinews/fascia can be restored.

LncRNA RMRP knockdown promotes proliferation and migration of Schwann cells by mediating the miR-766-5p/CAND1 axis

The proliferation and migration of Schwann cells (SCs) promote nerve regeneration after facial nerve injury. In recent years, the role of long noncoding RNAs (lncRNAs) in regulating SC proliferation and migration has been gradually uncovered. However, there is little evidence on the function of lncRNA RMRP (lnc-RMRP) in SC growth. In the present study, we performed loss-of-function and overexpression assays to explore the function of lnc-RMRP in SCs. The relationships between lnc-RMRP, miR-766-5p and CAND1 (cullin-associated and neddylation-dissociated 1) were analyzed using bioinformatics analysis, luciferase detection, RNA binding protein immunoprecipitation and RNA pulldown methods. CCK-8, EdU, Transwell and wound healing assays were utilized for the detections of cell proliferation and migration. We found that lnc-RMRP silencing enhanced cell proliferation and migration of SCs, while lnc-RMRP overexpression showed the opposite effect. Mechanistically, lnc-RMRP directly bound to and negatively modulated the expression of miR-766-5p. MiR-766-5p knockdown decreased cell viability, proliferation and migration of SCs, and also reversed the effects of lnc-RMRP silencing. In addition, lnc-RMRP positively regulated CAND1 expression by sponging miR-766-5p. Upregulation of CAND1 rescued the function of lnc-RMRP knockdown in regulating SC proliferation and migration. These data suggested that lnc-RMRP played a significant role in SC proliferation and migration, indicating that lnc-RMRP might be a potential therapeutic target for the treatment of facial nerve injury.

Neuroprotective Effect of Brimonidine against Facial Nerve Crush Injury in Rats via Suppressing GFAP/PAF Activation and Neuroinflammation

Objective: This study aimed to investigate the potential neuroprotective action of brimonidine against facial nerve crush injury in rats and the possible underlying mechanisms. Methods: Sixty Wistar adult rats were randomly and equally divided into 3 groups: 40 rats underwent unilateral facial nerve crush injury and were administered with either saline (intraperitoneal, n = 20) or brimonidine 1 mg/kg/day (intraperitoneal, n = 20) for 5 consecutive days. Functional and electromyographic recovery was recorded postoperatively. The facial nucleus of 5 mice in each group was analyzed for mRNA expression levels of GFAP, PAF, NT-4, P75^NTR, NF-κB, TNF-α, IL-6, and α₂-ARs by qRT-PCR. Results: Brimonidine promoted the recovery of vibrissae movement, eyelid closure, and electrophysiological function in a rat model of nerve crush injury. Hematoxylin and eosin staining and electron microscopy showed significant recovery of Schwann cells and axons in the brimonidine group. Brimonidine attenuated the crush-induced upregulation in GFAP and PAF mRNA (p < 0.05), as well as enhanced the mRNA levels of NT-4 and P75^NTR (p < 0.05), while decreased the expression of NF-κB, TNF-α and IL-6 (p < 0.05). Conclusions: Brimonidine could promote the recovery of facial nerve crush injury in rats via suppressing of GFAP/PAF activation and neuroinflammation and increasing neurotrophic factors. Brimonidine may be apromising candidate agent for the treatment of facial nerve injury.

The efficiency of ozone therapy and low-level laser therapy in rat facial nerve injury

PurposeComparison of low-level laser therapy (LLLT) and ozone therapy (OT) methods for the treatment of facial nerve injury (FNI) in rats, evaluated by histomorphometric measurement analysis. Materials and methodsThirty rats were randomly divided into control (C), LLLT, and OT groups. The left facial nerves (FNs) of all rats (n = 30) were used in this study. These were held in a surgical clamp for 30 s to create neuropathic damage. The non-injured right FNs of the rats in the control group formed the fourth, sham (S) group in this study (n = 10). Therefore the total number of evaluated samples was 40. The injured FNs of rats in the control group were left to heal spontaneously, whereas LLLT was applied for 21 consecutive days (output 100 mW/cm2 and wavelength 850 nm) and OT (2 ml; 80 μm/ml) once every 2 days for 21 days. ResultsAfter histomorphological evaluation, the OT group revealed statistically significant outcomes following FNI compared with the OT and control groups in terms of branching of nerve fibers (p = 0.003), nerve fiber diameters (p = 0.0398), nerve fiber areas (p = 0.042), and axon numbers (p = 0.0327). Although the LLLT group revealed a better healing process than the control group, the outcome was not statistically significant in terms of branching of nerve fibers (p = 0.6804), nerve fiber diameters (p = 0.7424), nerve fiber areas (p = 0.7048), and axon numbers (p = 0.7588). ConclusionsOT resulted in statistically significant differences in outcome when compared with the LLLT and control groups, and provided a safe and effective treatment for FNI in rats. OT could therefore be considered as an alternative treatment of FNI. Clinical studies should now be performed to establish whether comparable results can be achieved in humans.

Benefits of Combinatorial Therapies for Improving Functional Recovery in a Rat Model of Facial Nerve Injury

Injury to the facial nerve due to trauma or surgical intervention for head and neck pathologies is common; however, few effective treatments eliciting full functional recovery following facial nerve injuries exist. Previous studies in our laboratory have found that single‐agent therapies, while effective in improving functional recovery, are insufficient in promoting complete functional recovery after nerve injury. Consequently, our objective is to determine the efficacy of combination therapies for treatment of facial nerve injury. We have found that treating the repaired injured nerve with polyethylene glycol (PEG), a sealant that acts to fuse damaged cell membranes, and methylene blue (MB), an antioxidant, improves functional recovery in a rat model of facial nerve transection and suture. Given the ease in application of these therapies, either singularly or in combination, we anticipate that these and future studies will aid translation of such methods for application in human facial nerve injury patients.Support or Funding InformationSupported by a Roudebush VA IIMR Young Investigator Award (CLW) and IUCRG grant fromm IUSM (KJJ).

Practical Otologic Considerations in Head Injury

Program Description: After our nation’s longest period of conflict, it is important to look for experience and medical advances that might improve our care of the injured patient. Targeting general otolaryngologists, we will present an overview for otologic care of the trauma patient presenting to your office. Emphasis will include an update on surgical management of facial nerve injury, manifestations and treatment of balance disorders after concussion and head trauma, repair of traumatic tympanic membrane perforations, and hearing loss. Educational Objectives: 1) Articulate timing and indications for surgical treatment of facial nerve injury. 2) Describe treatment principles and best practice for post–head trauma balance disorders. 3) Recognize treatment of traumatic perforations and hearing injury.

Highlights of Archives of Facial Plastic Surgery

Archives of Facial Plastic SurgeryVol. 12, No. 5 Free AccessHighlights of Archives of Facial Plastic SurgeryPublished Online:1 Sep 2010AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail Functional and Aesthetic Concerns of Patients Seeking Revision RhinoplastyThe disparity between an individual's self-perception and how he or she is observed by others can be significant and very illuminating. In rhinoplasty, the extent of this difference is often the primary determinant in patient satisfaction and commonly the motivational force behind patients seeking surgical revision. Kathy Yu, MD, andcolleagues prospectively studied 104 consecutive patients seeking revision rhinoplasty. Systematic analysis of functional and aesthetic concerns, from both patient and physician perspectives, are presented as well as the most frequent reasons cited by patients for not returning to their primary surgeon.See page 291Functional Outcomes of Structured Nasal Tip RefinementFor many facial plastic surgeons, reduction rhinoplasty exemplifies the balance of aesthetic form and desired function while employing a complex understanding of nasal anatomy and airway dynamics. Daniel Timperley, MBChB,and colleagues discuss their approach in the refinement of the bulbous or boxy nasal tip in their prospective, 100-patient study. Multiple subjective and objective outcome measures are used, including nasal peak inspiratory flow; Sino-Nasal Outcome Test; nasal obstruction score; 36-Item Short Form (SF-36), version 2; and anchor scores. The authors further detail their surgical perspectives with clear illustrations, operative photographs, and case examples.See page 298Bone and Cartilage Wedge Technique in Posttraumatic Enophthalmos TreatmentTraumatic increases of orbital volume are often associated with bony disruption of the orbital floor as well as varying degrees of diplopia, enophthalmos, and soft-tissue entrapment. The surgical challenge in orbital trauma is to not only address the anterior facial skeleton but also restore the posterior bony orbit. Olivier Lieger, MD, DMD, and colleagues review a series of 8 cases in which autologous calvarial bone and irradiated rib cartilage grafts were used in the restoration of orbital volume. The authors review their operative technique and surgical outcomes while candidly presenting the challenges of persistent diplopia after orbital volume correction.See page 305A New Model for Facial Nerve Research: The Novel Transgenic Thy1-GFP RatFacial nerve injury is often associated with significant functional and emotional loss because complete physical recovery is rarely achieved. Considerable advances have been made in the understanding and treatment of facial nerve injury, but clinical outcomes are complicated by aberrant regeneration and synkinesis. Christina K. Magill, MD,and colleagues present a novel transgenic rat model (Thy1-GFP) that constitutively expresses a heritable green fluorescent protein within its axons and Schwann cells. The results of this pilot study highlight the considerable potential of a transgenic animal model that affords direct visualization of neural anatomy, injury, and recovery with confocal microscopy.See page 315Portrait of General Giles by Joseph Wright.See page 364This issue's Highlights were written by James Ridgway, MD.FiguresReferencesRelatedDetails Volume 12Issue 5Sep 2010 InformationCopyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.To cite this article:Highlights of Archives of Facial Plastic Surgery.Archives of Facial Plastic Surgery.Sep 2010.287-287.http://doi.org/10.1001/archfaci.2010.64Published in Volume: 12 Issue 5: September 1, 2010PDF download

Anatomy and Rationale for Trigeminal-Facial Nerve Anastomosis in the Treatment of Facial Nerve Injury

Anatomy and Rationale for Trigeminal-Facial Nerve Anastomosis in the Treatment of Facial Nerve Injury

Facial nerve injury. A short review

Despite considerable advances in technique, experience and skill, the precise place of surgery in the treatment of facial nerve injury remains uncertain. The mechanism of delayed facial palsy is not yet clear, and there is still debate about the value of tests for early evidence of denervation. Recent literature has been reviewed.

Die Chirurgie des Nervus Facialis

This scholarly and beautifully illustrated work on the facial nerve and the treatment of its diseases should be in the library of all head and neck surgeons, whether they are specialists in otolaryngology, plastic surgery, or general surgery. It contains detailed discussion of the cause and treatment of the diseases and injuries of the facial nerve in the cranial cavity and temporal bone. In particular, the illustrations and descriptions of multiple graft surgery by the method of John Conley will be useful to those who do parotid surgery. The proposition that following cancer surgery of this region the nerve should be immediately repaired by a second team, if necessary, always seemed to me the only sensible way to do this kind of surgery. Important to the general practitioner, otologist, and neurologist is the discussion of facial nerve decompression in Bell's palsy and treatment of facial nerve injuries following fractures of