SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
Facial nerve 2
1. SYMPTOMS ACCORDING TO
LEVEL OF INJURY
1.AT INTERNAL ACOUSTIC MEATUS
LOSS OF LACRIMATION
LOSS OF STAPEDIAL REFLEX
LOSS OF TASTE SENSATION FROM ANTERIOR 2/3RD
OF TONGUE
LACK OF SALIVATION
FACIAL MUSCLE PARALYSIS
2. 2.BETWEEN GREATER PETROSAL NERVE & NERVE TO
STAPEDIUS OR BELOW GENICULATE GANGLION
LOSS OF STAPEDIAL REFLEX
LOSS OF TASTE SENSATION FROM ANT2/3RD OF TONGUE
LACK OF SALIVATION
FACIAL MUSCLE PARALYSIS
3.B/W NERVE TO STAPEDIUS & CHORDAE TYMPANI
LOSS OF TASTE FROM ANTERIOR 2/3RD OF TONGUE
• FACIAL MUSCLE PARALYSIS
4. BELOW STYLOMASTOID FORAMEN
PARALYSIS OF MUSCLE OF FACIAL EXPRESSION
3. SURGERY OF FACIAL NERVE
• TO IDENTIFY FACIAL NERVE 3 METHODS ARE USED
1.BLOOD FREE PLANE IMMEDIATE IN FRONT OF
CARTELAGENOUS EXTERNL ACOUSTIC MEATUS
CAN BE OPENED BY BLUNT DISSECTION
LEADS SURGEON TO SKILL BASES JUST BELOW
STYLOID PROCESS & STYLOMASTOID FORAMEN
OPENED UP IN INFERIOR DIRECTIONBY BLUNT
DISSECTION TILLL TRUNK IS ENCOUNTERED
4. 2.EXPOSURE OF ANTERIOR BORDER OF STM
JUST BELOW ITS INSERTION IN MASTOID PROCESS
RETRACT MUSCLE POSTERIOR TO EXPOSE POST
BELLEY OF DIGASTRIC
6. UMN LESION
• LESION IN UPPER MOTOR NEURON
C/F
1. PATIENTS CAN MAKE FURROWS ON LOOKING
UPWARDS
2. LOWER PART OF FACE IS INVOLVED IN SIDE
OPPOSITE TO LESION IS INVOLVED
3. THIS IS LESION ABOVE PONS
7. LMN LESION
• LESION IN LOWER MOYOR NEURON
• LESION IN PONS OR ITS PATHWAY
C/F
1. FURROWS ARE LOST ON LOOKING UPWRDS
2. WHOLE OF FACE & FORE HEAD IS INVOLVED IN
SAME SIDE OF LESION
3. ISOLATED LESION
4. ASSOCIATED WTH HEMIPLAGIA
8. BELL’S PALSY
• DRIBBLING OR DROOPING OF SALIVA FROM ANGLE
OF MOUTH ON AFFECTED SITE
• CREASE ON FACE OR SKIN FOLDS ARE EFFECTED
OR BLUNTED ON AFFECTED AREAS
• FOREHEAD IS UN FURROWED
• DIFFFICULT IN CLOSURE OF EYES
• FOOD COLLECTION B/W TEETH AND CHEEK
• ANGLE OF MOUTH DROOPS ON AFFECTED SITE
• NASOLABIAL FOLD IS EFFACED IN AFFECTED SITE
• UN ABLE TO BLOW CHEEK
• LOSS OF TASTE