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2002, Number 4

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Cir Cir 2002; 70 (4)

Injured anatomic zones of lesion in peripheral facial palsy: A correlation with etiology. An experience of 780 cases

Domínguez-Carrillo LG

Language: Spanish
References: 42
Page: 239-245
PDF size: 52.40 Kb.


ABSTRACT

Objective: To evaluate usefulness of clinical examination to determine injured anatomic zone of patients with facial nerve palsy. Design: A prospective, descriptive, and observational study. Material and methods: Seven hundred eighty patients, all with clinical impairment of facial nerve. To evaluate anatomic zone of facial nerve palsy, we used muscular examination, taste and salivation tests, Schirmer and Rinne tests, and cranial nerve exploration. Results: The sample showed age of 44.5 years as mean and standard deviation (SD) ± 28.5 years with range from 1 to 90 years; female sex was 52%, and male 48%; we observed complete palsy in 292 cases (37.5%), partial in 483 cases (62%), and five cases presented bilateral palsy (0.5%). Distribution by anatomic impairment zone showed Zone I (nuclear) n = 5; II (auditive internal meatus) n = 20; III (geniculated ganglia) n = 36; IV (stapedial nerve) n = 102; V (tympani chord nerve) n = 220; VI (stylomastoid hole) n = 327, and Zone VII (terminal branches) n = 70. Etiology diagnosis was made in 306 cases (39.2%), including aneurysm, bulboprotuberantial bleeding, neurinomas, astrocytoma, glioma, temporal bone fracture, Guillain-Barre syndrome, diabetic neuropathy, otitis, mastoiditis, parotiditis, sclerodermy, multiple sclerosis, Melkersonn-Rosenthal syndrome, Ramsay-Hunt syndrome, auditive and plastic surgery complications, and skull and face contusion; 474 cases (60.8%) were cataloged as idiopathic (Bell’s palsy). Complete facial nerve exploration provides the opportunity to determine injured anatomic zone of the nerve and to propose the etiologic possibilities, because Bell’s palsy must be an exclusion diagnosis.


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