Transient Facial Palsy in Sphenoidal Electrode Placement

Summary: Purpose: Sphenoidal electrode (SE) insertion can cause pain, for which local anesthesia with lidocaine or intravenous administration of fentanyl has been advocated by different epilepsy treatment centers. Transient facial palsies have been observed after SE insertion. Their frequency of occurrence, distribution, and duration have not been well characterized, however. We hypothesized that this complication is due to the effect of local anesthesia on the peripheral branches of the seventh cranial nerve. To test this hypothesis, we compared the incidence and characteristics of facial palsy during SE insertions performed with either local anesthesia or after intravenous fentanyl administration.
Methods: We performed a retrospective study in two patient groups. Group A consisted of 25 patients aged 28 ± 8·2 years who underwent a prolonged video-EEG (VEEG) monitoring study with SE after subcutaneous infusion of 1% lidocaine in the insertion area. Group B included 25 patients aged 30·1 ± 8·9 years whose SE were inserted after intravenous administration of 100-200 μ fentanyl. Blood pressure (BP) was monitored every 3-5 min throughout the procedure.
Results: Five patients (20%) from group A had a transient facial palsy; in 4, it was complete and in 1 it was partial; 1 patient had a bilateral facial palsy. Paresis lasted 1-7 min (mean 3·2 min). In all patients, the recovery was complete. None of the patients in group B had complications (p = 0·025, Fisher's exact test).
Conclusions: Transient facial palsy is a relatively frequent complication of SE insertion when SE are placed under local anesthesia; patients should be forewarned of its possible occurrence.     

Techniques in facial identification: Computer-aided facial reconstruction using a laser scanner and video superimposition

A facial image was reconstructed from the skull, part of a complete skeleton found in woodland, of a male person who had hanged himself from a tree. In addition, video superimposition was carried out with antemortem photographs of a person suspected of being the victim, and a good match was obtained. In a further case, a cheaper video-transparency superimposition was carried out, with identity later being confirmed on the basis of dental records. The techniques and the problems encountered are discussed. According to our experience, 3D computer reconstruction and video superimposition have a useful role in the process of identification, particularly in the early stages of an investigation and when other more definitive methods may not be available.     

Neurodynamic Studies on Emotional and Inverted Faces in an Oddball Paradigm

The detection of a change in a face stimulus was studied in an oddball paradigm. Event-related potentials (ERPs) and MEG responses to face stimuli were recorded in four conditions: 1) happy standard, neutral deviant; 2) neutral standard, neutral deviant; 3) inverted happy standard, inverted neutral deviant; 4) inverted neutral standard, inverted neutral deviant. In all conditions, the target was a face with glasses. Neutral deviants elicited a negative deflection (with a maximum around 280 ms) in ERP and MEG responses, an effect similar to auditory mismatch negativity. Face inversion diminished deviance-related negativity, implying an important role of face recognition in the observed effect. Emotional content and larger physical differences between stimuli in conditions 1 and 3 compared to conditions 2 and 4 did not show statistically significant effect on the neutral-deviant-related negativity.     

网膜囊上隐窝的CT应用解剖

在42套腹部断面标本及50例整尸上观察到:网膜囊上隐窝呈“V”形间隙围绕肝尾状叶,前界为小网膜及肝左叶,后界是膈,顶由肝冠状韧带或膈形成,下抵胰,左邻食管;在正中矢状面上均出现肝尾状叶,且尾状叶套入或游离于网膜囊上隐窝。这些结果对在 CT 图像上鉴别尾状叶周围的积液及肿块具有重要意义。     

Self-Regulated Facial Muscle Tension Effects on Intraocular Pressure

This study was designed to examine the relationship between orbicularis muscle tension around the eyes and fluctuations in intraocular pressure (IOP) in normal subjects. Using a biofeedback paradigm, 20 male and female subjects were asked to increase and decrease their EMG activity from the orbicularis muscle while receiving EMG feedback. Subjects received 3 alternating blocks of trials in which they attempted to increase and decrease muscle tension while maintaining the eyes open. A fourth trial consisted of a forceful closure of the eyes during the increase period. IOP was measured every 60 s throughout the entire sequence, and electrodes placed above and below the eye recorded eyeblinks. Results suggest that IOP increases with increases in facial muscle tension in normal subjects, a finding which cannot be accounted for by changes in eyeblink frequency. These results imply that increases in IOP occur during periods of increased muscle tension around the eye and suggest that muscle tension levels should be examined among individuals who have abnormally high IOP levels.     

Anatomy of the arterial vascularization of the lips

Summary The findings from 12 dissections of previously injected facial masks, 8 dissections of the face following intrarterial injection of a red solution of Latex Neoprene, and a corrosion cast specimen allowed us to study the arterial supply of the lips. The arterial supply of the upper lip arises mainly from the superior labial arteries, but also from the subseptal arteries and from the subalar arteries. There is a figure of 8 shaped anastomotic system between these arteries lying on the upper lip. The arterial supply of the lower lip arises from the inferior labial arteries and from branches of the mental artery. A constant inferior labial arterial network was shown at the level of the lower lip arising in a fifth of cases from a T-shaped inferior labial artery. All these recent anatomic findings help us to improve our understanding of plastic surgery of the lips.

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Vascularisation artérielle des lèvres

Résumé Douze dissections de masques faciaux préalablement injectés à la gélatine minium, huit dissections de face après injection artérielle par une solution de latex néoprène rouge, et une injectioncorrosion a permis l'étude de la vascularisation artérielle labiale. La lèvre supérieure reçoit sa vascularisation artérielle des artères labiales supérieures principalement, mais aussi des artères sous-narinaires branches des artères faciales, et des artères de la sous-cloison. Il existe un système d'anastomose fréquent entre les trois artères décrivant un aspect de 8 de chiffre couché au niveau de la lèvre supérieure. La lèvre inférieure est vascularisée par les artères labiales inférieures et par des branches de l'artère mentonnière ; il existe de manière constante au niveau de la lèvre inférieure une arche artérielle labiale inférieure provenant une fois sur cinq d'une artère labiales inférieure en T unique. Toute ces données anatomiques récentes permettent d'envisager dans de meilleures conditions la chirurgie réparatrice des lèvres.

     

IL-15 and IL-15Rα gene deletion: Effects on T lymphocyte trafficking and the microglial and neuronal responses to facial nerve axotomy

IL-15 is a potent T cell chemoattractant, and this cytokine and its unique α subunits, IL-15Rα, can modify immune cell expression of several T cell chemokines and their receptors. Facial nerve axotomy in mice leads to T cell migration across an intact blood–brain-barrier (BBB), and under certain conditions T cells can provide neuroprotection to injured neurons in the facial motor nucleus (FMN). Although chemokines and chemoattractant cytokines are thought to be responsible for T cell migration to the injured cell bodies, data addressing this question are lacking. This study tested the hypothesis that T cell homing to the axotomized FMN would be impaired in knockout (KO) mice with the IL-15 and IL-15Rα genes deleted, and sought to determine if microglial responsiveness and motoneuron death are affected. Both IL-15KO and IL-15RαKO mice exhibited a marked reduction in CD3⁺ T cells and had fewer MHC2⁺ activated microglia in the injured FMN than their respective WT controls at day 14 post-axotomy. Although there was a relative absence of T cell recruitment into the axotomized FMN in both knockout strains, IL-15RαKO mice had five times more motoneuron death (characterized by perineuronal microglial clusters engulfing dead motoneurons) than their WT controls, whereas dead neurons in IL-15KO did not differ from their WT controls. Further studies are needed to dissect the mechanisms that underlie these observations (e.g., central vs. peripheral immune contributions).     

鼻内镜下额隐窝区域手术的应用解剖

目的:为鼻内镜下额隐窝区域手术提供相应的解剖基础。方法:(1)成人干颅骨5例(10侧),从正中矢状位锯开,观察额窦、额隐窝及毗邻骨性解剖结构;(2)成人湿性尸头5例(10侧),从正中矢状位锯开,观察额窦引流部位,以量角器、直尺等测量工具测量相关解剖数据;(3)另选成人湿性尸头标本5例(10侧),模拟经鼻内镜鼻丘径路额窦开放术,鼻内镜下观察额隐窝及毗邻结构解剖特征。结果:(1)额隐窝作为额窦引流通道,具有复杂的三维空间结构;(2)鼻内镜下经鼻丘径路额窦开放手术可充分暴露额隐窝范围,鼻丘、钩突和毗邻结构的解剖关系决定了具体的手术方式;(3)筛前动脉距鼻小柱与鼻翼交点(58.0±2.9)mm,与鼻底夹角(51.0±3.9)°,是辨认额窦口及前颅底的重要标志。结论:鼻丘、钩突及筛前动脉为鼻内镜下额隐窝区域手术的重要解剖标志,准确辨认额隐窝及毗邻结构的解剖关系,有助于提高手术的彻底性及避免严重的手术并发症。     

面神经锥体段的解剖学及其临床意义

在80侧成人颞骨干标本上,对面神经锥体段的埋藏位置及深度,面神经与面神经隐窝、鼓室窦三者之间的关系及其变异类型进行了应用解剖学研究。提出了耳科后鼓室进手术路中对面神经锥体段的予测方法。经90例手术验证有实用价值。     

体外膈肌起搏器在治疗面神经麻痹中的临床应用

目的 :探讨体外膈肌起搏器配合药物治疗特发性面神经麻痹的疗效。方法 :治疗组在常规使用激素、血管扩张剂和神经营养药等治疗的基础上配合应用体外膈肌起搏器 ,治疗面神经麻痹 ,对照组单纯使用药物治疗 ,对照两组的治愈率、好转率和平均治疗时间和好转时间。结果 :治疗组 73例 ,治愈 6 2例 ,好转 5例 ,总有效率 92 % ;对照组 32例 ,治愈 2 3例 ,好转 5例 ,总有效率 81% ,两组差异有显著性。 (P <0 0 5)。结论 :应用体外膈肌起搏器配合药物治疗面神经麻痹治愈率高 ,疗程缩短