Dr, Kathirvel Gopalakrishnan
M.D.S (OMFS)
Presentation on Facial nerve which helps for a quick refresh.
Applied aspects described well and slides contains images for easy understanding of the subject.
The facial nerve is the seventh cranial nerve, or simply CN VII. It emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of taste sensations from the anterior two-thirds of the tongue.
The facial nerve is the seventh cranial nerve, or simply CN VII. It emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of taste sensations from the anterior two-thirds of the tongue.
Facial nerve and its extracranial and intracranial rotssonambohra2
facial nerve its origin and insertion and its extracranial and intracranial roots and its branches and clinical significance and its related syndromes explained well along with treatment plan
facial nerve is the seventh cranial nerve supplies the submandibular, sublingual, lacrimal glands, the mucosal glands of the nose, palate, pharynx and taste fibres, and on being injured it leads to loss of lacrimation, loss of salivation, loss of taste sensation and paralysis of the muscles of facial expression.
FACIAL NERVE AND IT'S APPLIED ANATOMY AND IT'S SIGNIFICANCE FOR A DENTIST ALONG WITH THE CAUTIONS TO AVOID AN IATROGENIC INJURY TO FACIAL NERVE AND THE MANAGEMENT OF A PATIENT OF FACIAL NERVE DISORDER DURING ENDODONTIC PROCEDURES
Facial Nerve is one of the major nerves associated with the head and neck region. This presentation explains about its development, anatomy, and introduction on its clinical correlation.
Dr, Kathirvel Gopalakrishnan
M.D.S (OMFS)
Presentation on osteomyelitis of jaw which helps for a quick refresh.
Classification, management described in detail for easy understanding of the subject.
Dr, Kathirvel Gopalakrishnan
M.D.S (OMFS)
Presentation on Maxillary nerve block which helps for a quick refresh.
Applied aspects described well and slides contains images for easy understanding of the subject.
Dr, Kathirvel Gopalakrishnan
M.D.S (OMFS)
Presentation on Anatomy of orbit which helps for a quick refresh.
Applied aspects described well and slides contains images for easy understanding of the subject.
Dr, Kathirvel Gopalakrishnan
M.D.S (OMFS)
Presentation on Anterior triangles of neck which helps for a quick refresh.
Applied aspects described well and all slides will be informative with lot of image based examples
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
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This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. Contents
Nerve - Introduction
Cranial nerve
Facial nerve – Introduction
Embryology
Components and functions
Nuclei
Course
Ganglion
Branches and distribution
Applied aspects
3. INTRODUCTION:
A nervous system - an organized group of cells (neurons), specialized for the
conduction of an impulse to and from different parts of its body
6. FACIAL NERVE
Introduction:
• 7th cranial nerve
• Mixed nerve – Predominantly motor
Facial nerve: embryology and anatomy of its nucleus; MOJ Anat & Physiol. 2018;5(3):164‒166
7. Embryology:
Develops from the second branchial arch
and supply all the elements that derive from it
Facial nerve: embryology and anatomy of its nucleus; MOJ Anat & Physiol. 2018;5(3):164‒166
3rd week
of IUL
Facio-acoustic primordium
appears
4th week
of IUL
1st branch appears in rostral
aspect of embryo
5th week
of IUL
Nervus intermedius becomes
evident
4th week
8. 7th
week
Facial nerve: embryology and anatomy of its nucleus; MOJ Anat & Physiol. 2018;5(3):164‒166
7th week of
IUL
Chorda tympani derived
Joins lingual nerve
Middle of 7th week, trunk
bifurcates into
temporofacial and
cervicofacial branches
End of 7th week, temporal,
zygomatic, buccal, marginal
mandibular and cervical
regions are recognized
clearly
7 ½ week7th week end
9. 8th week
of IUL
The cartilaginous capsule
forms a groove around
• Facial nerve
• Stapedial artery and
• Stapes muscle.
This groove will become the
facial canal
12th week
of IUL
All the muscles of the face
are formed and all are
innervated by one of the
branches of the facial nerve
Facial nerve: embryology and anatomy of its nucleus; MOJ Anat & Physiol. 2018;5(3):164‒166
10. 21st week of IUL The ossification of the facial canal begins,
which will only end when the collateral
branches of the facial nerve are found in their
definitive location
End of pregnancy The tympanic bone and the mastoid process are
not fully developed, so the petrous portion of
the facial nerve does not exist and will not be
formed until 4 years of age
Facial nerve: embryology and anatomy of its nucleus; MOJ Anat & Physiol. 2018;5(3):164‒166
11. Component Function
General visceral efferent Preganglionic parasympathetic innervation of
sublingual/submandibular gland, lacrimal gland,
nasal mucosa/mucous membrane
Special visceral efferent Motor innervation of muscles of facial
expression, stylohyoid, stapedius, posterior belly
of digastric
General somatic afferent Provides sensory input from the auricular concha,
portions of external auditory canal and tympanic
membrane
Special visceral afferent Provides taste from the anterior two-thirds of the
tongue via the chorda tympani nerve
Facial Nerve and Parotid Gland Anatomy Amit Kochhar, MDa , Babak Larian, MDa,b , Babak Azizzadeh, MDa,b, ;
Otolaryngol Clin N Am 49 (2016) 273–284
12. Facial nerve: embryology and anatomy of its nucleus; MOJ Anat & Physiol. 2018;5(3):164‒166
NUCLEI
Facial nerve
Motor
Nervus Intermedius
General sensory
Special sensory
Superior salivatory
Lacrimal
13. Origin
The facial nerve arises from pons and exits the
brain stem from its ventrolateral surface
Consists of two parts:
• Facial nerve
• Nervus Intermedius
The Facial nerve - motor component and very
small general somatic afferent component
The nervus intermedius- sensory and
parasympathetic visceromotor components.
Neuroanatomy, Cranial Nerve 7 (Facial) ; Dominika Dulak; Imama A. Naqvi. ; Stat pearls publishing, 2020 Jan
14. Course
Divided based on its relation to the cranium and the temporal bone into
• Intracranial
• Intratemporal
• Extratemporal
Neuroanatomy, Cranial Nerve 7 (Facial) ; Dominika Dulak; Imama A. Naqvi. ; Stat pearls publishing, 2020 Jan
Intracranial part:
Two roots, Facial nerve motor root
and nervus intermedius arises from the
pons at a lateral aspect
It runs along with the
vestibulocochlear nerve and enters
internal acoustic meatus
15. Intratemporal part:
The Facial nerve and nervus
intermedius travel through the internal
acoustic meatus, a 1cm long opening in
the petrous part of the temporal bone.
Enters into the facial canal, a ‘Z’
shaped structure which consists of
Meatal segment
Labyrinthine segment
Tympanic segment
Mastoid segment
Facial Nerve Anatomy and Clinical Applications; Sinali O. Seneviratne; Bhupendra C. Patel; StatPearls Publishing LLC; 2020
16. Meatal segment:
The superior quadrant of the internal
acoustic meatus.
Labyrinthine segment:
•Facial nerve and nervus intermedius
fuse to form the geniculate ganglion
•Greater petrosal nerve –
parasympathetic fibres to mucous
glands and lacrimal gland.
Facial Nerve Anatomy and Clinical Applications; Sinali O. Seneviratne; Bhupendra C. Patel; StatPearls Publishing LLC; 2020
17. Tympanic segment:
Runs in the medial wall of the
middle ear cavity
Mastoid segment:
•Nerve to stapedius – motor fibres to
stapedius muscle of the middle ear.
•Chorda tympani – special sensory
fibres to the anterior 2/3 tongue and
parasympathetic fibres to the
submandibular and sublingual glands.
Facial Nerve Anatomy and Clinical Applications; Sinali O. Seneviratne; Bhupendra C. Patel; StatPearls Publishing LLC; 2020
18. Extratemporal parts:
Leaves the cranium through the
stylomastoid foramen, located just
posterior to the styloid process of the
temporal bone.
As it exits, it gives the first branch
posterior auricular supplying to the
pinna of the ear and external auditory
meatus
Then it gives branches to the posterior
belly of digastric, stylohyoid
Neuroanatomy, Cranial Nerve 7 (Facial) ; Dominika Dulak; Imama A. Naqvi. ; Stat pearls publishing, 2020 Jan
19. Neuroanatomy, Cranial Nerve 7 (Facial) ; Dominika Dulak; Imama A. Naqvi. ; Stat pearls publishing, 2020 Jan
Divides at the end of the posterior
edge of the parotid gland into the
terminal branches into two trunks:
• Temporofacial trunk
• Cervicofacial trunk
•Temporal branch – innervating the
frontalis and orbicularis oculi muscles
and the muscles in the upper part of
the face
•Zygomatic branch – innervating the
middle part of the face
20. •Buccal branch – innervating the
cheek muscles, including the
buccinator muscle
•Marginal mandibular branch –
innervating muscles of the lower
part of the face
•Cervical branch – innervating the
muscles below the chin and the
platysma muscle
Neuroanatomy, Cranial Nerve 7 (Facial) ; Dominika Dulak; Imama A. Naqvi. ; Stat pearls publishing, 2020 Jan
22. Classification of Terminal branching pattern of facial nerve by Katz et al (1987)
TYPE 1a TYPE 1b TYPE 2 TYPE 3a TYPE 3b
TYPE 3cTYPE 5TYPE 4bTYPE 4a TYPE 4bTYPE 4a
24. Branch of facial nerve Distribution
Within facial canal
Greater Petrosal Nerve Enters foramen lacerum and joins deep
petrosal nerve to form Nerve of Pterygoid
canal.
It then relays with Pterygopalatine ganglion
and supply lacrimal gland and mucosal
gland of nose and palate
Chorda tympani Nerve Passes through Pterygopalatine fissure and
joins with Lingual nerve
Taste sensation from anterior 2/3rd of the
tongue
Nerve to stapedius Stapedius muscle
25. After exiting Stylomastoid foramen
Posterior Auricular nerve Posterior auricular, Superior auricular,
Occipital belly of occipitofrontalis
Nerve to digastric Posterior belly of digastric muscle
Nerve to stylohyoid Stylohyoid
Terminal Branches
Temporal Anterior auricular, Superior auricular, Part of
frontalis, upper part of Orbicularis oculi
Zygomatic Lower part of Orbicularis oculi
Buccal Buccinator, Orbicularis oris, Muscles of upper lip
Marginal mandibular Mentalis, Orbicularis oris, Muscles of lower lip
Cervical Platysma
26. Ganglia:
Geniculate Ganglion:
• Sensory ganglion
• Located on the first bend of
facial nerve in relation to
medial wall of ear in facial
canal
• Taste sensation to anterior
2/3rd of tongue
B.D CHAURASIA’S HUMAN ANATOMY VOLUME 3
27. Submandibular Ganglion:
• Parasympathetic ganglion
• Secretomotor fibres for submandibular and sublingual gland relay with
this ganglion
• Preganglionic fibres from chorda tympani nerve
B.D CHAURASIA’S HUMAN ANATOMY VOLUME 3
28. Pterygopalatine Ganglion
• Largest Parasympathetic ganglion
• Secretomotor fibres for lacrimal gland relay with this ganglion
B.D CHAURASIA’S HUMAN ANATOMY VOLUME 3
29. Neuroanatomy, Cranial Nerve 7 (Facial) ; Dominika Dulak; Imama A. Naqvi. ; Stat pearls publishing, 2020 Jan
BRANCHES AND DISTRIBUTION
30. Neuroanatomy, Cranial Nerve 7 (Facial) ; Dominika Dulak; Imama A. Naqvi. ; Stat pearls publishing, 2020 Jan
BRANCHES AND DISTRIBUTION
32. Lesion:
• Upper motor neuron lesion
• Lower motor neuron lesion
The neurons to the upper face receive
bilateral UMN innervation
The neurons to the lower face receive
UMN from the contralateral motor cortex
Facial Palsy, a Disorder Belonging to Influential Neurological Dynasty: Review of Literature Ujwala R. Newadkar, Lalit
Chaudhari, Yogita K. Khalekar; North American Journal of Medical Sciences; 2016
33. Upper motor lesion:
Causes unilateral facial palsy with some sparing of the frontalis and orbicularis
oculi muscles because of the bilateral cortical representation.
Furthermore, although voluntary facial movements are impaired, the face may still
move with emotional responses, for example on laughing.
Paresis of the ipsilateral arm (monoparesis) or arm and leg (hemiparesis), or
dysphasia may be associated because of more extensive cerebrocortical damage.
Facial Palsy, a Disorder Belonging to Influential Neurological Dynasty: Review of Literature Ujwala R. Newadkar, Lalit
Chaudhari, Yogita K. Khalekar; North American Journal of Medical Sciences; 2016
34. Lower motor neuron
Characterized by unilateral paralysis of all muscles of facial expression for both
voluntary and emotional responses.
The forehead is unfurrowed and the patient is unable to close the eye on that side.
Facial Palsy, a Disorder Belonging to Influential Neurological Dynasty: Review of Literature Ujwala R. Newadkar, Lalit
Chaudhari, Yogita K. Khalekar; North American Journal of Medical Sciences; 2016
35. Bells palsy:
• Bell’s palsy is a common cranial neuropathy causing
acute unilateral lower motor neuron facial paralysis.
• Demonstrated by Sir Charles Bell in 1821
Etiology:
Herpes simplex virus
Trauma
Infection
Nerve compression
Idiopathic
Bell’s palsy: aetiology, clinical features and multidisciplinary care Timothy J Eviston, Glen R Croxson, Peter G E
Kennedy, Tessa Hadlock, Arun V Krishnan; J Neurol Neurosurg Psychiatry; April 2015.
36. Bell’s palsy: aetiology, clinical features and multidisciplinary care Timothy J Eviston, Glen R Croxson, Peter G E
Kennedy, Tessa Hadlock, Arun V Krishnan; J Neurol Neurosurg Psychiatry; April 2015.
Clinical features:
1. Unilateral involvement
2. Absence of wrinkles in forehead
3. Loss of blinking reflex
4. Inability to close the eye, wink or smile
5. Impossible to whistle
6. Obliteration of nasolabial fold
7. Drooping of corner of the mouth
6. Mask like appearance of face
7. Bell’s Sign: In an attempt to close the eyelid, the eyeball turns
upward so that the pupil is covered and only the white sclera is visible.
39. •Blink test (corneal reflex):
When tapping on the patient’s glabella, a
suspension in blinking will occur on the affected side
•Schirmer test (assessing lacrimation of the
lacrimal gland):
Lacrimation will be decreased by 75%
compared to the normal side using a folded strip of
blotting paper in the lower conjunctival fornix.
Facial nerve palsy; Nathan R. Walker; Rakesh K. Mistry; Thomas Mazzoni; StatPearls Publishing; Jan 2020.
40. Facial nerve palsy; Nathan R. Walker; Rakesh K. Mistry; Thomas Mazzoni; StatPearls Publishing; Jan 2020.
•Stapedial test:
This involuntary reaction in response to high-intensity sound stimuli causes
contraction of the stapedius muscle and gets mediated by the facial nerve.
Testing of the stapedius reflex can be performed using tympanometry.
41. •Salivary Test:
Salivation rate is assessed from a submandibular
duct following stimulation with a 6% citric acid
solution.
If positive, there will be a reduction in salivation
by 25% at the affected side and indicate a lesion at the
chorda tympani.
•Taste test:
Salt, sweet, sour and bitter tastes applied along
the lateral aspects of the anterior two-thirds of the
tongue.
A positive result will indicate a lesion at the
chorda tympani.
Facial nerve palsy; Nathan R. Walker; Rakesh K. Mistry; Thomas Mazzoni; StatPearls Publishing; Jan 2020.
42. Approaches to Grading Facial Nerve Function Michael J. Brenner, M.D and J. Gail Neely, M.D., F.A.C.S
43. Management:
Medical management:
Additional measures include eye protection, physiotherapy, acupuncture,
botulinum toxin. An eye patch is of value to protect the cornea.
Facial Palsy, a Disorder Belonging to Influential Neurological Dynasty: Review of Literature Ujwala R. Newadkar, Lalit
Chaudhari, Yogita K. Khalekar; North American Journal of Medical Sciences; 2016
44. Facial Palsy, a Disorder Belonging to Influential Neurological Dynasty: Review of Literature Ujwala R. Newadkar, Lalit
Chaudhari, Yogita K. Khalekar; North American Journal of Medical Sciences; 2016
Surgical management:
45. Facial Palsy, a Disorder Belonging to Influential Neurological Dynasty: Review of Literature Ujwala R. Newadkar, Lalit
Chaudhari, Yogita K. Khalekar; North American Journal of Medical Sciences; 2016
Surgical management:
46. Ramsay hunt syndrome:
Peripheral facial nerve palsy
accompanied by an erythematous vesicular
rash on the ear or in the mouth.
Varicella zoster virus (VZV) causes
Ramsay Hunt syndrome.
Bell’s palsy is significantly associated
with herpes simplex virus (HSV)
Ramsay Hunt syndrome C J Sweeney, D H Gilden; Jounal of Neurology, Neurosurgery and Psychiatry 2001
47. Ramsay Hunt syndrome C J Sweeney, D H Gilden; Jounal of Neurology, Neurosurgery and Psychiatry 2001
Signs and Symptoms:
Facial paralysis
Rash – Ear, Palate and tongue
Tinnitus
Hearing loss
Nausea
Vomiting
Vertigo
Nystagmus.
Due to close proximity of the geniculate
ganglion to the vestibulocochlear nerve
within the bony facial canal.
48. Management:
Ramsay Hunt syndrome C J Sweeney, D H Gilden; Jounal of Neurology, Neurosurgery and Psychiatry 2001
Medication Dose
Famciclovir 500 mg, three times daily for 7–10 days
Acyclovir 800 mg, five times daily for 7-10 days
Oral prednisone 60 mg daily for 3–5 days
49. Melkersson Rosenthal syndrome:
•Also known as Orofacial Granulomatosis
• Triad:
Relapsing facial paralysis
Persistent or recurrent orofacial edema
Fissured tongue
Rare to observe all aspects of the triad at the same time.
Melkersson–Rosenthal syndrome: a case report of a rare disease with overlapping features; Mauro Cancian, Stefano Giovannini, Annalisa
Angelini, Marny Fedrigo, Raffaele Bendo, Riccardo Senter & Stefano Sivolella; Allergy, Asthma and clinical immunology; 2019
50. Anatomical considerations:
Safe dissection:
Frontal Branch:
When using a lateral or superior approach,
staying right on or deep to the superficial leaf of
the deep temporal fascia is a safe plane of
dissection.
Anatomical Considerations to Prevent Facial Nerve Injury; Jason Roostaeian, Rod J. Rohrich, James M. Stuzin; The
American Society of Plastic Surgeons; 2015