This nerve innervates the muscles of facial expression, the tear gland, the front two-thirds of the tongue, the posterior belly of the digastric, the stylohyoid and the stapedius muscles.
We divide the facial nerve paralysis into:
· CENTRAL – is due to damage to the core of the nerve fibrosis in the brain. In that case, the patient can raise his forehead, and the treatment falls within the domain of neurology.
· PERIPHERAL- the damage to the nerve is at the exit of the brain to its end of the face. In this case, the patient cannot raise his forehead, and diagnosis and treatment belong to the domain of otorhinologist. · INCOMPLETE (Paresis n. Facialis)
· COMPLETE (Paralysis n. Facialis)
REASONS FOR PERIPHERAL PARALYSIS:
· VIRUSES – at least 60-70% of paralysis is caused by viral inflammations of which the most common trigger is the Herpes simplex type I virus and Nerpes zooster oticus. Other triggers include Coxackie, Epstein-Barr, Parotitis, Influenza, and so on.
· BACTERIES – during acute or chronic inflammation of the middle ear due to diseases that transmit ticks, tuberculosis, botulism, and so on.
· INJURIES – on the temples, the skull base, face, operation.
· TUMOR – the brain, skull base, ear, facial nerve, dental gland, skin.
· SYSTEMIC – in the composition of diabetes, pregnancy, increased blood pressure.
BELL’s paralysis – peripheral paralysis of the facial nerve with unknown etiology.
FEATURES: one-sided, sudden, peripheral, incomplete or complete. Increased risk in pregnant women, diabetics, age.
CLINICAL IMAGE OF THE PERIPHERAL PARALYZATION OF THE NERVOUS PERSON:
Asymmetry to the entire half of the face (the patient can not raise half of his forehead, cannot completely close his eye, his mouth angle is lowered, the nasolabial fold is not expressed)
· Dryness and burning in the eye, watery eyes,
· Chewing problems, especially when taking a fluid that leaks out of the mouth,
· Disordered sense of taste,
· Dryness of the mouth,
· Sounds in the ear
It is performed on the recommendation of the otorhinolaryngologist. It depends on the factor determined by examination and diagnostic tests. Given that viral inflammation is the most common cause of facial nerve paralysis, corticosteroids and antiviral drugs are commonly used.
Treatment should begin immediately, and in case of a severe clinical image (Herpes zoster), hospital treatment and intravenous therapy are indicated.
Symptom therapy involves eye protection with artificial tears and eye oils, as well as wearing protective goggles, i.e. bandage. Application of acupuncture is possible, while the application of electrostimulation is unnecessary, and more frequently harmful. Exercises should start before the nerve recovery begins.
The majority of patients (around 85%) are recovering for 3 weeks, and most of the remaining for 3-6 months.
In the facial nerve paralysis, which after 3 weeks do not show any signs of recovery or worsening, the Otolaryngologists indicates detailed diagnostic processing involving electromyography, magnetic resonance imaging, blood laboratory tests, etc.