New Treatment of Facial
Paralysis by Microsurgery
with NTL (Technical Viterbo)
Facial paralysis is a
disfiguring disorder with
important implications for
psychological, emotional and
family, leading these
patients to the brink of
suicide, because these
patients are marginalized
within their families, work
and social environment. This
condition is characterized a
complex combination of
axonal degeneration and
muscle.
Today with advances in
technology, the best results
are achieved in combination
with microsurgery by facial
nerve graft (Cross Face
Graft Nerv with NTL)
achieving a harmonious and
symmetrical smile on his
facie. Note that the
microsurgical treatment of
this pathology previously
performed in the United
States, France, Brazil,
Taiwan, Japan and available
today in Ecuador.
History:
This condition was
discovered by Charles Bell
in 1821, being called Bell
syndrome. Currently,
according to studies by
Murakami, Ko JY, Sheen TS,
Hsu MM and other authors, I
conclude that the causal
agent of this pathology is
the herpes simplex virus and
Herpes Zoster in 79% of the
cases studied in 1996 -2000,
other causes are for facial
nerve tumors and / or
parotid gland, trauma,
congenital (moebius
syndrome), infections by
proximity (otitis media with
effusion), fractures of the
skull base and others. It
has an incidence of 20-30
cases per 100 000
inhabitants, is more common
in women aged 10-20 years
and men over 40 years.
The clinical picture has a
sudden onset and progressive
during the first 14 days
with pain pre and / or
post-auricular, hypoesthesia
in the hemi-face involved,
10% of cases are bilateral
in 60-80% of cases has a
full recovery and 7% is
recurrent.
Clinical Treatment:
The use of
corticosteroids to
reduce edema of the facial
nerve.
Retrovirals to reduce
viral loads-zoster herpes
simplex. Eye drops and
eye ointments to keep
the eye lubricated,
preventing the formation of
ulcers in the cornea and the
most severe loss of the eye.
The electro-physiotherapy
to keep the facial muscle
trophism.
Surgical Treatment:
It is addressed to those who
have no improvement or
spontaneous regression of
facial movements during the
first 3 months, and in whom
permanent sequelae of facial
paralysis several years of
evolution. It should be
noted that the technique of
Viterbo, for its efficiency,
is considered among the best
3 results of facial
paralysis in the world.
The aim of
microsurgical treatment
start from 4 months, is for
the purpose of avoiding
facial muscle atrophy.
|
Figure A. Patients with facial paralysis. B. Results obtained after microsurgery. |