Oral and maxillofacial surgery allows you to recover most of the palsy facial.
section of the facial nerve by toro asta does not prevent its recovery.
-new monitoring techniques, the use of grafting and new materials of intubation improve the result
-Trauma is pervasive, as with stab wounds, gunshot or Spear of toro, in half the cases produces paralysis of the facial nerve
Madrid, December of 2011- speeches on the facial nerve allows to recover nearly 80% of the facial paralysis after trauma, such as the Bullfighter Juan Jose Padilla, according to Dr. Alberto GarcÃa-Perla, Member of the Board of Directors of the Spanish society of surgery Oral and maxillofacial (SECOM), who led the operation in the Hospital Virgen del RocÃo, in Seville. Among the most common causes of facial nerve section are, says, road accidents, sexist violence, fight with navajazos and in a growing number, precipitated high ”, mountaineers or hiking fans.
The recovery of paralysis is achieved in an average of 4 to 6 months period. Nerve reconstruction rates have increased due to the use of monitoring techniques, of new techniques of graft and even new materials intubation ”, explains Dr. GarcÃa-Perla. Thus, a study of Hospital Saint John in Scotland, published last August in the journal Laryngoscope showed that the use of a biodegradable material for piping the facial nerve allowed to repair it without sutures and with a higher speed of nerve impulse conduction.
After severe trauma the location of the facial nerve is not always possible with the simple vision of the oral and maxillofacial surgeon, although it increased ”, says doctor GarcÃa-Perla. Techniques such as the electroneurografÃa, high-resolution tomography, magnetic resonance imaging and, above all, the electromyography can detect nerve and, in the case of the latter, monitor the differences in the electrical potential of the nerve. The use of the electromyogram, as it has been observed in different studies, has allowed to alert the surgeon of the location of the nerve by 93 per cent of the cases, according to a review of studies of the Department of Otolaryngology, University of Texas. Its error rate is 4% while that of the traditional tension or pressure sensor is 21%.
Stab, shooting and bull Horn cause more paralysis
5% Of all injuries cause fractures of the temporal bone, which are the main cause of paralysis of the facial nerve, according to this review of studies. If the fracture is longitudinal, what happens between 70 and 80% of cases, a fourth part of the patients suffer from paralysis of the facial nerve. If it is transverse, what usually happens in a frontal or occipital, coup half of the injured suffers facial paralysis. When trauma is pervasive, as it is the case with injured by stab, shot or Spear of toro, in the middle of the accident there is a paralysis of the facial nerve.
The degree of conservation of the nerve determines the outcome of the reconstruction. Grafting of nerves from other parts of the body such as the surae (used in the case of the Bullfighter Juan Jose Padilla) is the technique that has become standard, according to Dr. GarcÃa-Perla. When the distal and proximal portions of the nerve are available about 95% of patients who undergo graft recover some kind of functionality in the face, with three-quarters of the cases the outcome is good.
Collaboration between different experts, coordinated by the surgeon oral and maxillofacial, improves the chances of recovery, not only with regard to the functionality of the facial nerves, but also of the tissues and bone structures damaged in a trauma ”, points out Dr. Arturo Bilbao, President of the SECOM.
The SECOM is a scientific society dedicated to the defense of the specialty and the promotion of science and outreach initiatives related to oral and maxillofacial interventions linked to deformities dentofacial, dentoalveolar, orthopedic surgery, pathology of head and neck Oncology, temporomandibular joint surgeryinfections and salivary gland pathology.
