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Transmastoid facial nerve decompression for persistent traumatic facial nerve paralysis

Facial nerve paralysis (FNP) can occur following trauma, with a small number of these patients requiring facial nerve decompression (FND) to aid recovery. The authors shared their experience in decompressing the facial nerve for persistent severe FNP via a transmastoid...

Long-term results of injection laryngoplasty with polydimethylsiloxane (Vox) for unilateral vocal fold paralysis

Polydimethylsiloxane (PDMS) is widely used for vocal cord injections to treat patients with a vocal cord palsy. It is commercially available as the Vox implant system. Alternative compounds that can be employed include hyaluronic acid and calcium hydroxyapatite (Radiesse Voice)....

How rare is vocal fold paralysis after spinal and epidural anaesthesia – should we be more concerned?

The authors present an unusual case of right vocal fold paralysis. Their patient was a 38-year-old woman who experienced new onset dysphonia following neuraxial anaesthesia (NA) for a caesarean section. Flexible nasendoscopy showed a right VFP with fixation in the...

How the world sees facial palsy patients

This paper from Australia gives an insightful perspective on the impact of facial paralysis on patients, and may explain the well-documented poor quality of life scores in this patient group, particularly those ‘successfully reconstructed’ with surgery. It explores how the...

Prospective evaluation of quality of life in the flaccid

Flaccid midface paralysis causes nasal valve collapse due to the lack of tonic muscular support. This causes both external nasal valve narrowing and collapse during inspiration. Correction of the nasal valve is performed in functional rhinoplasty. However, these procedures do...

Semi dynamic reconstruction of the lower lip

The main goal of reconstructive surgery for facial paralysis is the restoration of smiling and function of eye closure. The deformity of the lower lip in paralysis is ptosis of the corner of the mouth, eversion of the vermillion and...

Indication and timing of electrodiagnostic tests in facial palsy

This excellent review describes the benefits and limitations of electrodiagnostic testing for patients with facial paralysis. Tests such as Schirmer, stapedial reflex and electrogustometry have been largely replaced by neurophysiologic tests like nerve excitability test (NET), electroneuronography (ENoG), surface electromyography...

Righting the paralysed lip

Many surgical procedures that otolaryngologists perform put the facial nerve at risk of injury, a complication that the surgeon and patient fear alike. Unfortunately, injuries to the nerve can and do happen despite adequate precautions, and facial paralysis may be...

Exciting advances in facial reanimation

Despite several techniques for reanimation after facial paralysis, the management of these patients continues to challenge us. This paper reviews advances in facial reanimation surgery, provides updates on the timing of intervention, modifications to the traditional gracilis muscle transfer, other...

Facial nerve grafting – what’s the wait?

An uninterrupted facial nerve after resection of cerebellopontine angle (CPA) tumour does not always translate into preserved facial animation. Fortunately there is a high probability spontaneous recovery may occur and hence patients are typically observed for 12 months postoperatively. However,...