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If facial paralysis is caused by trauma or tumour surgery, direct reinnervation of the facial muscles (ideally within 72 hours after facial nerve damage) can be achieved by neurorrhaphy, with or without an interposition nerve graft. (Algorithm 1) [7] Neurorrhaphy is a primary end-to-end reconnection of the facial nerve stumps. [8]
The depressor labii inferioris muscle may be resected (cut and removed) using surgery to correct an asymmetry of the lower lip when smiling. [1] This asymmetry can be caused by paralysis of the marginal mandibular branch of the facial nerve on one side, so the healthy side may be cut to create symmetry. [ 1 ]
In patients with severe injury, progress is followed with nerve conduction studies. If nerve conduction studies show a large (>90%) change in nerve conduction, the nerve should be decompressed. The facial paralysis can follow immediately the trauma due to direct damage to the facial nerve, in such cases a surgical treatment may be attempted.
There are three main patterns of facial nerve compression. The type of injury also gives an idea about the prognosis. Neuropraxia: no wallerian degeneration and complete and rapid recovery of function. Axonotmesis: wallerian degeneration and necrosis of the distal segment (death of the part of the nerve after the compression). Recovery is not ...
The inferior alveolar nerve, which is a branch of the mandibular nerve, must be identified during surgery and worked around carefully in order to minimize nerve damage. The numbness may be either temporary, or more rarely, permanent. [25] Recovery from the nerve damage typically occurs within three months after repair.
Small defects of the upper and lower lip can be closed primarily. For the upper lip, defects of up to 1/4 (25%) of the lip may be closed primarily. For the lower lip, defects of up to 1/3 of the lip may be closed primarily. This means the edges of the defect are simply sutured together in three layers: oral mucosa, muscle, and skin.
Deformity in the face, for example a sunken cheekbone or teeth which do not align properly, suggests the presence of fractures. Asymmetry can suggest facial fractures or damage to nerves. [3] People with mandibular fractures often have pain and difficulty opening their mouths and may have numbness in the lip and chin. [4]
Hypoesthesia or numbness is a common side effect of various medical conditions that manifests as a reduced sense of touch or sensation, or a partial loss of sensitivity to sensory stimuli. In everyday speech this is generally referred to as numbness.