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Rehabilitationsmöglichkeiten bei Läsionen des N. facialis

Rehabilitation options for lesions of the facial nerve

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Zusammenfassung

Patienten mit dauerhafter Fazialisparese ist ihr Stigma ständig anzusehen; entsprechend hoch ist der Leidensdruck der Patienten. Um mit chirurgischen Methoden eine zufriedenstellende Rekonstruktion der mimischen Funktion zu erreichen, ist Erfahrung mit einer Vielzahl von chirurgischen und adjuvanten konservativen Maßnahmen notwendig. Der vorliegende Beitrag stellt das Repertoire der derzeitigen operativen und konservativen Möglichkeiten mit ihren Indikationsbereichen, den Grenzen und Kombinationsmöglichkeiten vor.

Abstract

Patients with permanent facial palsies cannot hide their conditions. As a consequence, these patients suffer from massive psychological stress. To achieve satisfactory reconstruction of mimic function, experience with a variety of surgical techniques and adjuvant nonsurgical treatments is necessary. This report provides information on the present repertoire of surgical and conservative options, emphasizing their fields of indications, limitations, and possible combinations.

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Literatur

  1. Angelov DN, Ceynowa M, Guntinas-Lichius O et al. (2007) Mechanical stimulation of paralyzed vibrissal muscles following facial nerve injury in adult rat promotes full recovery of whisking. Neurobiol Dis 26: 229–242

    Article  PubMed  Google Scholar 

  2. Atlas MD, Lowinger DSG (1997) A new technique for hypoglossal-facial nerve repair. Laryngoscope 107: 984–991

    Article  PubMed  CAS  Google Scholar 

  3. Bascom DA, Schaitkin BM, May M, Klein S (2000) Facial nerve repair: a retrospective review. Facial Plast Surg 16: 309–313

    Article  PubMed  CAS  Google Scholar 

  4. Berghaus A, Neumann K, Schrom T (2003) The platinum chain: a new upper-lid implant for facial palsy. Arch Facial Plast Surg 5: 166–170

    Article  PubMed  Google Scholar 

  5. Beurskens CH, Heymans PG (2004) Physiotherapy in patients with facial nerve paresis: description of outcomes. Am J Otolaryngol 25: 394–400

    Article  PubMed  Google Scholar 

  6. Dalla TE, Bossi D, Buonocore M et al. (2005) Usefulness of BFB/EMG in facial palsy rehabilitation. Disabil Rehabil 27: 809–815

    Article  Google Scholar 

  7. Devauchelle B, Badet L, Lengele B et al. (2006) First human face allograft: early report. Lancet 368: 203–209

    Article  PubMed  Google Scholar 

  8. Diels HJ (2000) Facial paralysis: is there a role for a therapist? Facial Plast Surg 16: 361–364

    Article  PubMed  CAS  Google Scholar 

  9. Falcioni M, Taibah A, Russo A et al. (2003) Facial nerve grafting. Otol Neurotol 24: 486–489

    Article  PubMed  Google Scholar 

  10. Frey M, Giovanoli P (2002) The three-stage concept to optimize the results of microsurgical reanimation of the paralyzed face. Clin Plast Surg 29: 461–482

    Article  PubMed  Google Scholar 

  11. Frey M, Giovanoli P, Tzou CH et al. (2004) Dynamic reconstruction of eye closure by muscle transposition or functional muscle transplantation in facial palsy. Plast Reconstr Surg 114: 865–875

    Article  PubMed  Google Scholar 

  12. Gillies H (1934) Experiences with fascia lata grafts in the operative treatment of facial paralysis. Proc R Soc Med 27: 1372–1378

    Google Scholar 

  13. Greulich M (2005) Anchoring the nasolabial fold. In: Beurskens CHG, Gelder RS van, Heymans PG et al. (eds) The facial palsies. Lemma Publishers, Utrecht, pp 235–243

  14. Guntinas-Lichius O (2004) The facial nerve in the presence of a head and neck neoplasm: assessment and outcome after surgical management. Curr Opin Otolaryngol Head Neck Surg 12: 133–141

    Article  PubMed  Google Scholar 

  15. Guntinas-Lichius O, Beurskens CH, Gelder RS van et al. (2005) The facial nerve grading systems. In: Beurskens CHG, Gelder RS van, Heymans PG et al. (eds) The Facial Palsies. Lemma Publishers, Utrecht, pp 51–68

  16. Guntinas-Lichius O, Irintchev A, Streppel M et al. (2005) Factors limiting motor recovery after facial nerve transection in the rat: combined structural and functional analyses. Eur J Neurosci 21: 391–402

    Article  PubMed  Google Scholar 

  17. Guntinas-Lichius O, Sittel C (2004) [Diagnostics of diseases and the function of the facial nerve]. HNO 52: 1115–1130; quiz 1131–1112

    Article  PubMed  CAS  Google Scholar 

  18. Guntinas-Lichius O, Straesser A, Streppel M (2007) Quality of life after facial nerve repair. Laryngoscope 117: 421–426

    Article  PubMed  Google Scholar 

  19. Guntinas-Lichius O, Streppel M, Stennert E (2006) Postoperative functional evaluation of different reanimation techniques for facial nerve repair. Am J Surg 191: 61–67

    Article  PubMed  Google Scholar 

  20. Guntinas-Lichius O, Wewetzer K, Tomov TL et al. (2002) Transplantation of olfactory mucosa minimizes axonal branching and promotes the recovery of vibrissae motor performance after facial nerve repair in rats. J Neurosci 22: 7121–7131

    PubMed  CAS  Google Scholar 

  21. Jungehulsing M, Guntinas-Lichius O, Stennert E (2001) [Rehabilitation of chronic facial paralysis. 2]. HNO 49: 484–496

    Article  PubMed  CAS  Google Scholar 

  22. Kaylie DM, Wax MK, Weissman JL (2003) Preoperative facial muscle imaging predicts final facial function after facial nerve grafting. AJNR Am J Neuroradiol 24: 326–330

    PubMed  Google Scholar 

  23. Laskawi R (1997) Combination of hypoglossal-facial nerve anastomosis and botulinum-toxin injections to optimize mimic rehabilitation after removal of acoustic neurinomas. Plast Reconstr Surg 99: 1006–1011

    Article  PubMed  CAS  Google Scholar 

  24. Levine RE, Shapiro JP (2000) Reanimation of the paralyzed eyelid with the enhanced palpebral spring or the gold weight: modern replacements for tarsorrhaphy. Facial Plast Surg 16: 325–336

    Article  PubMed  CAS  Google Scholar 

  25. MacGregor FC (1990) Facial disfigurement: problems and management of social interaction and implications for mental health. Aesthetic Plast Surg 14: 249–257

    Article  PubMed  CAS  Google Scholar 

  26. Manni JJ, Beurskens CH, van de Velde C, Stokroos RJ (2001) Reanimation of the paralyzed face by indirect hypoglossal-facial nerve anastomosis. Am J Surg 182: 268–273

    Article  PubMed  CAS  Google Scholar 

  27. May M (2002) Prospective evaluation of eyelid function with gold weight implant and lower eyelid shortening for facial paralysis. Arch Facial Plast Surg 4: 60–61

    Article  PubMed  Google Scholar 

  28. May M, Drucker C (1993) Temporalis muscle for facial reanimation. A 13-year experience with 224 procedures. Arch Otolaryngol Head Neck Surg 119: 378–382

    PubMed  CAS  Google Scholar 

  29. May M, Sobol SM, Mester SJ (1991) Hypoglossal-facial nerve interpositional-jump graft for facial reanimation without tongue atrophy. Otolaryngol Head Neck Surg 104: 818–825

    PubMed  CAS  Google Scholar 

  30. McLaughlin CR (1953) Surgical support in permanent facial paralysis. Plast Reconstr Surg 53: 302–314

    Article  Google Scholar 

  31. Navissano M, Malan F, Carnino R, Battiston B (2005) Neurotube for facial nerve repair. Microsurgery 25: 268–271

    Article  PubMed  Google Scholar 

  32. Pitty LF, Tator CH (1992) Hypoglossal-facial nerve anastomosis for facial nerve palsy following surgery for cerebellopontine angle tumors. J Neurosurg 77: 724–731

    Article  PubMed  CAS  Google Scholar 

  33. Reddy PG, Arden RL, Mathog RH (1999) Facial nerve rehabilitation after radical parotidectomy. Laryngoscope 109: 894–899

    Article  PubMed  CAS  Google Scholar 

  34. Roedel R, Christen HJ, Laskawi R (1998) Aplasia of the depressor anguli oris muscle: a rare cause of congenital lower lip palsy? Neuropediatrics 29: 215–219

    Article  PubMed  CAS  Google Scholar 

  35. Sajjadian A, Song AY, Khorsandi CA et al. (2006) One-stage reanimation of the paralyzed face using the rectus abdominis neurovascular free flap. Plastic Reconstr Surg 117: 1553–1559

    Article  CAS  Google Scholar 

  36. Spector JG (1985) Mimetic surgery for the paralyzed face. Laryngoscope 95: 1494–1522

    PubMed  CAS  Google Scholar 

  37. Stennert E (1982) Das autoparalytische Syndrom – ein Leitsymptom der postparetischen Fazialisfunktion. Arch Otorhinolaryngol 236: 97–114

    Article  PubMed  CAS  Google Scholar 

  38. Stennert E (1979) I. Hypoglossal facial anastomosis: its significance for modern facial surgery. II. Combined approach in extratemporal facial nerve reconstruction. Clin Plast Surg 6: 471–486

    PubMed  CAS  Google Scholar 

  39. Streppel M, Angelov DN, Guntinas-Lichius O, Neiss WF (1998) [Nerve-plasty interventions on the facial nerve in the elderly patient – morphological evaluation of disappointing functional results]. Laryngorhinootologie 77: 332–336

    PubMed  CAS  Google Scholar 

  40. Streppel M, Azzolin N, Dohm S et al. (2002) Focal application of neutralizing antibodies to soluble neurotrophic factors reduces collateral axonal branching after peripheral nerve lesion. Eur J Neurosci 15: 1327–1342

    Article  PubMed  CAS  Google Scholar 

  41. Streppel M, Popratiloff A, Angelov DN et al. (1998) Significance of trigeminal sensory input on regrowth of hypoglossal and facial motoneurons after hypoglossal facial anastomosis in rats. Acta Otolaryngol 118: 790–796

    Article  PubMed  CAS  Google Scholar 

  42. Terzis JK, Kalantarian B (2000) Microsurgical strategies in 74 patients for restoration of dynamic depressor muscle mechanism: a neglected target in facial reanimation. Plastic Reconstr Surg 105: 1917–1931; discussion 1932–1914

    Article  CAS  Google Scholar 

  43. Tos T, Caye-Thomasen P, Stangerup SE et al. (2003) Need for facial reanimation after operations for vestibular schwannoma: patients perspective. Scand J Plast Reconstr Surg Hand Surg 37: 75–80

    Article  PubMed  Google Scholar 

  44. Yla-Kotola TM, Kauhanen MS, Asko-Seljavaara SL (2004) Facial reanimation by transplantation of a microneurovascular muscle: long-term follow-up. Scand J Plast Reconstr Surg Hand Surg 38: 272–276

    Article  PubMed  Google Scholar 

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  1. Klinik und Poliklinik für Hals-, Nasen-, Ohrenkranke, Friedrich-Schiller-Universität Jena, Lessingstraße 2, 07740, Jena, Deutschland

    O. Guntinas-Lichius

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Correspondence to O. Guntinas-Lichius.

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Guntinas-Lichius, O. Rehabilitationsmöglichkeiten bei Läsionen des N. facialis. HNO 55, 605–612 (2007). https://doi.org/10.1007/s00106-007-1587-8

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