Facial Paralysis Treatment Status And Clinical Application Of Electromyography

Object Analysis of the status of treatment of facial paralysis and prevention of complications and methods to improve the prognosis. Methods Using meta-analysis method to analyze the documents of facial paralysis therapy published in the past10years in China in order to understand the disease characteristics, treatment and prognosis. Results52.0%of patients’etiologies were infection,22.3%of patients’etiologies were trauma,12.4%of patients’etiologies were surgery,10.6%of patients’ etiologies were cerebrovascular disease,1.0%of patients’etiologies were congenital. The most common form of facial paralysis was peripheral unilateral facial paralysis. Facial paralysis rarely occured within the central nervous system. Bilateral facial paralysis also rarely occured. The rate of patients with unilateral facial paralysis was98.7%.Conservative treatment was the main treatment in patients with facial paralysis.59.8%of the patients underwent conservative treatment, the rate of efficiency was96.2%,40.2%of the patients underwent open surgery,11.17%of the patients underwent muscle transplantation, the rate of efficiency was97.7%,21.2%of the patients underwent nerve anastomose, the rate of efficiency was91.8%,7.15%of the patients underwent nerve decompression, the rate of efficiency was90.2%,0.7%of the patients underwent static slings, the rate of efficiency was100%, the general rate of efficiency was95%. Muscle transplantation as the representative of the surgical interventions developed rapid in China in last decade with no postoperative complication. The indications involved the patient who hadn’t acquired treatment in time at the early stage of the course of disease and the patient who had underwent conservative treatment with no effectiveness. The general rate of complete recovery, the general rate of basic recovery, the general rate of all right, the general rate of ineff icacy, the general rate of complication separately were:59.8%,19.2%,16.0%,5.0%和0. Conclusions Infection was the leading cause of peripheral unilateral facial paralysis. Acupuncture was the main traditional treatment method for facial paralysis. The general rate of Complete recovery of the patient with nerve injury at the early stage of the course of disease and the patient with long-stangding facial paralysis had improved evidently. Early diagnosis, prompt treatment and effective perioperative care were the keys to improve the treatment results. Objective To evaluate the long-term effectiveness of denervated mini-muscle free micro-vascular transplantation and static sling for the dynamic treatment of long-standing facial paralysis. Methods We treated21cases of facial paralysis using denervated extensor digitorum brevis and extensor hallusis brevis from2003to January2012. In order to correct the nasal and oral deformity, we fixed the tendon end at ala nasi, middle point of nasal labial fold, oral commissure, chin, the muscle belly was put around the masseter nerve, microsurgery was applied to anastomoses the tarsus lateral vessels to the superficial temporalis vessels. In the other group, we treated45cases of facial paralysis using2-0PDS Ⅱ from2003to January2012. We sutured them at ala nasi, middle point of nasal labial fold, oral commissure. Results The House-Brackmann (H-B) grading system was used to determine postoperative effectiveness. Dynamic restoration operation:grade Ⅰ in15patients, grade Ⅱ in4patients, grade Ⅲ in1patients, grade Ⅳ and under grade Ⅳ in1patient. Static slings:grade Ⅰ inlO patients, grade Ⅱ in27patients, grade Ⅲ in5patients, grade Ⅳ and under grade Ⅳ in3patient. We used the statistical analysis method of Wilcoxon signed rank test, P<0.0005. The difference between the two groups had statistics significance. However, dynamic restoration had a better outcome. Conclusion The denervated extensor digitorum brevis and extensor hallusis brevis free vascular transplantation for the treatment of long-standing facial paralysis offered significant improvements. Symmetry and coordinated movements can be restored, with satisfying aesthetic and functional outcomes. The static slings offered significant improvments of static appearance. The two operation methods offered good postoperative effectiveness. We can alternative the dynamic restoration first. They were safe and effective methods to reconstruct the face expression and oral appearance.