Facial 麻痹

Signs & 症状

面瘫的症状可能包括:

• 不平衡或不对称的面部结构
• 不能扬起眉毛
• Inability to close an eyelid and protect the eyeball from drying out
• Looseness or sagging of the lower eyelid, leading to tears dripping down the cheek
• 无力抚养, 降低或噘起嘴唇, leading to dribbling when drinking and slurring of some words when 说话

诊断

面瘫的诊断通常很复杂. Facial paralysis may result from a disruption in the part of the brain called the motor cortex, injury to the facial nerve or damage to the muscles that control facial expression.

诊断需要咨询十大赌博平台排行榜, a complete physical exam and imaging studies of the brain and face. Your doctor may recommend one or more of the following imaging tests:

• 磁共振成像(MRI) and 计算机断层扫描 排除脑瘤，中风和感染的可能性
• 肌电图(EMG) 来评估神经和肌肉

准备

Complications affecting the eye are the most important concerns. The eye is constantly exposed to dry air and must be kept moist. 面瘫通常不会影响眼泪分泌, but it can affect the way the tears are distributed over the eye. 有很多方法可以防止干燥效果, 包括录制, 药膏, 湿度室, patches, 甚至暂时缝合眼睑.

Potential conditions that are examined before undergoing treatment include:

• Bell's phenomenon, a condition that causes an upward and outward movement of the eye
• 角膜麻醉，使人失去知觉
• 干眼综合征病史

To assess the facial nerves affecting the eyes, electromyography (EMG) may be performed

治疗

面瘫的治疗取决于许多因素, 包括病人的年龄, 瘫痪的原因, 麻痹的严重程度和症状的持续时间. 面部特征的对称性通常可以恢复, if the patient participates in facial muscle retraining and therapy. 两者都是成功的关键.

Doctors at UCSF's Facial Plastic and Reconstructive Surgery Clinic treat facial paralysis by transferring muscles and repairing blood vessels and nerves. The treatment is determined after the assessment of 症状 and is tailored to each patient's needs.

Treatment may include one or more of the following approaches:

• 直接再吻合或神经移植. To help restore nerve function, surgeons sew together the severed ends of damaged nerves. 如果神经的末端不能直接缝合, a piece of nerve is harvested and used as a connector or graft between the two ends.
• 眼皮手术. Lower-lid tightening procedures and upper-lid weighting operations are used to treat eye conditions. Platinum or gold weights may be implanted under the skin of the upper lid to allow the lid to close passively with gravity. These procedures are usually performed in a clinic or procedure room.
• 颞肌肌腱转移术(T3). The temporalis tendon connects the temple to the jaw and can be felt if the temple is lightly touched while clenching the jaw. Transferring the jaw tendon to the corner of the mouth can restore movement to the lips without altering the shape of the face.
• 12-7或5-7神经移植. 这个手术连接舌下神经, 神经:通向舌头的神经, to a facial nerve to produce nerve growth of the facial muscles. This may be performed within the first two years of nerve injury to maintain facial tone, 并可能恢复一些功能. These grafts may also serve as "babysitter" grafts until cross-facial grafting may be performed
• 轮廓恢复. Facial paralysis is sometimes a side effect of serious surgeries and can cause a change in the shape of a patient's face. 大腿上的脂肪和组织, 这个手术叫做大腿前外侧游离皮瓣, 是否用于恢复正常外观. 这种类型的“皮瓣”是微血管重建.
• 肉毒杆菌毒素. 在治疗期间恢复神经功能和生长, nerves can grow and branch into an unintended area of the patient's face, 造成“联带运动”, 随意肌和不随意肌运动的结合. 例如, if a bundle of nerves designated for lip puckering also grow to the patient's eyelid, 在皱起的过程中可能会导致无意的眼球运动. Some muscles can become hypertonic or overactive as a result of paralysis. Botox injections can be used to treat synkinesis and hypertonic movement by weakening specific muscles and thus restore facial symmetry. Brow ptosis, or a drooping brow, can be treated with botox injections or a brow lift.