CLINICAL PROFILE AND TREATMENT OUTCOME OF LOWER MOTOR NEURON FACIAL NERVE PALSY IN A UNIVERSITY TEACHING HOSPITAL IN SOUTH INDIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 19
Abstract
BACKGROUND Lower motor neuron facial palsy is characterised by paralysis of facial muscles on the affected side. The aetiology of facial nerve palsy is myriad. The most common being Bell’s palsy. Bell’s palsy is of acute onset and considered to be idiopathic in origin, even though lots of causative factors including viral agents, autoimmunity and vascular origin have been suggested. Prompt management of facial nerve palsy is required to ensure corneal clarity and to reduce long-term visual and cosmetic disability. Aims and Objectives- To study the aetiology, clinical profile of lower motor neuron (LMN) facial nerve palsy in a University Teaching Hospital and to determine the treatment outcome. MATERIALS AND METHODS This is a retrospective descriptive study of 99 eyes of 95 patients who had LMN facial nerve palsy over a period of 3 years. The Best Corrected Visual Acuity (BCVA), grading of lagophthalmos (House-Brackmann), assessment of lid laxity and Bell’s phenomenon, slit lamp grading of punctate epitheliopathy, corneal sensation and fundus of 95 patients were studied and the type of management that they were subjected to were analysed and the treatment outcome determined. RESULTS The most common aetiology of LMN facial palsy was found to be Bell’s (70.5%), while other causes included post-traumatic, congenital or Ramsay Hunt syndrome. Bell’s palsy of less than a week’s duration responds well to systemic antivirals, steroids and tear substitutes. For facial palsy of more than six months’ duration, Gold Weight Implant (GWI) is an effective procedure for providing adequate lid closure. Lateral Tarsal Strip (LTS) provides good apposition of the lower lid to globe. Lateral tarsorrhaphy (LT) is still the procedure of choice when there is impaired corneal sensation. CONCLUSION Bell’s palsy is the most common aetiology of LMN facial palsy. This retrospective case study highlights the significance of early recognition of LMN facial palsy and its prompt treatment. Early medical treatment of Bell’s palsy promotes complete recovery of facial nerve function. The sequelae of facial palsy can be adequately corrected surgically, providing good cosmetic and functional outcome.
Authors and Affiliations
Lily Daniel, Vaishnavi R, Varshini Varadaraj, Preethi K
Keywords
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- EP ID EP418275
- DOI 10.14260/jemds/2018/542
- Views 66
- Downloads 0
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