To,
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE.
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
|1 |Name of the candidate and |DR.ARUN INGALE |
| |address |P.G. IN OTO-RHINO-LARYNGOLOGY, |
| | |DEPARTMENT OF ENT, |
| | |VIMS, BELLARY. |
|2 |Name of the Institution |VIJAYANAGAR INSTITUTE OF |
| | |MEDICAL SCIENCES, BELLARY. |
|3 |Course of the study and subject |MS IN ENT |
|4 |Date of admission to the course |18-05-2012 |
|5 |Title of the topic |A CLINICAL STUDY OF ETIOLOGY AND MANAGEMENT OF LOWER MOTOR NEURON TYPE |
| | |PALSY OF FACIAL NERVE |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| |BRIEF RESUME OF INTENDED WORK |
| |6.1. Need for study; |
|6 |Like most cranial nerves, the facial nerve contain motor, sensory and parasympathetic fibers Among its functions the vital |
| |are control of facial expression, taste to the anterior two third of tongue and salivary and lacrimal gland secretion. |
| |More than 40 different causes of facial paralysis are known, classified as idiopathic, traumatic, infection, neoplastic and |
| |metabolic. Of the various causes, 75% are usually due to Bell’s palsy or secondary to trauma1.Of all the cranial nerves; the |
| |facial nerve is most susceptible to injury because the nerve has complex course through the temporal bone in proximity to |
| |various structures which are frequent sites of disease. |
| |A patient who suffers from facial paralysis experiences not only functional consequences but also the psychological impact of|
| |change of self-image and impaired communication ability2. |
| |In facial paralysis, history and physical examination provide the more information than do the lab tests. Diagnostic tests |
| |add information to what is already known and influences the choice of the therapy which can improve the clinical out |
| |come3.Successfull management of disease process that causes facial nerve dysfunction requires thorough knowledge of |
| |pathophysiology of disease process. Management of facial nerve dysfunction is individualized and may include observation, |
| |administration of pharmacological agents, surgical interventions, physical therapy and psychological counselling4. Degree of |
| |recovery also varies as per modality of treatment used. |
| |Keeping this in mind, this study aims at understanding different causes of facial nerve paralysis seen and to assess the |
| |outcome of treatment on the disease. |
| | |
| |6.2 Review of Literature; |
| |Sir Charles Bell, the British physician, in 1824 described onset, physical finding and course of idiopathic facial palsy5. |
| |Bell’s palsy is a self-limiting, non- progressive, non-life threatening and spontaneously remitting condition. Incidence |
| |varies between 15&40 per 100,000population. |
| |Bell’s palsy accounts for 60% to 80% of all causes of Facial palsy. Male to female ratio is equal except for predominance for|
| |men over 40yrs of age. At presentation 30% have incomplete paralysis, bilateral paralysis occurs in 0.3% of patients, 8% have|
| |family history,9% patients give previous history of paralysis.6,7 |
| |Paterson (1982)studied natural history of 1000patients with Bell’s palsy over |
| |Period of 15yrs and found that in 84% cases recovery was satisfactory. 85% patients begin recovery by 3weeks and fully |
| |recovered by 6months.The earlier recovery better prognosis8. |
| |Otogenic Facial palsy may be due to AOM, COM, acute mastoiditis, chronic mastoiditis. |
| |James Ramsay Hunt (1872-1937) an American neurologist described the clinical Syndrome of Herpes Zoster oticus that bears his |
| |name9. Herpes Zoster oticus is characterized by viral prodrome with severe pain in and around ear with vesicle involving |
| |pinna. Viral eruption distribution defends on which sensory afferent fibre involved, that communicates with Facial |
| |nerve.10,11 |
| |J.Douglas Green, et all (1994)12 reviewed 22 patients with iatrogenic Facial palsy. Injury during |
| |mastoidectomy(55%),tympanoplasty(14%),removal of exostoses(14%). Common area involved was lower tympanic segment in 55% and |
| |descending mastoid segment in 32% of patients. |
| |Facial paralysis is not an infrequent complication of basal skull fracture. 90% of fractures are longitudinal, of which only |
| |20% had Facial paralysis and 10% tansverse fractures, of which 50% had Facial paralysis.13 |
| |Approximately 5% Facial nerve dysfunction is by tumour.14vestibular schwannoma is common tumor of internal auditory canal. |
| |Intrinsic Facial nerve tumors like facial schwannoma, meningioma and haemangioma are very rare(Thomas R.Kertesz et all 2001 |
| |).15 |
| |Most common malignant tumour involving Facial nerve is squamous cell carcinoma of head and neck. Rare malignancy like |
| |rhabdomyosarcoma of middle ear and mastoid (R.K Mundra and Goyal Amit, 2002).16 Metastatic tumor like small cell carcinoma of|
| |lung to temporal bone.17 |
| |Management is directed to protect nerve or help to regenerate damaged nerves. Patient must be informed about Facial deformity|
| |if recovery is not expected and supported sympathetically, pharmacotherapy using prednisolone in large doses has recently |
| |found effective for Bell’s palsy(Taverner,1970)18 and also use of antiviral agents improve the recovery of Facial palsy.19 |
| |Even though no Facial movements noted in intact nerve fibers, will be activated and exercise will help to maintain muscle |
| |tone.16 Physical pain can be controlled with non-steroidal anti-inflammatory drugs. Surgery to reanimate paralyzed eyelids |
| |should be considered if medical treatment is ineffective for eye care20. |
| |Surgical decompression is considered if ENOG degeneration more than 90% of unaffected side, age is ................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related searches
- where to invest money to make money
- instructions on how to use baking soda to pass a drug test
- ways to invest money to make money
- things to make to sell
- why to go to college essay
- why not to go to college
- how to invest money to make money
- what to take to someone in hospice
- things to say to make someone s day
- how to add calculator to windows 10
- reasons to go to college essays
- easy things to sell to make money