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6 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Facial n supply includes (True or false)
1. Mm of facial expression 2. Mm of scalp and external ear, mm of mastication 3. Taste to anterior 1/3 of tongue 4. Sensation to portion of the internal auditory canal, soft palate and pharynx 5. Secremotor fibers for submandibular, sublingual, lacrimal, nasal and palatine glands |
True except 3. Anterior TWO THIRDS tongue and 4. Sensation to EXTERNAL AUDITORY MEATUS (rest is correct)
See side 3 |
Facial n travels from brainstem through internal auditory meatus into temporal bone. GIves off four branches (which supply everything EXCEPT mm of facial expression), exits temporal bone at stylomastoid foramen and enters parotid gland where it divides to supply mm of facial expression
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Bell's Palsy:
1 a lower or upper motor neuron paralysis? 2. Prodromal illness occurs in what percentage of patients? 3. Aetiology is probably.... 4. Common associated symptoms are ear pain, perception of sensory change, decreased tearing, epiphora, hyperacusis and dysgeusia. What do the last three terms mean? 5. Two primary therapies are... |
1. LOWER so INCLUDES the forehead (upper spares forehead)
2. 60% 3. Viral, herpes virus 4, Epiphora = overflow of tears on cheek, hyperacusis = abnormally acute hearing, dysgeusia = impairment or perversion of taste 5. Corticosteroids and antivirals |
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What is the theory behind corticosteroid use in Bell's palsy?
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Oedema of the nerve in the facial canal may be causing/contributing to the nerve injury. 1mg/kg/day prednisolone for 5/7
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Antiviral agents are routine treatment for Bell's palsy. T/F
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False. Only if vesicles seen in ipsilateral ear and symptoms present for less than 72 hours, then treat as per Ramsay Hunt syndrome.
Therapeutic Guidelines. |
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Ramsay Hunt syndrome has 3 key characteristics - what are they?
How does the pain compare with Bell's palsy? The outcomes? |
1) unilateral facial paralysis
2) herpetiform vesicular eruption (may be on pinna, external canal, tympanic membrane, soft palate, oral cavity, face and neck down to shoulder!!) 3) Vestibulocochlear dysfunction Pain much more prominent and often out of proportion to findings. Outcome worse - lower likelihood complete recovery and possible sensorineural hearing loss. Rx - as per any shingles. Antivirals if within 72 hours onset VESICLES, for 1/52 (famciclovir and valaciclovir 1st line), paracetamol and add prednisolone 50mg mane 1/52 if pain severe. Therapeutic guidelines |
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What is the likely cause/association of facial nerve paralysis in the following settings?
1) bilateral simultaneous onset 2) as a complication of OM or malignant OE 3) recurrent, prolonged symptoms |
1) rare but can occur with systemic infections e.g. infectious mononucleosis
2) immunocompromised and diabetic patients 3) consider neoplasm - usually onset over 3/52 but may be sudden (25%) |
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