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Trauma Treating Traumatic Facial Nerve Paralysis

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Trauma Treating Traumatic Facial Nerve Paralysis LETTERS TO EDITOR 205 206 LETTERS TO EDITOR In conclusion, the most frequent type of HBV R. Hepatitis B virus genotype A is more often hearing loss, and an impedance audiogram Strands of facial nerve interconnect with genotype in our study was D type, which associated with severe liver disease in northern showed absent stapedial reflex. CT scan cranial nerves V, VIII, IX, X, XI, and XII and usually causes a mild liver disease. Hence India than is genotype D. Indian J Gastroenterol showed no fracture of the temporal bone and with the cervical cutaneous nerves. This free proper vaccination, e ducational programs, 2005;24:19-22. intact ossicles. The patient was prescribed intermingling of Þ bers of the facial nerve with and treatment with lamivudine are efficient 6. Thakur V, Sarin SK, Rehman S, Guptan RC, high-dose steroids, along with vigorous facial Þ bers of other neural structures (particularly Kazim SN, Kumar S. Role of HBV genotype strategies in controlling HBV infection in our nerve stimulation and massages. the cranial nerve V) has been proposed as in predicting response to lamivudine therapy area. the mechanism of spontaneous return of facial in patients with chronic hepatitis B. Indian J After 3 weeks of treatment, the facial nerve nerve function after peripheral injury to the Gastroenterol 2005;24:12-5. stimulation tests were repeated and the ABDOLVAHAB MORADI, nerve.[4] VAHIDEH KAZEMINEJHAD1, readings were compared to those taken prior to GHOLAMREZA ROSHANDEL, treatment. There was negligible improvement. KHODABERDI KALAVI, Early onset/complete palsy indicates disruption EZZAT-OLLAH GHAEMI2, SHAHRYAR SEMNANI The patient was offered an exploratory of continuity of the nerve. A delayed onset/ Golestan Research Center of Gastroenterology and mastoidectomy to try to locate the lesion of partial paresis suggests secondary swelling Hepatology, Golestan University of TRAUMA TREATING TRAUMATIC 1 the facial nerve and decompress or repair Medical Sciences, Iran, Department of Pathology, FACIAL NERVE PARALYSIS: or compression of nerve that is more likely 5 Azar Hospital, Golestan University of Medical the damaged part, which he turned down. He to recover spontaneously. Most patients of Sciences, Iran, 2Department of Microbiology, Faculty TRUTH OR COINCIDENCE? of Medicine, Golestan University of Medical Sciences, chose to be discharged against medical advice peripheral traumatic facial nerve injury recover Iran and discontinued all medications. with time; and occasionally, treatment. The Correspondence: Sir, Dr. Gholamreza Roshandel, case we present is unique in the sense that a Number 77, 2 nd Floor, Qabooseieh Passage, Time and patience have been the conventional Three months after the initial trauma, the patient second similar episode of trauma resulted in Gorgan, Golestan Province, Iran 49166-53588 healers of delayed-onset traumatic facial nerve claimed to have suffered another episode of E-mail: [email protected] recovery of facial nerve motor function which paralysis. Facial nerve stimulation has played trauma similar to the first episode but less is inexplicable. It is possible that the repeat REFERENCES a supportive role in speeding up the recovery. severe and with no loss of consciousness. The trauma to the facial nerve stimulated the nerve It is managed depending on time of onset and patient did not seek any medical advice. He and speeded the recovery process or that the 1. Alexopoulou A, Dourakis SP. Genetic heterogeneity completeness of the paralysis. Delayed-onset however reported that his facial disÞ gurement facial nerve recovered spontaneously and the of hepatitis viruses and its clinical signifi cance. paralysis is usually managed conservatively as started improving and recovery was complete in second episode of trauma was coincident. Curr Drug Targets Infl amm Allerg 2005;4:47-55. the rate of spontaneous recovery in such cases 6 to 7 days. There was, however, no reported 2. Gholamreza R, Shahryar S, Abbasali K, is very high. improvement in lacrimation or taste. In the literature, we have not come across any Hamidreza J, Abdolvahab M, Khodaberdi K, et mention of repeat trauma leading to recovery al. Seroprevalence of hepatitis B virus and its We present a case of a 46-year-old man who A repeat audiogram showed an increased of traumatic facial nerve palsy. This case co-infection with hepatitis D virus and hepatitis developed progressive facial paralysis 5 days sensorineural component. Impedance highlights the fact that the hope of recovery C virus in Iranian adult population. Indian J Med following head injury and temporary loss of audiometry showed an absent stapedial reß ex. in traumatic facial paralysis (delayed onset) Sci 2007;61:263-8. consciousness. The patient developed all We concluded that the motor component of should not be lost, and the patient should 3. Alavian SM, Keyvani H, Rezai M, Ashayeri N, the classical features of lower motor neuron the facial nerve had recovered but the other Sadeghi HM. Preliminary report of hepatitis be advised electro-physiotherapy for up to 6 facial paralysis, along with loss of lacrimation functions remained depressed. B virus genotype prevalence in Iran. World J and taste perception. He primarily presented months after the initial episode. Gastroenterol 2006;12:5211-3. complaining of hearing loss in the right ear. Facial nerve paralysis can be a disfiguring 4. Amini-Bavil-Olyaee S, Sarrami-Forooshani R, [1] SANJAY ARORA, BS TULI On examination, his tympanic membrane was disorder with profound impact on the patient. Department of ENT, MMIMSR, Mullana (Ambala), India Adeli A, Sabahi F, Abachi M, Azizi M, et al. Patients suffering from this debilitating condition normal, and there was no associated bleeding Correspondence: Complete genomic sequence and phylogenetic [2] are unable to express various emotional states. Dr. Sanjay Arora, relatedness of hepatitis B virus isolates from Iran. from the ear or hemotympanum. Tuning fork It occurs in 5% of the cases of head injuries,[3] and D- 23, MMET Residential Complex, J Med Virol 2005;76:318-26. tests suggested mixed hearing loss. The pure- Mullana - 133 203, Ambala, India. 25% of facial injuries recover spontaneously.[4] E-mail: [email protected] 5. Kumar A, Kumar SI, Pandey R, Naik S, Aggarwal tone audiogram of the patient showed mixed Indian J Med Sci, Vol. 62, No. 5, May 2008 Indian J Med Sci, Vol. 62, No. 5, May 2008 LETTERS TO EDITOR 207 208 REFERENCES head injury: Case incidence, causes, clinical profi le and outcome. J Trauma 2006;61:388-91. PRACTITIONERS’ SECTION 4 Schaitkin B, May M. Disorders of the facial nerve. 1 Napoli AM, Panagos P. Delayed presentation of Scott-Brown’s Otolaryngology. 6th ed. Vol. 3, TELEDERMATOLOGY IN INDIA: PRACTICAL IMPLICATIONS traumatic facial nerve (CN VII) paralysis J Emerg Butterworth Heinemann; 1997. p. 24/11-12. KALIYADAN FEROZE Med 2005;29:421-4. 2 Popovic D, Stankovic M, Popovic Z, Milisavljevic D. Traumatic facial Palsy. Med Biol 2003;10:145-7. Source of Support: Nil ABSTRACT Confl ict of Interest: None declared. 3. Odebode TO, Ologe FE. Facial nerve palsy after Teledermatology is considered to be one of the solutions to the problem of inadequate number of dermatologists in remote parts of India. We present a brief account of the technological components involved in teledermatology in India, and an evaluation of the advantages and limitations of the use of teledermatology as a clinical tool. Key words: Interactive video consultation, ‘store and forward’ technology, teledermatology by telephone or e-mail, but the unique feature INTRODUCTION of advanced teledermatology is the two-way electronic network that allows immediate “I shall be telling this with a sigh interactive communication between the patient, Somewhere ages and ages hence: the primary care physician, and the specialist[1] Two roads diverged in a wood, The advantages of such an arrangement are I took the one less traveled by, immense, especially in a country like India with And that has made all the difference.” a large rural population having minimal access to specialist treatment. Author Help: Reference checking facility (From ‘The Road Not Taken’ by Robert Frost) The manuscript system (www.journalonweb.com) allows the authors to check and verify the accuracy and style of BACKGROUND references. The tool checks the references with PubMed as per a predefined style. Authors are encouraged to use Telemedicine is one of the most recent this facility before submitting articles to the journal. advances in medical technology. The Telemedicine services in our institution • The style as well as bibliographic elements should be 100% accurate to get the references verified from application of the principles of telemedicine started toward the end of 2002. Since then, the system. A single spelling error or addition of issue number / month of publication will lead to error to to dermatology is generally referred to as verifying the reference. the institution has had more than 1000 • Example of a correct style ‘teledermatology.’ Dermatologists have for teleconsultations from all over India. Included Sheahan P, O’leary G, Lee G, Fitzgibbon J. Cystic cervical metastases: Incidence and diagnosis using fine many years conducted long-range consultations in this are more than 100 teledermatology needle aspiration biopsy. Otolaryngol Head Neck Surg 2002;127:294-8. consultations (two-way interactive consultations). • Only the references from journals indexed in PubMed would be checked. In our short experience with teledermatology,
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