Pediatric Allergy, Immunology, and Pulmonology, Ahead of Print.
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Σάββατο 5 Μαΐου 2018
Measuring Knowledge of Disease Management in Adolescents with Cystic Fibrosis: Initial Psychometric Evaluation
Shaping a universally broad antibody response to influenza amidst a variable immunoglobulin landscape
Sarah F Andrews | Adrian B McDermott
https://ift.tt/2Ik6EPV
Influenza vaccines: ‘tailor-made’ or ‘one fits all’
Giulietta Saletti | Thomas Gerlach | Guus F Rimmelzwaan
https://ift.tt/2HYSL6l
Immune evasion of the CD1d/NKT cell axis
Randy R Brutkiewicz | Laura Yunes-Medina | Jianyun Liu
https://ift.tt/2HXvphm
FDA approves new uses for two drugs administered together for the treatment of BRAF-positive anaplastic thyroid cancer
The U.S. Food and Drug Administration approved Tafinlar (dabrafenib) and Mekinist (trametinib), administered together, for the treatment of anaplastic thyroid cancer (ATC) that cannot be removed by surgery or has spread to other parts of the body (metastatic), and has a type of abnormal gene, BRAF V600E (BRAF V600E mutation-positive). Read the FDA's press release for more information.
The post FDA approves new uses for two drugs administered together for the treatment of BRAF-positive anaplastic thyroid cancer appeared first on American Thyroid Association.
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Cystadenoma of the mandible: a rare presentation
To our knowledge this is only the second reported case of a cystadenoma that arose in the mandible. These are rare benign epithelial neoplasms of the salivary gland that comprise 0.8%-6.3% of all minor tumours of the salivary gland. Because cystadenoma of the mandible is so rare, there is little evidence or guidance about management, and enucleation remains the recommended treatment. Careful histological diagnosis is important for differentiation from other morphologically similar salivary gland tumours such as a mucoepidermoid carcinoma.
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Factors predicting success in the Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination: a summary for OMFS
The Intercollegiate Membership of the Royal College of Surgeons (MRCS, parts A and B) is a mandatory examination for entry into higher surgical training in the UK. We investigated which factors predict success in both the written (Part A) and clinical (Part B) parts of the examination, and provide a summary for oral and maxillofacial surgeons (OMFS). All UK graduates who attempted both parts between 2007 and 2016 were included. There was a positive correlation between the scores in parts A and B (r=0.41, p<0.01).
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Epidemiology of epistaxis in the emergency department of a southern European tertiary care hospital
Publication date: Available online 5 May 2018
Source:Acta Otorrinolaringológica Española
Author(s): Luis Roque Reis, Filipe Correia, Luis Castelhano, Pedro Escada
ObjectiveEpistaxis is the most common rhinological emergency seen in the emergency department. The purpose of this study was to evaluate epidemiological data of epistaxis in a southern European tertiary care hospital.MethodsA retrospective study was conducted during the period between January 2009 and December 2015. We analyzed the distribution by cross-referencing the demographic variables, destination after medical discharge, inpatient characteristics (major comorbid diseases, medication, bleeding localization and treatment) and health-care costs with the disease.ResultsEpistaxis accounted for approximately 1 in 30 visits to the ED and 77 out of a population of 100,000 was served by that ED. Overall, 71,624 patients were treated and 2371 patients presented with epistaxis (3.31%). One-thousand three-hundred and twenty-seven cases were male and 1044 female (p <.001). The mean age was 56 years (±26). Age distribution was bimodal, with peaks among those <10 years and >70 (p <.001). Epistaxis was more common in the winter months (p < 0.001). The main referral destinations (6.8%) included outpatient (2.9%) and inpatient (1.9%) services. Hospitalization was more frequent between the ages of 60 and 80 years (p =.029), and the major comorbidity was hypertension (47.8%). Medication interfering with haemostasis was documented in 30.4%. Most inpatient epistaxis was managed in a non-interventional manner and only. 5% of patients needed surgery. The mean total health-care cost was 69.8 € per episode.ConclusionEmergency epistaxis was more frequent in men, the elderly, patients with underlying comorbidities, during the winter months, and showed a higher risk of referral and hospitalization with increasing age (as a result of an aging population in western countries). The main hospital expenses for epistaxis are related to hospitalization and health care costs.
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Selective Neck Dissection Technique in the Treatment of Recurrent Pyriform Sinus Fistula
Abstract
The 3rd and 4th branchial arch fistulas are rare conditions which are due to embryological persistence or incomplete developmental anomalies. They have a typical course as described by the embryological development but the presentation of cases with true course as per embryology is rare. These patients usually present with repeated infections, inadequate surgical interventions and recurrences. We present two index cases of 3rd and 4th pyriform sinus fistulas with their varied anatomical course and clinical presentation who were treated by selective neck dissection technique.
https://ift.tt/2JTzvrk
Selective Neck Dissection Technique in the Treatment of Recurrent Pyriform Sinus Fistula
Abstract
The 3rd and 4th branchial arch fistulas are rare conditions which are due to embryological persistence or incomplete developmental anomalies. They have a typical course as described by the embryological development but the presentation of cases with true course as per embryology is rare. These patients usually present with repeated infections, inadequate surgical interventions and recurrences. We present two index cases of 3rd and 4th pyriform sinus fistulas with their varied anatomical course and clinical presentation who were treated by selective neck dissection technique.
https://ift.tt/2JTzvrk
Multicentric Castleman’s disease in human immunodeficiency virus infection: two case reports
Castleman's Disease is a rare B-cell lymphoproliferative disease. It is mostly benign and is characterized by non-neoplastic lymph node hypertrophy, associated with infection by human herpesvirus-8 in people w...
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Outcome of Septorhinoplasty in Deviated Nose Deformity: One Year Cross-Sectional Study
Abstract
To evaluate outcome of Septorhinoplasty in Deviated nose deformity using Nasal Obstruction Symptom Evaluation (NOSE) scale and Rhinoplasty outcome evaluation score (ROE). This observational study was conducted in the department of Otorhinolaryngology and Head and Neck Surgery of KLE University's Jawaharlal Nehru Medical College and KLES Dr. Prabhakar Kore Hospital and Medical Research Center, Belagavi from January 2015 to December 2015. Forty patients were evaluated and comparisons were made for NOSE score preoperatively and postoperatively. Comparison of decrease in NOSE score with age distribution, sex distribution, type of septorhinoplasty, ROE score of patients and ROE score of surgeons were also made. ROE score of patients and ROE score of surgeons were correlated. Their statistical significance (p value) and Cohen's kappa (k) were calculated. Out of 40 patients, there were total of 16 Open Septorhinoplasty cases and 24 Close septorhinoplasty cases. NOSE score preoperatively and postoperatively showed statistically significant i.e., total score (p = 0.001). ROE score of patients and surgeons had poor correlation (k = 0.1; p = 0.2). Decrease in NOSE score postoperatively with ROE score of patients showed statistically significant (p = 0.01). There was no significance on comparison of decrease in NOSE score postoperatively with ROE score of surgeons (p = 0.09), age distribution (p = 0.1), sex distribution (p = 0.2) and septorhinoplasty (open/close) (p = 0.2). The outcome of septorhinoplasty has been validated with NOSE scale and ROE score and has been proven that there is improvement in nasal obstruction and quality of life after septorhinoplasty. The quality of life scoring is essential for patients subjected to septorhinoplasty for assessing success of the surgery.
https://ift.tt/2KD57Tl
Outcome of Septorhinoplasty in Deviated Nose Deformity: One Year Cross-Sectional Study
Abstract
To evaluate outcome of Septorhinoplasty in Deviated nose deformity using Nasal Obstruction Symptom Evaluation (NOSE) scale and Rhinoplasty outcome evaluation score (ROE). This observational study was conducted in the department of Otorhinolaryngology and Head and Neck Surgery of KLE University's Jawaharlal Nehru Medical College and KLES Dr. Prabhakar Kore Hospital and Medical Research Center, Belagavi from January 2015 to December 2015. Forty patients were evaluated and comparisons were made for NOSE score preoperatively and postoperatively. Comparison of decrease in NOSE score with age distribution, sex distribution, type of septorhinoplasty, ROE score of patients and ROE score of surgeons were also made. ROE score of patients and ROE score of surgeons were correlated. Their statistical significance (p value) and Cohen's kappa (k) were calculated. Out of 40 patients, there were total of 16 Open Septorhinoplasty cases and 24 Close septorhinoplasty cases. NOSE score preoperatively and postoperatively showed statistically significant i.e., total score (p = 0.001). ROE score of patients and surgeons had poor correlation (k = 0.1; p = 0.2). Decrease in NOSE score postoperatively with ROE score of patients showed statistically significant (p = 0.01). There was no significance on comparison of decrease in NOSE score postoperatively with ROE score of surgeons (p = 0.09), age distribution (p = 0.1), sex distribution (p = 0.2) and septorhinoplasty (open/close) (p = 0.2). The outcome of septorhinoplasty has been validated with NOSE scale and ROE score and has been proven that there is improvement in nasal obstruction and quality of life after septorhinoplasty. The quality of life scoring is essential for patients subjected to septorhinoplasty for assessing success of the surgery.
https://ift.tt/2KD57Tl
The characteristics and clinical significance of REM<10% in children with sleep-disordered breathing
Source:International Journal of Pediatric Otorhinolaryngology, Volume 110
Author(s): Liqiang Yang, Zhenyun Huang, Jianwen Zhong, Shuyao Qiu, Dabo Liu
ObjectiveFractional time in REM sleep <20% ('little REM sleep') is indicative of more severe sleep-disordered breathing (SDB) in adults. We examined if other REM% is predictive of more severe SDB in children.MethodsIn this retrospective study of 616 pediatric SDB patients, age, sex ratio, BMI, sleep efficiency, awakening frequency, sleep latency, apnea-hypopnea index (AHI), obstructive apnea index (OAI), and lowest oxygen pulse saturation (LSpO2) were compared among groups stratified according to REM%: REM≥20%, REM<20%, 15% ≤ REM<20%, 10% ≤ REM<15%, and REM<10%. Correlations with AHI, OAI, LSpO2, sleep efficiency, and awakening frequency were examined in REM<20% and REM<10% groups. Associations of these parameters with REM<10% were examined by single- and multifactor regression.ResultsPediatric SDB patients with little REM sleep demonstrated poorer sleep quality than patients with REM≥20%, while patients with REM<10% also exhibited more severe SDB. Specifically, the REM<20% group exhibited higher number of awakenings and lower sleep efficiency than the REM≥20% group (both P ≤ 0.001), as did each REM%<20% subgroup (lower sleep efficiency: all P < 0.05; higher awakening frequency: all P < 0.001). Moreover, compared to the REM≥20% group, the REM<10% also exhibited higher AHI (P = 0.025) and lower LSpO2 (P = 0.019). In the REM<10% group, individual REM% was negatively correlated with AHI (r = −0.216, P = 0.031) and positively with LSpO2 (r = 0.2, P = 0.046). Multifactor logistic regression correcting for age and BMI identified AHI as an independent predictor of REM<10% (P = 0.012, OR = 1.016, 95% CI [1.004,1.029]).ConclusionREM% <10% is associated with poor sleep quality and SDB severity in children, suggesting that this threshold should define "little REM sleep" in pediatric patients.
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Diagnostic Evaluation of Chronic Nasal Obstruction Based on Nasal Endoscopy and CT Scan Paranasal Sinus
Abstract
Evaluation of the accuracy of objective diagnostic modalities for nasal obstruction and their comparison to each other to reach the correct diagnosis with minimum cost and highest accuracy. This study was conducted in the Department of Otorhinolaryngology and Head Neck Surgery, Chirayu Medical College and Hospital, Bhopal from August 2016 to September 2017. A total of 50 patients from age group 1–70 years irrespective of sex with complaints of chronic nasal obstruction, which were unresponsive to routine appropriate medical therapy, were selected for this study. Comparative study among findings of nasal endoscopy and CT scan of the paranasal sinuses done. After clinical examination, patients were subjected to high resolution computed tomography (HRCT) of paranasal sinuses and diagnostic nasal endoscopy (DNE). The diagnostic results of both modalities were compared. The most common symptoms were nasal obstruction and nasal discharge 100%, followed by post nasal drip 62%. The complaints related to eye and ears were less frequent, found in 4% only. CRS (Chronic Rhinosinusitis) was most common pathology of nose for nasal obstruction which is in 72% cases. Sinonasal polyp is present in 20% of cases. Inverted papilloma in 4% cases. Granulomatous disease (Rhinosporidiosis) in 2% cases. Malignancy in 2% cases. In this series of 50 cases, nasal endoscopy revealed various pathological abnormalities mainly in the osteomeatal area. These include mucopurulent discharge in middle meatus seen in 100% of cases (50 patients). This could not be revealed in HRCT. Oedematous and polypoid infundibular mucosa/polyp in nasal cavity in 28% cases (14 patients) where it was not diagnosed in HRCT in three patients. Hence DNE proved superior to HRCT. Other abnormalities detected on nasal endoscopy were septal deviation 80% of cases (40 patients), inferior turbinate hypertrophy 66% of cases (33 patients), middle turbinate hypertrophy/concha bullosa in 48% of cases (24 patients). DNS was diagnosed in 42 patients in HRCT other causes of nasal obstruction such as Agar nasi cell is detected in 16% (8 patients), medialised uncinate process in 16% (8 patients), paradoxical MT in 30% cases were diagnosed more accurately in nasal endoscopy than HRCT. So nasal endoscopy proved better than CT scan. Nasal obstruction is the most common presenting complaint in day to day otolaryngology practice. Nobody would disagree with the role of CT scan and diagnostic nasal endoscopy in diagnosing the nasal and paranasal pathologies. But as a treating physician we are always concerned about early diagnosis and cost effectiveness. At the same time we also have to consider about patient waiting and work load. In this study we attempted to find out whether diagnostic nasal endoscopy can be better then CT scan, so that we can treat our patient appropriately. Though there has been an increased demand for imaging the paranasal sinuses with coronal CT because of functional endoscopic sinus surgery, nasal endoscopy is a better option in diagnosing and assessing the extent of disease and anatomy.
https://ift.tt/2HREGLZ
Round-robin test for the cell-of-origin classification of diffuse large B-cell lymphoma—a feasibility study using full slide staining
Abstract
Diffuse large B-cell lymphoma (DLBCL) is subdivided by gene expression analysis (GEP) into two molecular subtypes named germinal center B-cell-like (GCB) and activated B-cell-like (ABC) after their putative cell-of-origin (COO). Determination of the COO is considered mandatory in any new-diagnosed DLBCL, not otherwise specified according to the updated WHO classification. Despite the fact that pathologists are free to choose the method for COO classification, immunohistochemical (IHC) assays are most widely used. However, to the best of our knowledge, no round-robin test to evaluate the interlaboratory variability has been published so far. Eight hematopathology laboratories participated in an interlaboratory test for COO classification of 10 DLBCL tumors using the IHC classifier comprising the expression of CD10, BCL6, and MUM1 (so-called Hans classifier). The results were compared with GEP for COO signature and, in a subset, with results obtained by image analysis. In 7/10 cases (70%), at least seven laboratories assigned a given case to the same COO subtype (one center assessed one sample as not analyzable), which was in agreement with the COO subtype determined by GEP. The results in 3/10 cases (30%) revealed discrepancies between centers and/or between IHC and GEP subtype. Whereas the CD10 staining results were highly reproducible, staining for MUM1 was inconsistent in 50% and for BCL6 in 40% of cases. Image analysis of 16 slides stained for BCL6 (N = 8) and MUM1 (N = 8) of the two cases with the highest disagreement in COO classification were in line with the score of the pathologists in 14/16 stainings analyzed (87.5%). This study describes the first round-robin test for COO subtyping in DLBCL using IHC and demonstrates that COO classification using the Hans classifier yields consistent results among experienced hematopathologists, even when variable staining protocols are used. Data from this small feasibility study need to be validated in larger cohorts.
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Reliability and validity of the Japanese translation of the DN4 Diagnostic Questionnaire in patients with neuropathic pain
Abstract
Background
The Douleur Neuropathique 4 questionnaire (DN4) is a simple and objective tool developed by the French Neuropathic Pain Group to screen for neuropathic pain.
Methods
This prospective observational study was undertaken in three hospitals to assess the validity of a Japanese translation of the DN4. We first translated the DN4 into Japanese using a forward–backward method. Pain specialists then examined patients independently and diagnosed them with neuropathic or non-neuropathic pain, according to the International Association for the Study of Pain definitions. The Japanese version of the DN4 questionnaire was then given to each patient.
Results
Of 187 patients that met our inclusion criteria, 100 and 87 were diagnosed with neuropathic and non-neuropathic pain, respectively. The test–retest intra-class correlation coefficient (95% confidence interval) was 0.827 (0.769–0.870). Among patients with identical diagnoses of neuropathic or non-neuropathic pain, receiver-operating characteristic curve analysis revealed an area under the curve of 0.89. A cut-off point of equal or greater than 4 resulted in a sensitivity of 71% and specificity of 92%.
Conclusion
The Japanese version of the DN4 was found to be a helpful tool for discriminating between neuropathic and non-neuropathic pain.
https://ift.tt/2rlcNkX
Treatment of Tympanic Membrane Retraction Pockets by Excision and Cartilage Tympanoplasty: A Prospective Study
Abstract
To assess the role of cartilage tympanoplasty in management of retraction pockets of the pars flaccida. This was a prospective study at a tertiary care centre. Twenty patients having grade III or grade IV retraction pockets were included in the study. Retraction pockets were treated by excision and cartilage tympanoplasty. Findings noted on follow-up were recorded and analysed. Graft was taken up in 18 (90%) cases with residual perforation in 2 (10%) cases. Recurrence of retraction pockets was observed in 6 (30%) cases. Hearing was improved up to 15 dB in 16 (80%) cases. It is concluded that grade III and IV retraction pockets can be well managed by excision and cartilage tympanoplasty.
https://ift.tt/2jveMyY
Diagnostic Evaluation of Chronic Nasal Obstruction Based on Nasal Endoscopy and CT Scan Paranasal Sinus
Abstract
Evaluation of the accuracy of objective diagnostic modalities for nasal obstruction and their comparison to each other to reach the correct diagnosis with minimum cost and highest accuracy. This study was conducted in the Department of Otorhinolaryngology and Head Neck Surgery, Chirayu Medical College and Hospital, Bhopal from August 2016 to September 2017. A total of 50 patients from age group 1–70 years irrespective of sex with complaints of chronic nasal obstruction, which were unresponsive to routine appropriate medical therapy, were selected for this study. Comparative study among findings of nasal endoscopy and CT scan of the paranasal sinuses done. After clinical examination, patients were subjected to high resolution computed tomography (HRCT) of paranasal sinuses and diagnostic nasal endoscopy (DNE). The diagnostic results of both modalities were compared. The most common symptoms were nasal obstruction and nasal discharge 100%, followed by post nasal drip 62%. The complaints related to eye and ears were less frequent, found in 4% only. CRS (Chronic Rhinosinusitis) was most common pathology of nose for nasal obstruction which is in 72% cases. Sinonasal polyp is present in 20% of cases. Inverted papilloma in 4% cases. Granulomatous disease (Rhinosporidiosis) in 2% cases. Malignancy in 2% cases. In this series of 50 cases, nasal endoscopy revealed various pathological abnormalities mainly in the osteomeatal area. These include mucopurulent discharge in middle meatus seen in 100% of cases (50 patients). This could not be revealed in HRCT. Oedematous and polypoid infundibular mucosa/polyp in nasal cavity in 28% cases (14 patients) where it was not diagnosed in HRCT in three patients. Hence DNE proved superior to HRCT. Other abnormalities detected on nasal endoscopy were septal deviation 80% of cases (40 patients), inferior turbinate hypertrophy 66% of cases (33 patients), middle turbinate hypertrophy/concha bullosa in 48% of cases (24 patients). DNS was diagnosed in 42 patients in HRCT other causes of nasal obstruction such as Agar nasi cell is detected in 16% (8 patients), medialised uncinate process in 16% (8 patients), paradoxical MT in 30% cases were diagnosed more accurately in nasal endoscopy than HRCT. So nasal endoscopy proved better than CT scan. Nasal obstruction is the most common presenting complaint in day to day otolaryngology practice. Nobody would disagree with the role of CT scan and diagnostic nasal endoscopy in diagnosing the nasal and paranasal pathologies. But as a treating physician we are always concerned about early diagnosis and cost effectiveness. At the same time we also have to consider about patient waiting and work load. In this study we attempted to find out whether diagnostic nasal endoscopy can be better then CT scan, so that we can treat our patient appropriately. Though there has been an increased demand for imaging the paranasal sinuses with coronal CT because of functional endoscopic sinus surgery, nasal endoscopy is a better option in diagnosing and assessing the extent of disease and anatomy.
https://ift.tt/2HREGLZ
Does the association of blood-derived growth factors to nanostructured carbonated hydroxyapatite contributes to the maxillary sinus floor elevation? A randomized clinical trial
Abstract
Objective
The combination of calcium phosphate with blood-derived growth factors (BDGF) has been widely used in bone regeneration procedures although its benefits are still unclear. The purpose of this study was to evaluate whether or not BDGF improves the efficacy of a modified carbonated calcium phosphate biomaterial in sinus floor augmentation.
Material and methods
Ten patients underwent 20 sinus floor augmentation procedures using nanostructured carbonated hydroxyapatite (cHA) microspheres alone or associated with BDGF in a randomized controlled clinical trial. The in vitro release of growth factors was assessed by an elution assay. Bone grafts were randomly implanted in the right and left maxillary sinuses of each participant, associated either with a 0.9% saline solution or BDGF. Bone gain was evaluated through cone beam tomography after 180 days.
Results
Nine women and one man composed the sample. The blood-derived concentrates were able to release high levels of growth factors and cytokines. A significant clinical advantage was observed in the use of the BDGF after fibrin polymerization around the biomaterial microspheres, optimizing the surgical procedures, thereby reducing the time and displacement, and improving the adaptation of the biomaterial in the maxillary sinus. No synergistic effect was observed in bone formation when cHA was associated with BDGF (p > 0.05).
Conclusion
Equivalent new bone formation was observed for cHA in the presence or absence of the BDGF concentrate in bilateral sinus floor elevation after 6 months. Blood-derived growth factors did not improve bone repair when associated with calcium phosphate in sinus lift procedures.
https://ift.tt/2jx7efb
Evaluation of the low-level laser therapy application parameters for skin burn treatment in experimental model: a systematic review
Abstract
Burn is defined as a traumatic injury of thermal origin, which affects the organic tissue. Low-level laser therapy (LLLT) has gained great prominence as a treatment in this type of injury; however, the application parameters are still controversial in the literature. The aims of this study were to review the literature studies that use LLLT as a treatment in burns conducted in an experimental model, discuss the main parameters used, and highlight the benefits found in order to choose an appropriate therapeutic window to be applied in this type of injury. The selection of the studies related to the theme was carried out in the main databases (PubMed, Cochrane Library, LILACS, Web of Science, and Scopus in the period from 2001 to 2017). Subsequently, the articles were then chosen that fell within the inclusion criteria previously established. In the end, 22 were evaluated, and the main parameters were presented. The analyzed studies presented both LLLT use in continuous and pulsed mode. Differences between the parameters used (power, fluence, and total energy) were observed. In addition, the protocols are distinct as to the type of injury and the number of treatment sessions. Among the results obtained by the authors are the improvements in the local microcirculation and cellular proliferation; however, a study reported no effects with LLLT as a treatment. LLLT is effective in accelerating the healing process. However, there is immense difficulty in establishing the most adequate protocol, due to the great discrepancy found in the applied dosimetry values.
https://ift.tt/2wcyJE3
Treatment of Tympanic Membrane Retraction Pockets by Excision and Cartilage Tympanoplasty: A Prospective Study
Abstract
To assess the role of cartilage tympanoplasty in management of retraction pockets of the pars flaccida. This was a prospective study at a tertiary care centre. Twenty patients having grade III or grade IV retraction pockets were included in the study. Retraction pockets were treated by excision and cartilage tympanoplasty. Findings noted on follow-up were recorded and analysed. Graft was taken up in 18 (90%) cases with residual perforation in 2 (10%) cases. Recurrence of retraction pockets was observed in 6 (30%) cases. Hearing was improved up to 15 dB in 16 (80%) cases. It is concluded that grade III and IV retraction pockets can be well managed by excision and cartilage tympanoplasty.
https://ift.tt/2jveMyY
How Best to Manage Facial Synkinesis?
Abstract
Purpose of Review
Facial synkinesis is a sequela of facial nerve injury that results in involuntary facial movement occurring simultaneously with volitional facial movement. Inability to control facial movement has functional and psychological consequences and can be socially isolating. This review discusses the involved facial nerves and musculature, evaluation of the synkinetic face, and different treatment options.
Recent Findings
We reviewed the literature for advancements and outcomes in assessment, rehabilitation, and non-surgical and surgical treatments for facial synkinesis while highlighting anatomical correlates and movement patterns of commonly affected facial musculature.
Summary
Understanding facial muscular anatomy, including the intended vectors of movement, guides appropriate therapeutic intervention and improves outcomes. Chemodenervation and rehabilitation continue to be the main treatment strategy for facial synkinesis. In select cases, other techniques, such as selective neurolysis, selective myectomy, nerve grafting, or free muscle transfer, are also available.
https://ift.tt/2JX0Glh
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