Objective To evaluate the effect of PNS on Idiopathic facial palsy. Methods A total of 86 cases of acute idiopathic facial paralysis were randomly divided into the treatment group (PNS group, 44 cases), and the control group (42 cases). The basis of the two groups included hormone therapy, B vitamins, anti-viral treatment, as well as acupuncture and physical therapy, both in the incidence of 7 days to give the treatment. House-Brackmann facial nerve function classification and evaluation were used to determine clinical efficacy; ENoG line was tested before and after treatment. Results Before H-B classification of facial nerve function, EnoG side of the latency and amplitude in the two groups were comparable. At 28 days after treatment, H-B scores for the treatment group and the control group were (2.33 ± 1.21) and (3.08 ± 1.35), respectively, and the two groups had significant differences (Plt;0.05); ENoG incubation period (2.46 ± 0.34) and amplitude (189 ± 67) of the treatment group were more than those of the control group; the incubation period (3.37 ± 0.49) and amplitude (131 ± 52) improved, and there were significant differences between the two groups (Plt;0.05). Comparison of efficacy of the two groups showed the total effective rate: 95.45% in the treatment group, 80.95% in the control group, and the efficacy of the treatment group was better than that of the control group (Plt;0.05). Conclusion Sanqi tongshu, B vitamins, anti-virus, such as the acupuncture and physical therapy for the treatment of acute idiopathic facial paralysis have significant effect.
Using transplantation of free muscle with microneurovascular anastomosis for 46 cases of late facial paralysis, we selected M. latissimus dorsi as neurovascularized muscle bundle graft in 28 of them. This was not only an operation for facial dynamic reconstruction but also a new method for reinnervation of oral and ocular sphincter. After operation all of them revealed symmetry with voluntary motions. The results were satisfactory. The indications for surgical treatment, the procedure, and the management after the treatment were discussed in details. The importance of reeducation of the regenerating nerve and the necessity of twostaged operation were also discussed.
Objective To evaluate the therapeutic effect and complications of modified surgical treatment for parotid benign tumors. Methods Forty-nine patients with parotid tumors treated between February 2007 and February 2013 were randomly divided improved surgery group (trial group,n=24) and traditional surgery group (control group,n=25). Follow-up lasted from two months to two years after surgery. Postoperative complications (facial paralysis, Fery’s syndrome, local deformity, and salivary fistula) and recurrence were observed and compared between the two groups. Results All the 49 patients were followed up from two months to one year after surgery. Two years after surgery, three patients in the trial group and four in the control group were missing during the follow-up. No recurrence occurred in all the patients. There were no permanent facial paralysis cases in both groups. No temporary facial paralysis occurred in the trial group, while there were five such cases in the control group with an incidence rate of 20.0%. The trial group had one case of Fery’s syndrome with an incidence rate of 4.2%, and the control group had 4 such cases with an incidence rate of 16.0%. After surgery, the 24 patients in the trail group achieved general facial symmetry without any facial depression deformity, while there were 3 cases of mild facial depression and 1 obvious facial depression in the control group with an incidence rate of 16.0%. Five patients in the control group had saliva fistula with an incidence rate of 24.0% while one in the trail group (4.2%). The differences in the total rate of complications occurrence between the two groups were statistically significant (P<0.05). Conclusion The improved surgical treatment can effectively reduce complications after surgery for parotid benign tumors, which is worthy of clinical promotion.
ObjectivesTo assess the efficacy and safety of corticosteroid and antiviral agents for idiopathic facial nerve paralysis (IFNP) by network meta-analysis.MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WangFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) of corticosteroid and antiviral agents for IFNP from inception to January 31th, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. The meta-analysis was performed by R 3.3.3 and Stata 13.0 software.ResultsA total of 16 RCTs involving 3 061 patients were included. The results of network meta-analysis showed that: for the facial function recovery rates, corticosteroid plus antiviral agents was superior to placebo and antiviral agents alone at 3-month follow-up. Corticosteroid plus antiviral agents was superior to placebo, antiviral agents or corticosteroid alone at 6-month follow-up (if the satisfactory recovery was defined as a House-Brackmann grade class Ⅱ or below). When the follow-up exceeded 6 months, corticosteroid alone was superior to placebo and antiviral agents alone, corticosteroid plus antiviral agents was superior to placebo and antiviral agents alone. All of the differences above were statistically significant. For the sequelae, corticosteroid plus antiviral agents and corticosteroid alone were superior to placebo and antiviral agents alone. Corticosteroid plus antiviral agents was superior to corticosteroid alone. The differences were statistically significant. For the adverse events, there were no significant differences between any other pairwise comparisons of these different interventions.ConclusionConsidering the efficacy and safety, patients with IFNP treated corticosteroid plus antiviral agents are more likely to have a better recovery of facial function and less likely to develop sequelae, followed by corticosteroid alone. More high-quality, large scaled and multicenter RCTs are required to verify the conclusions above, and focus on the treatment of children and patients with severe facial paralysis.