No abstract

1 . Loss of facial nerve function leads to facial disfigurement, increased salivation, alteration of taste as well as ocular complications. Decreased orbicularis oculi muscle strength can lead to ocular surface and eyelid problems such as epiphora, lagophthalmos, paralytic ectropion and exposure keratopathy. Loss of corneal protection can lead to corneal ulceration and potential blindness if treatment is delayed 2 . Treatment usually consists of a combination of eye lubrication, eyelid taping and, in severe cases, a tarsorrhaphy.Cranial nerve VII (CN VII) paresis occurs with an incidence of approximately 20.2 cases per 100,000 people per year 3 . It can occur at any age but the highest incidence is in people between 15-45 years of age 4 . Cranial Nerve VII paresis typically has a sudden onset (i.e. within 24 hours) and its progression can be followed during the first seven to ten days. A large, observational study conducted in Copenhagen studied the natural history of 1,701 patients with CN VII paresis by examining patients weekly for the first six months and then monthly for the following six months. The CN VII paresis was diagnosed ABSTRACT: Background: To determine if fine-motor eye exercises can be used for treatment of unilateral, idiopathic cranial nerve VII paresis to improve rate of recovery. Methods: In this prospective, randomized controlled trial, eligible patients were randomized to perform fine-motor eye exercises (n=18) or to do no exercise (n=9) for a period of four weeks. Orbicularis oculi muscle strength was measured in paretic and unaffected eyes at baseline, two weeks and four weeks using an Orbicularis Oculi Pressure Sensor. Results: The average initial strength of the paretic orbicularis oculi muscle was 34±10 mm Hg compared to the unaffected muscle which was 103±17 mm Hg at baseline (n=27). By four weeks, patients who performed eye exercises improved more than those who did not (74.4 versus 47.4 mm Hg, p=0.029). While there was some loss to follow-up, 63.8% of patients performing exercises (7/11) achieved functional recovery at four weeks compared to 12.5% (1/8) of those who did not (p=0.059). Steroids and antivirals were found to have independent positive effects on improving functional outcome. Conclusions: Eye exercises have a potential role in the treatment of idiopathic cranial nerve VII paresis and warrant consideration in the management of these patients.RÉSUMÉ: Exercices oculaires dans le traitement de la paralysie idiopathique du VIIe nerf crânien : une étude pilote. Contexte : Le but de l'étude était de déterminer si les exercices oculaires de motricité fine peuvent être utilisés pour traiter la paralysie du VIIe nerf crânien afin d'améliorer le taux de guérison. Méthode : Les patients éligibles à cette étude prospective, randomisée et contrôlée, ont fait soit des exercices oculaires de motricité fine (n = 18) ou aucun exercice (n = 9) pendant quatre semaines. La force du muscle orbiculaire de l'oeil a été mesurée au niveau de l'oeil parétique et de l'oeil normal avant l'intervent...

No abstract