Neuroanatomical correlation of the House-Brackmann grading system in the microsurgical treatment of vestibular schwannoma

Sun, Matthew Z.; Oh, Michael C.; Safaee, Michael; Kaur, Gurvinder; Parsa, Andrew T.

doi:10.3171/2012.6.focus12198

Cited by 19 publications

(15 citation statements)

References 86 publications

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“…House and Brackmann classification was followed for demarcating the type of nerve injury in patients with extraoral surgical approach. This was carried out accounting the time period from date of surgery (nerve injury), and age factor as related to the progress of recovery and regeneration after nerve injury [3,[8][9][10][11].…”

Section: Extraoral Submandibular Approachmentioning

confidence: 99%

Comparison of Management of Mandibular Angle Fractures by Three Approaches

Sudhakar

Gaddipati

Dhanala

et al. 2015

J. Maxillofac. Oral Surg.

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Background and Objectives Various methods have been reported in the literature for treating mandibular angle fractures comparing extra oral, intra oral and transbuccal approaches for achieving the goals of restoration of anatomic form, maintenance of segment position and bony union. Materials and Methods This study was conducted to assess the simple and effective surgical approach in treating mandibular angle fractures and the outcome by means of three approaches i.e. intra oral, transbuccal and extra oral approaches. Results/Conclusion A total of 45 patients with mandibular angle fracture were divided into three groups. Group Iintra oral approach-15 patients, Group II-transbuccal with intraoral approach-15 patients, Group III-extra oral approach-15 patients. The results of our study found intraoral approach to be much better because it is simple, precise, duration is short, and post operative complications are less with minimal morbidity and pain.

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Section: Extraoral Submandibular Approachmentioning

confidence: 99%

Comparison of Management of Mandibular Angle Fractures by Three Approaches

Sudhakar

Gaddipati

Dhanala

et al. 2015

J. Maxillofac. Oral Surg.

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“…The progress phase lasts from the onset for 1-7 days [3], during which facial muscles become flaccid and asymmetry develops until complete progression [40]. The House-Brackmann grading system (HBGS) is below Grade 6 (Table 1) in this phase [41]. Relaxation and assist techniques for the face are necessary to prevent the progression of facial palsy and to stimulate the muscles and nerves (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…The plateau phase spans from complete progression to about 2-3 weeks. This phase is divided into 2 parts: first, the muscle strength of the weaker side doesn't change (the HBGB is between Grade 5 and Grade 6; Table 1), then the strength begins to increase (the HBGS is under Grade 5) [40,41]. To improve the strength of muscles and conduction of nerves, assistance and resistance techniques are needed (Fig.…”

Section: Discussionmentioning

confidence: 99%

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A Facial Chuna Manual Therapy for Peripheral Facial Nerve Palsy

Park¹,

Lee²,

Lee³

et al. 2019

J Acupunct Res

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The purpose of this study was to investigate useful manual therapy techniques for peripheral facial nerve palsy and to propose guidelines to be applied for current manual therapy techniques. Several databases were searched to find manual therapies for facial palsy. These therapies included cervical, and temporomandibular joint chuna manual therapy, proprioceptive neuromuscular facilitation, neuromuscular re-education, facial exercise, and mime therapy. Both cervical, and temporomandibular joint chuna manual therapy release nerve compression, helping blood circulation and nerve conduction. Proprioceptive neuromuscular facilitation uses irradiation, bilateral activation, and eccentric facilitation to improve muscle power and symmetry. Neuromuscular re-education, as a retraining tool for facial movement patterns, enhances neuromuscular feedback. Facial exercise helps the patient continuously move and massage facial muscle themselves. Mime therapy aims to develop a conscious connection between the use of certain muscles and facial expressions. The use of facial chuna manual therapy for peripheral facial nerve palsy can stimulate the proprioceptive neuromuscular receptors in the face. Peripheral facial nerve palsy has 4 phases; progress phase, plateau phase, recovery phase, and sequelae phase. Each phase needs different treatments which include relaxation, assistance, resistance, origin-insertion extension, and nerve pathway expansion.

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“…All patients had total hearing loss, proved by both clinical examination and audio-vestibular studies. All patients had intact facial nerve preoperatively (House-Brackmann grade I) [4]. All patients' data, diagnosis, and treatment outcomes are confidentially kept private, and patients are presented by specific codes.…”

Section: Patient Populationmentioning

confidence: 99%

Preservation of facial nerve functions during vestibular schwannoma surgery: outcome analysis

Farid

Elkholy

2019

Egypt J Neurosurg

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Background: The goal of modern vestibular schwannoma surgery is not only to complete tumor removal but also to preserve functions. Cerebellopontine angle surgery carries a significant risk of impairing facial nerve function especially with large masses. Avoidance of facial nerve injury postoperatively requires preoperative and intraoperative identification and hence the role of preoperative imaging and intraoperative monitoring. Objectives: To evaluate the impact of identification of facial nerve preoperatively and intraoperative neurophysiological monitoring on the preservation of facial nerve function. Study design: This is a retrospective clinical case series. Patients and methods: This study was conducted on 32 patients operated upon for excision of vestibular schwannoma. All had hearing loss but intact facial nerve (House-Brackmann (HB) grade I). Fast imaging employing steady-state acquisition was used preoperatively to predict the location of the facial nerve. Intraoperative monitoring was used for all patients. Patients were followed up for 24 months. Results: House-Brackmann grade I was achieved in 68.75% of patients. Grade VI was achieved in 12.5% of patients. Near-total removal was achieved in 62.5% of patients, and subtotal removal was achieved in 37.5%. The higher percentage of normal facial function postoperatively (HB grade I) was associated with subtotal resection and soft consistency of the neoplasm. Conclusion: Facial preservation requires preoperative prediction of the location of the nerve in relation to the capsule, extra-arachnoidal dissection during surgery, and subtotal resection if intraoperative monitoring predicts a high risk.

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Neuroanatomical correlation of the House-Brackmann grading system in the microsurgical treatment of vestibular schwannoma

Cited by 19 publications

References 86 publications

Comparison of Management of Mandibular Angle Fractures by Three Approaches

Comparison of Management of Mandibular Angle Fractures by Three Approaches

A Facial Chuna Manual Therapy for Peripheral Facial Nerve Palsy

Preservation of facial nerve functions during vestibular schwannoma surgery: outcome analysis

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