You lose all voluntary control of half of your facial muscles, and you will have problems keeping food in your mouth while you are chewing. There will be a sensory loss in certain areas of the face which will feel numb. The facial nerve affects your ability to produce saliva and taste food.
Damage to the facial nerve can cause the taste to be altered. Food and beverages will taste strange or very bland. Some patients with facial nerve trauma will have no sense of taste at all. These changes can be permanent or temporary, depending on the nature of the trauma to the facial nerve.
Hearing changes can be a part of the damage to the facial nerve. One of your ears can hear things abnormally loud which can lead to a severe headache.
The condition called hyperacusis can be extremely uncomfortable. Because the facial nerve affects the sensation behind the ear, there can be pain and discomfort behind the affected ear. The facial nerve controls the motor aspect of the muscles of facial expression, taste, hearing, and some sensory areas.
Trauma to the nerve can damage the nerve permanently. Some things that can damage the facial nerve include:. If the damage to the facial nerve involves a crash injury or partial laceration of the nerve, there may be a spontaneous resolution of the function of the nerve.
If the nerve is totally cut, there may be no hope of recovering the function. A nervous system problem can do damage to the facial nerve in the same way other nerves of the body are affected.
For example, if a person has a stroke involving the brain stem, they may have a unilateral or bilateral loss of function of the complete seventh cranial nerve. Swallowing and chewing may be difficult if the stroke is large enough. It is a crucial area to lose because of a stroke. There are certain tumors a person can get which involve the face or anywhere along the tract of the seventh cranial nerve.
The specific tumors include:. Infections of the face or ear can damage the facial nerve. One such infection is herpes zoster or shingles. Shingles involve having the chicken pox infection just along a single nerve. It often yields severe pain, followed by numbness, and pustules on the side of the face which is involved in the infection. When herpes zoster affects the facial nerve, the condition is called Ramsay Hunt syndrome.
Toxins can cause damage to the facial nerve like alcohol ; the disease happens in chronic alcoholism. Exposure to excessive amounts of carbon monoxide can damage the facial nerve on a temporary basis. It is also known as idiopathic facial nerve paralysis. It involves the relatively quick onset of complete facial paralysis and the inability to close the eye on one side of the face.
It is completely painless but annoying. It is sometimes linked with patients also having diabetes mellitus and in patients who are pregnant at the time of the onset of the disease. Regardless of the cause of the facial nerve disorder, the workup of the seventh cranial nerve involves looking at the face and checking on the symmetry of the muscles of facial expression.
The patient needs to raise their eyebrows, close their eyes, smile widely, grimace, and wiggle their nose. These are all just ways of seeing which muscles work and which muscles do not. All the many branches of the seventh cranial nerve need to be assessed. Specialists have certain scales they use to measure the function of the facial nerve.
If the main portion of the nerve is involved, the House-Brackmann scale is used, but it is not used when only branches of the nerve are affected.
Instead, the doctors subjectively describe the deficits. If there is a deficit at the level of the brainstem, the entire left or right side of the face is affected. If the damage is at the level of the brain, only the lower half of the face is affected because the upper half is innervated by both sides of the brain. It is vital to assess the severity of the injury to the seventh cranial nerve.
The more severe the injury, the less likely it is for the patient will recover. There are five different degrees of injury labeled in the Sunderland Classification. First degree injuries almost always recover while fifth degree injuries are likely to have no recovery. Leitch et al. A year-old amateur soccer player with a minor head injury while heading a ball in the air.
After two days he developed profound left lower motor neuron facial nerve palsy. On examination, his Glasgow coma score was 15 and his cranial nerves were intact. He had surgical emphysema in the left pre-auricular area and blood in the left external auditory canal. Despite delayed treatment, the patient experienced complete recovery 5. White believes that facial paralysis is a fundamental challenge for the surgical team, which requires a full evaluation to guide the surgeon to choose the appropriate treatment.
Immediate facial nerve repair is necessary to be continued as the standard of care following traumatic denervation. Secondary repair is preferred using special techniques.
However, patients should be advised that it is difficult to return their initial symmetry and facial movements and the methods described are not able to return all facial movements 6. We would like to express our special thanks to all Fatemi hospital personnel for their help and support. National Center for Biotechnology Information , U. Journal List Trauma Mon v. Trauma Mon. Published online Mar Author information Article notes Copyright and License information Disclaimer. Received Jul 16; Accepted Jul This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.
This article has been cited by other articles in PMC. Abstract Introduction Facial paralysis is a devastating condition with profound functional, aesthetic and psychosocial consequences. Case Presentation Our patient was a year-old man with deep laceration wounds. Conclusions Complete rupture of the facial nerve is challenging and the treatment is surgery, which requires careful planning. Introduction Facial nerve palsy causes functional, aesthetic and psychological difficulties.
Case Presentation Our patient was a year-old man referred with stab wound causing deep lacerations in the left temporal area of approximately 2 cm in front of the ears to the area under the lower lip. The seventh cranial nerve travels through parts of the skull alongside the eighth cranial nerve, which controls hearing, so these symptoms may occur at the same time.
MRI scans use radio waves and a magnetic field to create computerized, three-dimensional images of soft tissues in the body. Doctors use an MRI to examine the entire facial nerve.
This imaging test also allows a doctor to identify swelling or a growth on or near the nerve. Your doctor may recommend a type of MRI that uses a contrast agent, or dye, called gadolinium. When the dye is injected into the bloodstream, it travels to the facial nerve, highlighting areas of inflammation.
The stapedius reflex test is a type of hearing test that audiologists—specialists who study hearing loss, balance problems, and related disorders—use to assess damage to the seventh cranial nerve. During the test, an audiologist uses noise to stimulate the stapedius muscle, a tiny muscle in the middle ear.
The nerve that controls facial muscles also controls the stapedius muscle. A doctor may be able to pinpoint the location of a problem on the facial nerve based on whether the stapedius muscle responds to the test. If this muscle does not respond, it may indicate that the area of the facial nerve that controls the stapedius is affected.
Electroneurography is a test used to evaluate the function of peripheral nerves, which include the facial nerve. Ideally, this test is performed within 14 days of the onset of paralysis.
The results help doctors determine whether further testing or intervention may be required. To perform this test, an audiologist places several electrodes on the face and at the base of the ear on both sides of your face.
The electrodes are flat, adhesive discs that stick to the skin and are attached to a machine that produces a low electrical current. The sensation may tingle but is not painful.
A doctor stimulates the facial nerves and measures the muscle response to stimulation. The results help doctors determine whether the nerves can return to full function without intervention. If the paralyzed muscles display less than 10 percent of the function that healthy muscles show on the other side, this may suggest that the paralysis may be permanent. Your doctor may conduct this test two or three times during the weeks after diagnosis to assess whether nerve function is improving.
An electromyogram measures the electrical impulses transmitted along nerves and muscle tissue. This test helps doctors evaluate weakness or paralysis in the facial muscles or nerves. During an electromyogram, a doctor inserts small, thin needle electrodes through the skin and into facial muscles that correspond to specific nerves. He or she then asks you to move these muscles if you can.
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