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[Facial paralysis in children]
Insights
Neonatal facial paralysis, often caused by birth trauma, usually resolves spontaneously. Persistent cases may require surgical intervention for the facial nerve.
Area of Science:
- Pediatric Neurology
- Otolaryngology
Context:
- Facial paralysis in children presents with varied causes and clinical courses.
- Neonatal facial paralysis is common, often linked to birth trauma affecting the facial nerve pathway.
Purpose:
- To categorize and describe the diverse etiologies of facial paralysis in pediatric patients.
- To outline diagnostic and therapeutic approaches for different types of childhood facial paralysis.
Summary:
- Neonatal facial paralysis typically resolves within days, but persistent cases (over three months) may necessitate decompressive surgery.
- Otitis media and mastoiditis are common causes of facial paralysis in children, requiring treatments like paracentesis, mastoidectomy, and antibiotics.
- Less frequent causes include viral infections, trauma, poliomyelitis, shingles, middle ear tumors, and rare conditions like vitamin D intoxication.
Impact:
- Provides a comprehensive overview of pediatric facial paralysis, aiding clinicians in diagnosis and management.
- Highlights the importance of considering anatomical variations in neonatal facial nerve surgery.
- Emphasizes the need for timely intervention in persistent cases to prevent long-term complications.
Abstract:
Facial paralyses in children may be grouped under headings displaying a certain amount of individuality. Chronologically, first to be described are neonatal facial paralyses. These are common and are nearly always cured within a few days. Some of these cases are due to the mastoid being crushed at birth with or without the use of forceps. The intra-osseous pathway of the facial nerve is then affected throughout its length. However, a cure is often spontaneous. When this desirable development does not take place within three months, the nerve should be freed by decompressive surgery. The special anatomy of the facial nerve in the new-born baby makes this a delicate operation. Later, in all stages of acute otitis, acute mastoiditis or chronic otitis, facial paralysis can be seen. Treatment depends on the stage reached by the otitis: paracentesis, mastoidectomy, various scraping procedures, and, of course, antibiotherapy. The other causes of facial paralysis in children are very much less common: a frigore or viral, traumatic, occur ring in the course of acute poliomyelitis, shingles or tumours of the middle ear. To these must be added exceptional causes such as vitamin D intoxication, idiopathic hypercalcaemia and certain haemopathies.