Ultrasound-Guided Treatment for Facial Paralysis (Facial Nerve Block)

Release time:

2024/06/20

Ultrasound-Guided Treatment for Facial Paralysis (Facial Nerve Block)

 

Facial nerve paralysis, also known as idiopathic facial nerve palsy or Bell's palsy, is a condition where damage to the facial nerve results in muscle paralysis. There are two main types: central and peripheral facial paralysis.

 

Central Facial Paralysis:

  • Affects the lower part of the face on the side opposite to the lesion.
  • Symptoms include a shallow nasolabial fold, crooked mouth, speech leakage, but preserved forehead wrinkles, and no issues with eyebrow raising or eye closing.
  • While voluntary facial movements are lost on the lesion's opposite side, expressions like crying or laughing remain intact.

Peripheral Facial Paralysis:

  • Affects the upper and lower face muscles on the same side as the lesion.
  • Symptoms include larger eye fissures, shallow nasolabial folds, crooked mouth, speech leakage, drooling, and inability to frown, close the eyes, or whistle. Some patients may feel discomfort in the lips and cheeks.
  • The most common idiopathic facial nerve palsy symptom is the Bell phenomenon, where the eye moves upward and outward when trying to close it forcefully, exposing the white sclera.

Causes of Facial Paralysis:

  • Exposure to cold, cold wind, or cold water, and sleeping with open windows.
  • Prolonged fatigue, weakened immune system, leading to susceptibility.
  • Viral infections, often triggered by viruses latent in the facial nerve ganglia.
  • Ear infections, such as otitis media.
  • Autoimmune reactions.
  • Tumors.
  • Neurogenic and traumatic causes.

 

 

 

The facial nerve originates from the central nervous system within the skull and ultimately extends to the face, controlling facial muscle movements. Due to its long pathway, damage to any motor neurons along this route can result in facial paralysis. Ultrasound-guided facial nerve block can significantly alleviate the pain caused by geniculate neuralgia, facial muscle spasms, and facial dystonia. The ultrasound technique shows the following:

Using a convex array probe better distinguishes anatomical structures, allowing for precise guided injections of a mixture of betamethasone, lidocaine, vitamin B12, and sodium chloride.

 

Advantages of Ultrasound Guidance:

Increased Success Rate:

  1. Accurate Positioning: Ultrasound clearly identifies the nerve and surrounding structures, aiding in precise needle placement.
  2. Shortened Onset Time: Visualization of the drug spreading helps in timely needle adjustments for optimal diffusion.

Reduced Complications:

  1. Minimized Puncture-Related Complications: Fewer punctures and reduced risk of damaging surrounding tissues and organs.
  2. Lower Drug Dosage: Ultrasound guidance allows for precise injection, reducing the amount of anesthetic needed.
  3. Decreased Systemic Toxicity: Reduced risk of accidental intravascular injection and subsequent drug toxicity.
  4. Reduced Nerve Damage: Evidence shows a significant reduction in inadvertent intraneural injections.

 

In conclusion, ultrasound-guided treatment offers a safer and more effective approach to managing facial paralysis, ensuring better patient outcomes and fewer complications.