15/03/2023
THE CLINICAL EXAMINATION FOR FACIAL PALSY
👐 As you know, clinical examination is the basis of the diagnosis for facial palsy. It helps determine the extent and severity of nerve damage, as well as any accompanying symptoms. Some important criteria include eyelid closure, involvement of the stapedius muscle, tear and saliva secretion, and taste. It's important to note that incomplete eyelid closure and reduced tear production can carry the risk of corneal ulceration.
👂 Dysfunction of the stapedius muscle can cause hyperacusis for low frequencies, and taste disorders can lead to unpleasant sensations when eating. While taste disturbance is not enough to differentiate between idiopathic and Borrelia-induced facial palsy, OTOSCOPY must always be performed during the initial examination to rule out herpes blisters in the ear canal. In cases of severe pain, even without herpes blisters, Zoster infection (Zoster sine herpete) should be considered.
👂To assess the severity of facial palsy, the House-Brackmann scale (grades I to VI) can be used. Ultrasound can also be used for the assessment of reinnervation after nerve suture. The Stennert index in otolaryngology provides a good description of defect healing, allowing for evaluation of disease progression after surgical reconstruction.
🤳Standardized photo and video documentation is also used for tracking progress. Additionally, a new way of tracking progress is through the use of the FaceRehab application, which allows for the measurement of facial movements and progress over time. Another clinical scale, the Sunnybrook classification, is more elaborate but also more valid.
⚠️ REMEMBER, THERE IS SUPPORT AVAILABLE FOR THOSE WITH FACIAL PALSY. DON'T HESITATE TO REACH OUT TO YOUR HEALTHCARE PROVIDER OR SUPPORT GROUP FOR ASSISTANCE.
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Stay strong, Your Dr. Vyrvova