Treatment of facial nerve neuritis: correction protocol
Neuritis is an inflammation of the nerves responsible for controlling the movements of the facial muscles.
Marina Storozhuk , Ph.D., dermatologist-cosmetologist, assistant at the Department of Dermatovenereology of the Belarusian State Medical University, founder of the MSlinic Cosmetology & SPA Center (Ukraine)
The facial muscles are innervated peripherally (innervation of the infraorbital region) by the uncilateral seventh cranial nerve, and centrally (innervation of the supraorbital region) by the contralateral cerebral cortex. Central innervation is usually bilateral for the upper part of the face (eg, muscles of the forehead) and unilateral for the lower part. As a result of damage to both central and peripheral nerves, the lower part of the face is usually paralyzed. However, peripheral lesions (facial palsy) tend to affect the superior surface more than central lesions (eg, stroke).
Clinical picture : patient T., 47 years old, was diagnosed 2 years ago with right-sided neuritis of the facial nerve.
Complaints : decreased sensitivity on the right side of the face, asymmetrical smile, lag in the corner of the mouth when talking or smiling. PCR diagnostics for the presence of viruses, ultrasound, surface and stimulation electromyography were performed. Examination revealed weakness of the facial muscles, asymmetry of the smile, and lagophthalmos.
Present : sensory disturbance – the affected area becomes numb, paresthesia, disappearance/decrease in sensitivity, Chvostek’s sign, “racket” sign.
Cosmetological correction: Botulinum neuprotein (m. frontalis, m. corrugator, m. procerus, m. orbicularis oculi, m. nasalis, m. zygomaticus major, m. zygomaticus minor, m. levator labi superior, m. orbicularis oris, m. depressor anguli oris, m. mentalis, modiolus zone, t. Platysma), thread lifting 2 stages: reinforcing threads and lifting threads, laser resurfacing (CO2 laser, 1 pass, DEEP MODE: E 10 MJ, DENSITY 10% SUPERFICIAL MODE: E 70 MJ, DENSITY 60%) thermolifting (2D protocol, 3 procedures) contour plastic middle third, temporal area, perioral, periorbital zones.
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Photos provided by the author of the article.