Facial nerve injury in neurosurgery: a rehabilitation potential of botulinum therapy

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Surgical treatment of posterior cranial fossa and cerebellopontine angle tumors is associated with a risk of facial nerve dysfunction. The causes for facial muscle paresis include nerve compression by the tumor, destruction of the nerve structure by the tumor growing from nerve fibers, nerve injury during surgical removal of the tumor, etc. The first 3 months after facial nerve injury are a potential therapeutic window for the use of botulinum toxin type A (BTA). During this period, the drug is introduced both in the healthy side to improve the facial symmetry at rest and during mimetic movements and in the affected side to induce drug-induced ptosis. Post-paralytic syndrome develops 4—6 months after facial nerve injury. At this stage, administration of BTA is also an effective procedure; in this case, drug injections are performed on the affected side at small doses and symmetrically on the healthy side at doses doubling those for the affected side. BTA injections are mandatory in complex treatment of facial muscle paralysis.

Keywords:

posterior cranial fossa tumors

cerebellopontine angle tumors

skull base tumors

facial nerve injury

drug-induced ptosis

synkinesis

botulinum toxin type A

Authors:

Akulov M.A.

FGBNU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Orlova O.R.

Moskovskiĭ nauchno-prakticheskiĭ Tsentr dermatovenerologii i kosmetologii Departamenta zdravookhraneniia Moskvy, 119071, Moskva, Rossiĭskaia Federatsiia

SPIN RSCI: 9007-4907
Scopus AuthorID: 7006342537
ORCID: 0000-0003-2225-3642

Tabashnikova T.V.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Karnaukhov V.V.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Orlova A.S.

I.M. Sechenov First Moscow State Medical University, Moscow

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