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Lassaletta L, Calvino M, Díaz M, Morales-Puebla JM, Sánchez-Cuadrado I, Varela-Nieto I, Gavilán J. Intraoperative assessment of cochlear nerve functionality in various vestibular schwannoma scenarios: Lessons learned. Hear Res 2024; 446:108997. [PMID: 38564963 DOI: 10.1016/j.heares.2024.108997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/04/2024]
Abstract
The use of cochlear implants (CIs) is on the rise for patients with vestibular schwannoma (VS). Besides CI following tumor resection, new scenarios such as implantation in observed and/or irradiated tumors are becoming increasingly common. A significant emerging trend is the need of intraoperative evaluation of the functionality of the cochlear nerve in order to decide if a CI would be placed. The purpose of this paper is to explore the experience of a tertiary center with the application of the Auditory Nerve Test System (ANTS) in various scenarios regarding VS patients. The results are compared to that of the studies that have previously used the ANTS in this condition. Patients with unilateral or bilateral VS (NF2) who were evaluated with the ANTS prior to considering CI in a tertiary center between 2021 and 2023 were analyzed. The presence of a robust wave V was chosen to define a positive electrical auditory brainstem response (EABR). Two patients underwent promontory stimulation (PromStim) EABR previous to ANTS evaluation. Seven patients, 2 NF-2 and 5 with sporadic VS were included. The initial scenario was simultaneous translabyrinthine (TL) tumor resection and CI in 3 cases while a CI placement without tumor resection was planned in 4 cases. The ANTS was positive in 4 cases, negative in 2 cases, and uncertain in one case. Two patients underwent simultaneous TL and CI, 1 patient simultaneous TL and auditory brainstem implant, 3 patients posterior tympanotomy with CI, and 1 patient had no implant placement. In the 5 patients undergoing CI, sound detection was present. There was a good correlation between the PromStim and ANTS EABR. The literature research yielded 35 patients with complete information about EABR response. There was one false negative and one false positive case; that is, the 28 implanted cases with a present wave V following tumor resection had some degree of auditory perception in all but one case. The ANTS is a useful intraoperative tool to asses CI candidacy in VS patients undergoing observation, irradiation or surgery. A positive strongly predicts at least sound detection with the CI.
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Affiliation(s)
- Luis Lassaletta
- Department of Otolaryngology, La Paz University Hospital, Madrid, Spain; La Paz Research Institute (IdiPAZ), Madrid, Spain; Biomedical Research Networking Centre On Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain
| | - Miryam Calvino
- Department of Otolaryngology, La Paz University Hospital, Madrid, Spain; La Paz Research Institute (IdiPAZ), Madrid, Spain; Biomedical Research Networking Centre On Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain
| | - Miguel Díaz
- MED-EL Elektromedizinische Geräte GmbH. Madrid, Spain
| | - José Manuel Morales-Puebla
- Department of Otolaryngology, La Paz University Hospital, Madrid, Spain; La Paz Research Institute (IdiPAZ), Madrid, Spain; Biomedical Research Networking Centre On Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain
| | - Isabel Sánchez-Cuadrado
- Department of Otolaryngology, La Paz University Hospital, Madrid, Spain; La Paz Research Institute (IdiPAZ), Madrid, Spain
| | - Isabel Varela-Nieto
- La Paz Research Institute (IdiPAZ), Madrid, Spain; Biomedical Research Networking Centre On Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain; Neuropathology of Hearing and Myelinopathies, Instituto de Investigaciones Biomédicas Sols-Morreale, CSIC-UAM, Madrid, Spain
| | - Javier Gavilán
- Department of Otolaryngology, La Paz University Hospital, Madrid, Spain; La Paz Research Institute (IdiPAZ), Madrid, Spain
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Mato-Patino T, Sánchez-Cuadrado I, Peñarrocha J, Morales-Puebla JM, Díez-Sebastián J, Gavilán J, Lassaletta L. Validation of the Spanish version of the Electronic Facial Palsy Assessment (eFACE). Eur Arch Otorhinolaryngol 2024; 281:673-682. [PMID: 37535079 PMCID: PMC10796419 DOI: 10.1007/s00405-023-08132-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/13/2023] [Indexed: 08/04/2023]
Abstract
PURPOSE The clinician-graded electronic facial paralysis assessment (eFACE) is a relatively new digital tool for assessing facial palsy. The present study aimed to determine the validity and reliability of the Spanish version of the eFACE. METHODS Forward-backward translation from the original English version was performed. Videos and photographs from 65 adult patients with unilateral facial paralysis (any severity, time course, and etiology) were evaluated twice by five otolaryngologists with varying levels of experience in facial palsy evaluation. Internal consistency was measured using Cronbach's α and the intra- and inter-rater reliability were measured using intraclass correlation coefficient. Concurrent validity was established by calculating Spearman's rho correlation (ρ) between the eFACE and the House-Brackmann scale (H-B) and Pearson's correlation (r) between the eFACE and the Sunnybrook Facial Grading System (SFGS). RESULTS The Spanish version of the eFACE showed good internal consistency (Cronbach's α > 0.8). The intra-rater reliability was nearly perfect for the total score (intraclass correlation coefficient: 0.95-0.99), static score (0.92-0.96), and dynamic score (0.96-0.99) and important-to-excellent for synkinesis score (0.79-0.96). The inter-rater reliability was excellent for the total score (0.85-0.93), static score (0.80-0.90), and dynamic score (0.90-0.95) and moderate-to-important for the synkinesis score (0.55-0.78). The eFACE had a very strong correlation with the H-B (ρ = - 0.88 and - 0.85 for each evaluation, p < 0.001) and the SFGS (r = 0.92 and 0.91 each evaluation, p < 0.001). CONCLUSION The Spanish version of the eFACE is a reliable and valid instrument for assessment of facial function in the diagnosis and treatment of patients with facial paralysis.
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Affiliation(s)
- Teresa Mato-Patino
- Department of Otolaryngology, La Paz University Hospital, Madrid, Spain.
- PhD Program in Medicine and Surgery, Autonomous University of Madrid, Madrid, Spain.
| | - Isabel Sánchez-Cuadrado
- Department of Otolaryngology, La Paz University Hospital, Madrid, Spain
- IdiPAZ Research Institute, Madrid, Spain
| | - Julio Peñarrocha
- Department of Otolaryngology, La Paz University Hospital, Madrid, Spain
| | - José Manuel Morales-Puebla
- Department of Otolaryngology, La Paz University Hospital, Madrid, Spain
- IdiPAZ Research Institute, Madrid, Spain
- Biomedical Research Networking Centre On Rare Diseases (CIBERER), Institute of Health Carlos III (CIBERER-U761), Madrid, Spain
| | | | - Javier Gavilán
- Department of Otolaryngology, La Paz University Hospital, Madrid, Spain
- IdiPAZ Research Institute, Madrid, Spain
| | - Luis Lassaletta
- Department of Otolaryngology, La Paz University Hospital, Madrid, Spain
- IdiPAZ Research Institute, Madrid, Spain
- Biomedical Research Networking Centre On Rare Diseases (CIBERER), Institute of Health Carlos III (CIBERER-U761), Madrid, Spain
- PhD Program in Medicine and Surgery, Autonomous University of Madrid, Madrid, Spain
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Morales-Puebla JM, Gavilán J, Lassaletta L. Inverted clip technique for cochlear implant electrode array fixation: how I do it. Eur Arch Otorhinolaryngol 2024; 281:1057-1060. [PMID: 38001386 DOI: 10.1007/s00405-023-08329-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Electrode migration has been identified as a complication primarily related to straight electrodes. To address this issue, the use of a fixation clip has been suggested as an alternative to stabilize the electrode lead and reduce the risk of migration. METHODS A modified approach to the standard fixation clip procedure is introduced. Steps and technical considerations are presented in the video attached. CONCLUSIONS This novel configuration offers enhanced fixation of the electrode array without requiring additional surgical time and without posing any additional risk to the facial nerve.
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Affiliation(s)
- José Manuel Morales-Puebla
- Department of Otorhinolaryngology, La Paz University Hospital, Paseo La Castellana 261, 28046, Madrid, Spain.
- IdiPAZ Research Institute, Madrid, Spain.
- Biomedical Research Networking Centre On Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain.
| | - Javier Gavilán
- Department of Otorhinolaryngology, La Paz University Hospital, Paseo La Castellana 261, 28046, Madrid, Spain
| | - Luis Lassaletta
- Department of Otorhinolaryngology, La Paz University Hospital, Paseo La Castellana 261, 28046, Madrid, Spain
- IdiPAZ Research Institute, Madrid, Spain
- Biomedical Research Networking Centre On Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain
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Lassaletta L, Sánchez-Cuadrado I, Mato-Patino T, Peñarrocha J, Angélica Rivera-Núñez M, María Torres Santos-Olmo R, Gavilán J, Manuel Morales-Puebla J, Group COHC. Has Coranavirus Disease 2019 Changed the Incidence and Outcome of Bell's Palsy? J Int Adv Otol 2024; 20:19-25. [PMID: 38454284 PMCID: PMC10895820 DOI: 10.5152/iao.2024.231254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 08/23/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Objectives: (1) To determine whether the incidence of Bell's Palsy (BP) increased during the pandemic. (2) To investigate whether the outcomes of patients with BP and COVID-19 infection or vaccination differ from those in the pre-pandemic era. METHODS Patients with BP were studied in 2 periods retrospectively (March 2021-March 2022 and August 2018-August 2019). A prospective study from March 2021 to March 2022 was also performed. Primary outcome was grade ≤Ⅱ in the House-Brackmann (HB) and/or >70 in the Sunnybrook facial grading system (SFGS) scales at the 12-week visit. Reverse transcriptase polymerase chain reaction (PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and enzyme-linked immunosorbent assay-based SARS-CoV-2 immuonoglobulin G (IgG) test (blood) were measured. RESULTS About 162 and 196 patients with BP were identified between March 2021 and March 2022 and August 2018 and August 2019, respectively. Forty-seven patients (29%) entered the prospective study; 85% had HB grades I or II, while 92% had an SFGS score of 71-100 at the last visit. Only 3 patients (6.5%) had a positive PCR during the initial episode, whereas 35 patients (77%) had positive IgG SARS-CoV-2. There was no association between positive PCR and facial function outcomes. Of the 162 patients, 105 (67%) had received COVID-19 vaccine. In 23 of them (22%), the paralysis appeared within the first 30 days after a vaccine dose. CONCLUSION Coronavirus disease 2019 did not increase the incidence of BP. A direct association between the coronavirus and BP outcome cannot be established. The considerable number of patients developing BP within the first month suggests a possible association between COVID-19 vaccines and BP.
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Affiliation(s)
- Luis Lassaletta
- Department of Otorhinolaryngology, La Paz University Hospital, Madrid, Spain, IdiPAZ Research Institute, Madrid, Spain, Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain
| | - Isabel Sánchez-Cuadrado
- Department of Otorhinolaryngology, La Paz University Hospital, Madrid, Spain, IdiPAZ Research Institute, Madrid, Spain
| | - Teresa Mato-Patino
- Department of Otorhinolaryngology, La Paz University Hospital, Madrid, Spain
| | - Julio Peñarrocha
- Department of Otorhinolaryngology, La Paz University Hospital, Madrid, Spain
| | | | | | - Javier Gavilán
- Department of Otorhinolaryngology, La Paz University Hospital, Madrid, Spain
| | - José Manuel Morales-Puebla
- Department of Otorhinolaryngology, La Paz University Hospital, Madrid, Spain, IdiPAZ Research Institute, Madrid, Spain, Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain
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Morales-Puebla JM, Fernández-Fournier M, Plana-Blanco A, Lassaletta L. Variations in the treatment of acute peripheral facial paralysis. A nationwide survey. Acta Otorrinolaringol Esp (Engl Ed) 2024; 75:31-39. [PMID: 37722655 DOI: 10.1016/j.otoeng.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/09/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Acute peripheral facial paralysis may be diagnosed and treated by different specialists. OBJECTIVE The aim of this study was to explore the variability in the treatment of Bell's palsy (BP) and Ramsay Hunt Syndrome (RHS) among different medical specialties. METHODS An anonymous nationwide online survey was distributed among the Spanish Societies of Otorhinolaryngology (ORL), Neurology (NRL) and Family and Community Medicine (GP). RESULTS 1039 responses were obtained. 98% agreed on using corticosteroids, ORL using higher doses than NRL and GP. Among all, only 13% prescribed antivirals in BP routinely, while 31% prescribed them occasionally. The percentage of specialists not using antivirals for RHS was 5% of ORL, 11% of NRL, and 23% of GP (GP vs. NRL p = 0.001; GP vs. ORL p < 0.0001; NRL vs. ORL p = 0,002). 99% recommended eye care. Exercises as chewing gum or blowing balloons were prescribed by 45% of the participants with statistically significant differences among the three specialties (GP vs. NRL p = 0.021; GP vs. ORL p < 0.0001; NRL vs. ORL p = 0.002). CONCLUSION There is general agreement in the use of corticosteroids and recommending eye care as part of the treatment of acute peripheral facial paralysis. Yet, there are discrepancies in corticosteroids dosage, use of antivirals and recommendation of facial exercises among specialties.
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Affiliation(s)
- José Manuel Morales-Puebla
- Department of Otolaryngology, La Paz University Hospital, IdiPaz, Paseo de La Castellana 261, 28046, Madrid, Spain; Otology Commission of the Spanish Society of Otolaryngology and Head and Neck Surgery, Spain; Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, U761, Madrid, Spain; Autonomous University of Madrid, School of Medicine, Madrid, Spain.
| | - Mireya Fernández-Fournier
- Neurology Department, La Paz University Hospital, IdiPaz, Paseo de La Castellana 261, 28046, Madrid, Spain; Neuroepidemiology Coordinator of the Spanish Society of Neurology, Spain
| | - Antoni Plana-Blanco
- Primary Care Center of Balàfia-Pardinyes-Secà de St. Pere, Lleida, Spain; Neurology Coordinator of the Spanish Society of Family and Community Medicine, Spain; University of Lleida, School of Medicine, Lleida, Spain
| | - Luis Lassaletta
- Department of Otolaryngology, La Paz University Hospital, IdiPaz, Paseo de La Castellana 261, 28046, Madrid, Spain; Otology Commission of the Spanish Society of Otolaryngology and Head and Neck Surgery, Spain; Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, U761, Madrid, Spain; Autonomous University of Madrid, School of Medicine, Madrid, Spain
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Lassaletta L, Morales-Puebla JM, Molnar D, González-Otero T, Gavilán J. Side-to-End Intratemporal Hypoglossal-to-Facial Transfer. Atlas Oral Maxillofac Surg Clin North Am 2023; 31:9-17. [PMID: 36754510 DOI: 10.1016/j.cxom.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Luis Lassaletta
- Department of Otolaryngology, Hospital Universitario La Paz, IdiPAZ Research Institute, Paseo de la Castellana, 261, Madrid 28046, Spain; Biomedical Research Networking Centre on Rare Diseases (CIBERER), (CIBERER-U761), Institute of Health Carlos III, Madrid, Spain.
| | - José Manuel Morales-Puebla
- Department of Otolaryngology, Hospital Universitario La Paz, IdiPAZ Research Institute, Paseo de la Castellana, 261, Madrid 28046, Spain; Biomedical Research Networking Centre on Rare Diseases (CIBERER), (CIBERER-U761), Institute of Health Carlos III, Madrid, Spain
| | - David Molnar
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical Centre Hungarian Defence Forces, Róbert Károly körút 44, Budapest 1134, Hungary; Department of Anatomy, Histology and Embryology, Semmelweis University, Tűzoltó utca 58, Budapest 1094, Hungary
| | - Teresa González-Otero
- Department of Maxillofacial Surgery, Hospital Universitario La Paz, IdiPAZ Research Institute, Paseo de la Castellana, 261, Madrid 28046, Spain
| | - Javier Gavilán
- Department of Otolaryngology, Hospital Universitario La Paz, IdiPAZ Research Institute, Paseo de la Castellana, 261, Madrid 28046, Spain
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Sanchez-Cuadrado I, Mato-Patino T, Morales-Puebla JM, Peñarrocha J, Diez-Sebastian J, Gavilán J, Lassaletta L. Validation of the Spanish version of the Sunnybrook facial grading system. Eur Arch Otorhinolaryngol 2023; 280:543-548. [PMID: 35737100 DOI: 10.1007/s00405-022-07484-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 05/31/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE The Sunnybrook facial grading system (SFGS) is one of the most widely employed tools to assess facial function. The present study aimed to determine the validity and reliability of the Spanish language version of the SFGS. METHODS Forward-backward translation from the original English version was performed by fluent speakers of English and Spanish. Videos from 65 patients with facial paralysis (FP) were evaluated twice by five otolaryngologists with experience in FP evaluation. Internal consistency and intra- and inter-rater reliability were assessed. The House-Brackmann scale was used to display concurrent validity which was established by Spearman's rho correlation. RESULTS The Cronbach's α score exceeded 0.70. The intra-rater intraclass correlation coefficient (ICC) was nearly perfect for the composite score (0.96-0.99), voluntary movements (0.97-0.99), and synkinesis (0.91-0.98), and important to almost perfect for symmetry at rest (0.79-0.97). In both evaluations, the inter-rater ICC was higher than 0.90 for the composite score (0.92-0.96) and voluntary movements (0.91-0.96) and slightly lower for symmetry at rest (0.66-0.85) and synkinesis (0.72-0.87). A strong negative correlation was found between the H-B scale and SFGS (Spearman's rho coefficient = - 0.92, p < 0.001) in both evaluations. CONCLUSION The Spanish version of the SFGS is a reliable and valuable instrument for the assessment of facial function in the diagnosis and treatment of patients with FP.
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Affiliation(s)
- Isabel Sanchez-Cuadrado
- Department of Otolaryngology, La Paz University Hospital, P° Castellana, 261, 28046, Madrid, Spain. .,IdiPAZ Research Institute, Madrid, Spain.
| | - Teresa Mato-Patino
- Department of Otolaryngology, La Paz University Hospital, P° Castellana, 261, 28046, Madrid, Spain
| | - José Manuel Morales-Puebla
- Department of Otolaryngology, La Paz University Hospital, P° Castellana, 261, 28046, Madrid, Spain.,IdiPAZ Research Institute, Madrid, Spain.,Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III (CIBERER-U761), Madrid, Spain
| | - Julio Peñarrocha
- Department of Otolaryngology, La Paz University Hospital, P° Castellana, 261, 28046, Madrid, Spain
| | | | - Javier Gavilán
- Department of Otolaryngology, La Paz University Hospital, P° Castellana, 261, 28046, Madrid, Spain.,IdiPAZ Research Institute, Madrid, Spain
| | - Luis Lassaletta
- Department of Otolaryngology, La Paz University Hospital, P° Castellana, 261, 28046, Madrid, Spain.,IdiPAZ Research Institute, Madrid, Spain.,Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III (CIBERER-U761), Madrid, Spain
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Mato-Patino T, Morales-Puebla JM, Moraleda S, Sánchez-Cuadrado I, Calvino M, Gonzalez-Otero T, Peñarrocha J, Hernández B, Gavilan J, Lassaletta L. Contribution and safety of the side-to-end hypoglossal-to-facial transfer in multidisciplinary facial reanimation. Head Neck 2022; 44:1678-1689. [PMID: 35506436 DOI: 10.1002/hed.27076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 04/19/2022] [Accepted: 04/22/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND This study evaluates facial and tongue function in patients undergoing side-to-end hypoglossal-to-facial transfer (HFT) with additional techniques. METHODS Thirty-seven patients underwent a side-to-end HFT. Twelve had additional cross-face grafts, and 9 had an additional masseter-to-facial transfer. Facial was assessed with House-Brackmann (HB), Sunnybrook Facial Grading Scale (SFGS), and eFACE. Martins scale and the Oral-Pharyngeal Disability Index (OPDI) were used to assess tongue function. RESULTS Ninety-four percent of cases reached HB grades III-IV. Mean total SFGS score improved from 16 ± 15 to 59 ± 11, while total eFACE score from 52 ± 13 to 80 ± 5. Dual nerve transfers were a predictor for a better eFACE total score p = 0.034, β = 2.350 [95% CI, 0.184-4.516]), as well as for a higher SFGS total score (p = 0.036, β = 5.412 [95% CI, 0.375-10.449]). All patients had Martin's grade I. Mean postoperative OPDI scores were 84 ± 17 (local physical), 69 ± 16 (simple and sensory motor components), 82 ± 14 (complex functions), and 73 ± 22 (psychosocial). CONCLUSIONS The side-to-end HFT offers predictable facial function outcome and preserves tongue function in nearly all cases. Dual nerve transfers appear to improve the final outcome.
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Affiliation(s)
- Teresa Mato-Patino
- Department of Otolaryngology, Hospital Universitario La Paz, Madrid, Spain
| | - José Manuel Morales-Puebla
- Department of Otolaryngology, Hospital Universitario La Paz, Madrid, Spain.,IdiPAZ Research Institute, Madrid, Spain.,Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain
| | - Susana Moraleda
- Department of Physical Medicine and Rehabilitation, Hospital Universitario La Paz, Madrid, Spain
| | - Isabel Sánchez-Cuadrado
- Department of Otolaryngology, Hospital Universitario La Paz, Madrid, Spain.,IdiPAZ Research Institute, Madrid, Spain
| | - Miryam Calvino
- Department of Otolaryngology, Hospital Universitario La Paz, Madrid, Spain.,IdiPAZ Research Institute, Madrid, Spain.,Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain
| | - Teresa Gonzalez-Otero
- IdiPAZ Research Institute, Madrid, Spain.,Department of Maxillofacial Surgery, Hospital Universitario La Paz, Madrid, Spain
| | - Julio Peñarrocha
- Department of Otolaryngology, Hospital Universitario La Paz, Madrid, Spain
| | - Borja Hernández
- IdiPAZ Research Institute, Madrid, Spain.,Department of Neurosurgery, Hospital Universitario La Paz, Madrid, Spain
| | - Javier Gavilan
- Department of Otolaryngology, Hospital Universitario La Paz, Madrid, Spain.,IdiPAZ Research Institute, Madrid, Spain
| | - Luis Lassaletta
- Department of Otolaryngology, Hospital Universitario La Paz, Madrid, Spain.,IdiPAZ Research Institute, Madrid, Spain.,Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain
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9
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Lassaletta L, Morales-Puebla JM, Altuna X, Arbizu Á, Arístegui M, Batuecas Á, Cenjor C, Espinosa-Sánchez JM, García-Iza L, García-Raya P, González-Otero T, Mañós M, Martín C, Moraleda S, Roda JM, Santiago S, Benítez J, Cavallé L, Correia V, Estévez JM, Gómez J, González R, Jiménez J, Lacosta JL, Lavilla MJ, Peñarrocha J, Polo R, García-Purriños F, Ramos F, Tomás M, Uzcanga M, Vallejo LÁ, Gavilán J. Facial paralysis: Clinical practice guideline of the Spanish Society of Otolaryngology. Acta Otorrinolaringol Esp (Engl Ed) 2020; 71:99-118. [PMID: 31097197 DOI: 10.1016/j.otorri.2018.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 12/10/2018] [Indexed: 12/28/2022]
Abstract
Bell's palsy is the most common diagnosis associated with facial nerve weakness or paralysis. However, not all patients with facial paresis/paralysis have Bell's palsy. Other common causes include treatment of vestibular schwannoma, head and neck tumours, iatrogenic injuries, Herpes zoster, or trauma. The approach to each of these conditions varies widely. The purpose of this guideline is to provide clinicians with guidance on the treatment and monitoring of patients with different causes of facial paralysis. We intend to draft a practical guideline, focusing on operationalised recommendations deemed to be useful in the daily management of patients. This guideline was promoted by the Spanish Society of Otolaryngology and developed by a group of physicians with an interest in facial nerve disorders, including at least one physician from each Autonomous Community. In a question and answer format, it includes 56 relevant topics related to the facial nerve.
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Affiliation(s)
- Luis Lassaletta
- Servicio de Otorrinolaringología, Hospital Universitario La Paz, Madrid, España; Comisión de Otoneurología de la SEORL, Madrid, España; IdiPAZ, Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, España.
| | | | - Xabier Altuna
- Servicio de Otorrinolaringología, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Álvaro Arbizu
- Servicio de Oftalmología, Hospital Universitario La Paz, Madrid, España
| | - Miguel Arístegui
- Servicio de Otorrinolaringología, Hospital Universitario Gregorio Marañón, Madrid, España
| | - Ángel Batuecas
- Servicio de Otorrinolaringología, Hospital Universitario de Salamanca, Salamanca, España; Comisión de Otoneurología de la SEORL, Madrid, España
| | - Carlos Cenjor
- Servicio de Otorrinolaringología, Fundación Jiménez Díaz, Madrid, España; Comisión de Otoneurología de la SEORL, Madrid, España
| | - Juan Manuel Espinosa-Sánchez
- Servicio de Otorrinolaringología, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitariaibs, Granada, España; Comisión de Otoneurología de la SEORL, Madrid, España
| | - Leire García-Iza
- Servicio de Otorrinolaringología, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Pilar García-Raya
- Servicio de Neurorradiología, Hospital Universitario La Paz, Madrid, España
| | | | - Manuel Mañós
- Servicio Otorrinolaringología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - Carlos Martín
- Servicio de Otorrinolaringología, Hospital Universitario Gregorio Marañón, Madrid, España
| | - Susana Moraleda
- Servicio de Rehabilitación, Hospital Universitario La Paz, Madrid, España
| | - Jose María Roda
- Servicio de Neurocirugía, Hospital Universitario La Paz, Madrid, España
| | - Susana Santiago
- Servicio de Neurofisiología, Hospital Universitario La Paz, Madrid, España
| | - Jesús Benítez
- Servicio de Otorrinolaringología, Hospital Doctor Negrín, Las Palmas de Gran Canaria, Las Palmas, España
| | - Laura Cavallé
- Departamento de Otorrinolaringología, Hospital Universitario La Fe, Valencia, España
| | - Victor Correia
- Servicio de Otorrinolaringología, Hospital de CUF de Porto, Porto, Portugal
| | - Jose Manuel Estévez
- Servicio de Otorrinolaringología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, España
| | - Justo Gómez
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - Rocío González
- Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
| | - Jorge Jiménez
- Servicio de Otorrinolaringología, Complejo Hospitalario de Toledo, Toledo, España
| | - Jose Luis Lacosta
- Servicio de Otorrinolaringología, Hospital San Pedro, Logroño, La Rioja, España
| | - María José Lavilla
- Servicio de Otorrinolaringología, Hospital Lozano Blesa, Zaragoza, España
| | - Julio Peñarrocha
- Servicio de Otorrinolaringología, Hospital Universitario La Paz, Madrid, España
| | - Rubén Polo
- Servicio de Otorrinolaringología, Hospital Universitario Ramón y Cajal, Madrid, España
| | | | - Francisco Ramos
- Servicio de Otorrinolaringología, Hospital San Pedro de Alcántara, Cáceres, España
| | - Manuel Tomás
- Servicio de Otorrinolaringología, Hospital Son Espases, Mallorca, Islas Baleares, España
| | - María Uzcanga
- Servicio de Otorrinolaringología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | - Luis Ángel Vallejo
- Servicio de Otorrinolaringología, Hospital Universitario Río Hortega, Valladolid, España
| | - Javier Gavilán
- Servicio de Otorrinolaringología, Hospital Universitario La Paz, Madrid, España
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Lassaletta L, Morales-Puebla JM, Altuna X, Arbizu Á, Arístegui M, Batuecas Á, Cenjor C, Espinosa-Sánchez JM, García-Iza L, García-Raya P, González-Otero T, Mañós M, Martín C, Moraleda S, Roda JM, Santiago S, Benítez J, Cavallé L, Correia V, Estévez JM, Gómez J, González R, Jiménez J, Lacosta JL, Lavilla MJ, Peñarrocha J, Polo R, García-Purriños F, Ramos F, Tomás M, Uzcanga M, Vallejo LÁ, Gavilán J. Facial Paralysis: Clinical Practice Guideline of the Spanish Society of Otolaryngology. Acta Otorrinolaringologica (English Edition) 2020. [DOI: 10.1016/j.otoeng.2018.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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