Gaudin Robert A, Remenschneider Aaron K, Phillips Katie, Knipfer Christian, Smeets Ralf, Heiland Max, Hadlock Tessa A
Department of Otolaryngology, Harvard Medical School, Boston, MA, USA; Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA; Department of Otolaryngology, Harvard Medical School, Boston, MA, USA.
J Craniomaxillofac Surg. 2017 Jan;45(1):71-75. doi: 10.1016/j.jcms.2016.11.002. Epub 2016 Nov 17.
Herpes labialis viral reactivation has been reported following dental procedures, but the incidence, characteristics and outcomes of delayed peripheral facial nerve palsy following dental work is poorly understood. Herein we describe the unique features of delayed facial paresis following dental procedures.
An institutional retrospective review was performed to identify patients diagnosed with delayed facial nerve palsy within 30 days of dental manipulation. Demographics, prodromal signs and symptoms, initial medical treatment and outcomes were assessed.
Of 2471 patients with facial palsy, 16 (0.7%) had delayed facial paresis following ipsilateral dental procedures. Average age at presentation was 44 yrs and 56% (9/16) were female. Clinical evaluation was consistent with Bell's palsy in 14 (88%) and Ramsay-Hunt syndrome in 2 patients (12%). Patients developed facial paresis an average of 3.9 days after the dental procedure, with all individuals developing a flaccid paralysis (House Brackmann (HB) grade VI) during the acute stage. 50% of patients developed persistent facial palsy in the form of non-flaccid facial paralysis (HBIII-IV).
Facial palsy, like herpes labialis, can occur in the days following dental procedures and may also be related to viral reactivation. In this small cohort, long-term facial outcomes appear worse than for spontaneous Bell's palsy.
已有报道称牙科手术后会出现唇疱疹病毒再激活，但牙科手术后延迟性周围性面神经麻痹的发生率、特征和结局尚不清楚。在此，我们描述牙科手术后延迟性面神经麻痹的独特特征。
进行一项机构回顾性研究，以确定在牙科操作后30天内被诊断为延迟性面神经麻痹的患者。评估人口统计学、前驱症状和体征、初始治疗及结局。
在2471例面神经麻痹患者中，16例（0.7%）在同侧牙科手术后出现延迟性面神经麻痹。就诊时的平均年龄为44岁，56%（9/16）为女性。14例（88%）患者的临床评估符合贝尔麻痹，2例（12%）符合拉姆齐-亨特综合征。患者在牙科手术后平均3.9天出现面神经麻痹，所有患者在急性期均出现弛缓性麻痹（House Brackmann（HB）分级VI级）。50%的患者出现持续性面神经麻痹，表现为非弛缓性面神经麻痹（HBIII-IV级）。
与唇疱疹一样，面神经麻痹可能在牙科手术后数天出现，也可能与病毒再激活有关。在这个小队列中，长期面部结局似乎比自发性贝尔麻痹更差。
