Introduction: Surgical procedures involving the temporomandibular joint (TMJ) are frequently associated with nerve injuries and subsequent dysfunctions. Considering that traumatic peripheral nerve injuries may resolve slowly and their prognosis is generally unpredictable, the current study aimed to report a clinical case in which both motor (affecting the temporal and zygomatic branches of the facial nerve) and sensory dysfunctions (affecting the auriculotemporal nerve of the trigeminal nerve) following TMJ surgery were effectively treated by using photobiomodulation therapy (PBMT). Case Report: PBMT sessions, involving a total of 30 facial points, were administered twice a week for 10 weeks. The following parameters were utilized: wavelength of 808 nm, energy density of 75 J/cm2, power output of 100 mW, total energy of 3 J, and duration of 30 seconds per point. A considerable improvement in both facial asymmetry and muscle function was achieved within 5 weeks, along with a total restoration of cutaneous sensitivity. By the 10th week of PBMT, the facial movement dysfunction was completely resolved. Conclusion: According to the current case, PMBT seems to be an effective intervention to manage motor and sensory nerve dysfunctions following TMJ surgery.

BACKGROUND: In patients with traumatic head injuries, the percentage of cranial nerve injuries (CNI) range from4.3 to 17.6% in which majority are isolated CNI[1-5].In present literature, moderate to severe types of head injuries are often studied which may result in a lack of representation and description of CNI associated with minor head injuries (MHI). Alongside this peculiar case of a traumatic cavernous sinus syndrome (CSS) that is non-thrombotic and non-fistulous in nature, this paper aims to analyse traumatic CNI in non-severe head injuries and the surrounding literature.
METHODS: A 65-year-old man who had sustained a minor head injury was found to have CNI of III, IV and VI.Brain imaging showed scattered traumatic subarachnoid haemorrhage and a non-displaced right zygomatic arch fracture. Despite the short course of high dose dexamethasone, he showed only partial recovery of his CNI after one year.
CONCLUSIONS: We present a case of traumatic CSS likely secondary to tractional injury from a MHI. Injury to the extraocular nerves wasfound to be one of the more commonly observed combination of CNI from the literature review conducted. In patients with MHI, multiple CNI is less common. Hence, consideration should be given to work upfor secondary causes such as tumours. There is presently no known clear identifiable pattern of CNI associated with MHI. CT brain findings of skull base fractures and early onset of cranial nerve palsies are generally associated with worse outcomes. More remains to be studied about tractional CNI in non-severe head injuries.

Chimeric antigen receptor (CAR-T) cell therapy is highly effective against hematological cancers but is associated with immune mediated side effects, including neurotoxicity. The most commonly described presentations of immune cell mediated neurotoxicity syndrome (ICANS) include cortical symptoms and generally localize to the central nervous system. In this report, we present a patient with acute onset of bilateral facial nerve palsy following CAR-T cell therapy, followed by a complete clinical recovery. Aside from a temporary anisocoria, he had no other neurologic symptoms and no encephalopathy or seizures. MRI Brain was non-contributory and cerebrospinal fluid revealed a modest increase in lymphocytes without systemic leukocytosis and viral studies were all negative. He was diagnosed with bilateral facial nerve palsy secondary to CAR-T cell therapy and subsequently treated with a course of steroids. Several weeks after presentation he returned to his neurological baseline. The presentation of CAR-T cell mediated facial nerve palsy is both clinically and scientifically relevant for physicians, patients, and researchers.

Injury of lower cranial nerves (CNs) by skull base fracture after head trauma can occur sometimes. However, selectively different CN damage on either side is extremely rare. A 53-year-old man had difficulty of swallowing, phonation, and articulation after falling off his bicycle. In physical examination, a deviated tongue to the right side was shown. Brain computed tomography showed a skull base fracture involving bilateral jugular foramina and right hypoglossal canal. Left vocal cord palsy was confirmed by laryngoscopy. Electromyography confirmed injury of left superior laryngeal nerve, recurrent laryngeal nerve, and right hypoglossal nerve. Video fluoroscopic swallowing study revealed large amounts of remnant in vallecula and pyriform sinus without opening of upper esophageal sphincter due to dysfunction of cricopharyngeus muscle. After constant rehabilitation for dysphagia, he was allowed to eat a general diet with compensatory techniques at discharge and further recovery after 3 months. Injury of lower CNs after fracture of the skull base can cause severe morbidity. However, the prognosis of such injuries can be favorable with early rehabilitation treatment by identifying the injured CN. A careful and accurate examination of lower CN injury in skull base fracture is essential for planning a treatment strategy.

BACKGROUND: In some cases, surgery of cerebellopontine angle meningioma (CPAM) might result in multiple cranial nerve injury, which could bring serious impact on the patients, especially when it affects the function of facial muscles and eyeballs. This report describes a successful application of acupuncture for rehabilitation in a patient after surgery for CPAM.
UNASSIGNED: A 27-year-old patient presented with limitation of left eye abduction, accompanied with frontal and facial sensory disturbance on the left after resection of the pontocerebellar angle tumor. The patient also suffered from significant anxiety and depression as concomitant symptoms.
UNASSIGNED: Based on medical history, clinical symptoms, and magnetic resonance imaging results, the patient was diagnosed with the fourth, fifth, sixth, and seventh cranial nerve injury after surgery for CPAM.
METHODS: Acupuncture treatment was applied for this patient. One acupuncture session was given every 2 days in 35 days, and the needles were retained for 30 minutes per session.
RESULTS: After acupuncture treatment, the limitation of left eye abduction had totally recovered. The superficial sensory disturbance in the frontal and facial region was significantly relived. Besides, the scores of Hamilton Anxiety and Depression Scale showed a significant reduction. However, the superficial sensory of the alar and nasolabial groove on the left side still decreased mildly when compared with the right side.
CONCLUSIONS: Acupuncture might be an option for rehabilitation after surgery for CPAM.

The purpose of this study was to investigate the outcomes of surgical resection of carotid body tumors with and without preoperative embolization.
There were 31 patients who underwent surgical resection combined with preoperative embolization (SRE group), and 27 patients who underwent conventional surgical resection (SR group); all clinical data were included and reviewed.
There was no difference in the approach for carotid reconstruction in either group (P > .05). The mean surgical time (110.65 ± 35.77 minutes vs 188.33 ± 66.44 minutes) and intraoperative blood loss (140.32 ± 57.12 mL vs 396.43 ± 272.82 mL) were significantly less in the SRE group (P < .05). The volume of blood transfusions required (475 ± 301.18 mL vs 0 mL) and incidence rate of total complications (33.3% vs 9.7%) were higher in the SR group (P < .05). However, the length of hospital stay was similar in both groups (P > .05).
Our results demonstrate that preoperative embolization of a carotid body tumor can reduce blood loss and complications and improve tumor excision.

A 53-year-old Afghan man presented with a 12-month history of left proptosis, diplopia and facial swelling 20 years after a bomb blast injury. Magnetic resonance and computed tomography imaging revealed a well-circumscribed lesion centred within the left inferior orbit/superior maxillary sinus along with left orbital fracture. Histopathology and immunostaining of the debulked lesion were consistent with traumatic neuroma of the infraorbital nerve. Infraorbital neuromas have developed following orbital decompression surgeries but have not been reported previously following non-surgical trauma.

暂无摘要。

Cranial nerve injuries are unusual complications of supraglottic airway use. Branches of the trigeminal, glossopharyngeal, vagus and the hypoglossal nerve may all be injured. We performed a systematic review of published case reports and case series of cranial nerve injury from the use of supraglottic airway devices. Lingual nerve injury was the most commonly reported (22 patients), followed by recurrent laryngeal (17 patients), hypoglossal (11 patients), glossopharyngeal (three patients), inferior alveolar (two patients) and infra-orbital (one patient). Injury is generally thought to result from pressure neuropraxia. Contributing factors may include: an inappropriate size or misplacement of the device; patient position; overinflation of the device cuff; and poor technique. Injuries other than to the recurrent laryngeal nerve are usually mild and self-limiting. Understanding the diverse presentation of cranial nerve injuries helps to distinguish them from other complications and assists in their management.

BACKGROUND: Choosing the optimal treatment modality for patients with recurrent carotid artery stenosis depends upon many variables, including the etiology of the recurrent plaque morphology and the location of the recurrent lesion. The most important considerations for interventions are the safety, short- and long-term durability of the repair, and the surgical team\'s skills and experience. We reviewed the results of our operative series on primary and redo carotid endarterectomy (CEA) data to evaluate the short- and long-term outcomes of surgical intervention. We also evaluated the relationship between plaque lesion characteristics with respect to the development of recurrent stenosis.
METHODS: The charts of all patients who underwent CEAs and redo CEAs (RCEAs) performed by one vascular surgeon were retrospectively reviewed for a 10-year period. Preoperative data, including patients\' demographics and interval between the primary CEAs and RCEAs, were recorded and summarized. The surgical procedure, location, and morphologic characteristics of the carotid lesions (primary or recurrent) were also recorded. Surgical outcomes, including local complications, systemic complications, length of stay, restenosis rate, and short-and long-term stroke rates, were reviewed.
RESULTS: From 1997 to 2007, one vascular surgeon performed 1324 consecutive CEA procedures on a total of 1198 patients. Restenosis that required RCEA was performed on 212 patients, which included 192 first RCEAs and 27 second RCEAs. All patients who underwent primary CEAs were original patients of the senior author. RCEAs were performed on 7 of our original patients, and the remaining RCEA cases were referred patients. The interval from primary CEA to first RCEA ranged from 2 months to 29 years, with an average of 4.4 years. In this group of patients, the male/female ratio was 45%/55% and average age was 61 years (range 38-74 years). Eighty-three percent (159 of 192) used tobacco, compared with 54% in the primary CEA group. Also, in this group of patients, cranial nerve injuries occurred in 25 of the 192 patients (13%). The majority of these injuries were temporary, but 4 patients had prolonged injury and 1 patient had a permanent injury. One nonfatal myocardial infarction (MI) occurred. There were no incidents of stroke or death. Significant restenosis occurred in 3 patients (1.5%) over an average of 2.1 years. These statistics compare favorably with finding from our series of primary CEAs, in which cranial nerve injury was 4% (44 of 1105), postoperative myocardial infarction was 0.5% (6 of 1105), stroke rate was 0.18% (2 of 1105), and death rate was 0%, with significant restenosis occurring in 0.36% (4 of 1105) of patients over an average of 4.4 years.
CONCLUSIONS: In our retrospective study, the stroke and restenosis rates after RCEAs were similar to those after primary CEA. Therefore, we consider RCEA to be a viable therapeutic option in patients with carotid disease that recurs after a primary CEA.