What is facial neuritis? Will facial neuritis cause crooked mouth and eyes? Will there be any residual effects? Let's learn about this disease together.
Firstly, facial neuritis is a peripheral facial paralysis caused by non-specific inflammation of the facial nerve within the stylomastoid foramen, also known as idiopathic facial nerve paralysis or Bell's palsy. So, what causes facial neuritis? When the face is exposed to cold air, infected with viruses, otitis media, edema around the mastoid foramen, and pressure, ischemia, and edema of the facial nerve at the outlet of the facial nerve duct, this disease can all be caused. Some theories suggest that this disease may be related to immune response.
The early pathological changes of facial neuritis are mainly nerve edema and demyelination, and severe cases may have axonal degeneration. The specific clinical manifestations are:
1. Incidence: It can occur at any age and in any season, and is more common in men than women aged 20-40.
2. Onset form: Generally acute onset, with symptoms peaking within a few hours or 1-3 days.
3. Clinical symptoms and signs:
(1) Facial expression muscle paralysis: commonly seen on one side, mainly manifested as facial expression muscle paralysis on the affected side, disappearance of forehead wrinkles, and inability to furrow the forehead and brow; Inability or incomplete closure of eye fissures; When the affected side closes their eyes, both eyeballs rotate outward and upward, exposing the white sclera, which is called Bellsign; The nasolabial groove on the affected side becomes shallower, and the angle of the mouth tilts towards the healthy side (more pronounced when teeth are exposed); Due to paralysis of the orbicularis oris muscle, there may be whistling, bulging cheeks, and air leakage; Due to the paralysis of the cheek muscles, food is easily trapped in the affected side of the gums, and saliva or soup can leak out from the affected side of the mouth.
(2) Other manifestations: Some patients may experience persistent pain behind the affected ear or tenderness in the mastoid region 1-2 days before the onset of the disease; Patients with facial nerve lesions in the middle ear drum segment may experience excessive echoes during speech and loss of taste in the anterior two-thirds of the affected tongue. When the knee ganglion is affected, in addition to the above symptoms, there may also be pain in the affected mastoid region, decreased sensation in the auricle and external auditory canal, and herpes in the external auditory canal or tympanic membrane, known as Ramsay Hunt syndrome.
The treatment principle for facial neuritis is to improve local blood circulation, reduce facial nerve edema, relieve nerve compression, and promote functional recovery. Among them, drug therapy: glucocorticoids should be used as early as possible in the acute phase, and intramuscular injections of vitamin B1 and vitamin B12 can also be used to promote the recovery of nerve myelin sheaths. Ramsay Hunt syndrome patients can take oral acyclovir 0.2g 5 times a day for 7-10 days. For those whose eye fissures cannot be closed, eye ointment, eye drops, eye masks, etc. can be used according to the situation to prevent infection and protect the cornea. Physical therapy: During the acute phase, ultra short wave diathermy therapy, infrared irradiation, or local hot compress can be performed near the stem and breast opening, which is beneficial for improving local blood circulation and reducing nerve edema. Recovery period treatment: Facial muscle exercise, or electric ion penetration therapy, acupuncture or electroacupuncture treatment can be performed. If there is still no recovery after more than one year of onset, cosmetic surgery or facial hypoglossal nerve or facial accessory nerve anastomosis may be considered.
In the care of facial neuritis, general nursing requirements: pay attention to rest during the acute phase, prevent wind and cold on the face, avoid direct cold wind, wear a mask and scarf when going out, which can keep warm and improve one's own image. The affected side of the face can be externally applied with a damp heat towel at a water temperature of 50-60 ℃, 3-4 times a day for 15-20 minutes each time; Massage the affected side by yourself in the morning and evening, gently, moderately, and accurately. Dietary care requirements: The diet should be light and avoid rough, dry, hard, and spicy foods. Patients with taste disorders should pay attention to the temperature of the food to prevent burns to the oral mucosa; Guide patients to rinse their mouths promptly after meals, remove food from the affected side of the mouth, maintain oral hygiene, and prevent oral infections. At the same time, it is necessary to prevent eye complications.