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dr yasmina laouar

Chin Muscle

correction of sequelae of facial paralysis in a child

intro image child

Dr.Yasmina Laouar

Official Endopeel Trainer in Algeria

Young male Patient - Emergency Check Up -End 2020- DAY O

  • victim of a serious cranial trauma during while doing sport in 2020.

  • The Head Trauma Score is 1-15 on the Glasgow Scale

  • isocoria of the 2 pupils

  • Right Facial Paralysis
  • Absence of Motor Sensory Deficit
  • An early craniocerebral computed tomography ( < 1h) was performed.

Early Craniocerebral Computed Tomography Results <1h-DAY 0

  • Right fronto parieto occipital fracture lines passing through the petrous bone with depression of a bone fragment estimated at 6 mm.
  • Cervical Spine : Nothing to repor

Craniocerebral Computed Tomography Results at 12 h-DAY 0

  • parietal hemorrhagic contusion next to a non-compressive extradural hematoma 15 mm thick without mass effect on the cerebral parenchyma and median structures.
  • hematic filling of the prepontic cistern on the right as well as in the right latero cerebella.

CRANIOCEREBRAL COMPUTED TOMOGRAPHY-DAY 11

  • right extra dural hematoma in the process of organization on a background of clinical improvement
  • Clinical Improvement with conscious patient, absence of motor sensory deficit, reactive isochoric pupils, facial paralysis on the right.

DAY 73-neurophysiologic exams

Electroneurography ENG Electromyography EMG-BLINK REFLEX
  • ENG with recording of the nasalis muscle: absence of motor response
  • study of the reflex right blink: small reflex response R1 of elongated latency on the ipsilateral side
  • EMG at the level of the right frontal muscle: signs of almost total denervation without signs of reinnervation.
  • EMG at the level of the orbicularis muscle of the eyelids: signs of almost total denervation without signs of reinnervation
  • EMG at the level of the right chin muscle: signs of reinnervation

1st consultation

intro1-consult
intro4-consult

1 st Results

WHILE SMILING

PF-child-endopeel-1

WHILE SMILING

PF-child-endopeel-2

without mimicry

PF-child-endopeel-without-mimicry-nosmile

SEMIOLOGIC ANALYSIS

static view

  • absence of forehead wrinkles.

  •  absence of Drooping lower eyelid.

  •  absence of Drooping eyebrow.

  • light facial asymmetry

dynamic view

  • Forehead without movement.

  • inability to wrinkle brow.

  •  incomplete closure of the eye

  • mouth asymmetry

Conclusions

The chosen techniques have been those of M.TIZIANI , applied to the facial expression muscles :
-zygomatics
-levators/depressors
-risorius.

 

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