shallow nasolabial folds
Introduction
Introduction Shallow nasolabial fold is one of the symptoms of facial paralysis. "Face nerve paralysis" is "face sputum", "squeaky mouth", "squeaky mouth", "hanging wind", usually refers to the central dyskinesia caused by non-face facial nerve abnormalities caused by various reasons is facial expression Muscle motor dysfunction is a common feature of the main symptoms, the general symptoms are mouth and eye skew. It is a common disease, frequently-occurring disease, and it is not limited by age. The patient's face often fails to complete the basic eyebrow lifting, eye closing, and drumming.
Cause
Cause
Causes of facial nerve paralysis:
1. Infection: about 42.5%
Most of the infectious lesions are caused by the activation of herpes zoster (VZV), which is latent in the dormant state of the facial nerve sensory ganglia. In addition, meningitis, mumps, influenza, scarlet fever, malaria, multiple cranial neuritis, local infections, etc. can be caused.
Lyme disease is a vector-borne disease. The disease is regional and more common in summer. People living in forests and in rural areas are more susceptible to disease.
Otogenic diseases such as otitis media, labyrinthitis, mastoiditis, and purulent inflammation of the humerus.
2. Idiopathic (often called Bell palsy): about 30.3%, Bell numbness caused by fatigue and the face, cold after the ear, caused by the wind.
3. Tumor: about 5.5%, the tumor itself and surgical removal of the tumor can be caused. Tumors include: basal aneurysms, skull base tumors, acoustic neuromas, parotid adenomas, primary cholesteatoma, and jugular bulb tumors.
4. Neurogenicity: about 13.5%, caused by cerebrovascular disease, intracranial, non-traumatic neurogenicity.
5. Trauma: About 8.2%, skull base fracture, humeral fracture, facial trauma, surgery and injection of neurotoxic drugs in the facial nerve distribution area such as alcohol, penicillin and botulinum toxin are the most common facial paralysis in traumatic causes.
6. Poisoning: such as alcoholism. Prolonged exposure to toxic substances.
7. Metabolic disorders: such as diabetes, vitamin deficiency.
8. Vascular insufficiency.
9. Congenital facial nucleus hypoplasia.
Examine
an examination
Related inspection
Facial nerve examination
Regular examination of facial nerve paralysis:
Static check
Stem mastoid: Check for pain in the mastoid or pain in the palate or on the face.
Forehead: Check whether the skin wrinkles in the forehead are the same, light or disappear, and whether the outside of the eyebrows is symmetrical and sagging.
Eye: Check the size of the eye crack, whether the sides are symmetrical, smaller or larger, whether the upper eyelid is drooping, whether the lower eyelid is everted, whether the eyelid is twitching, swelling, whether the conjunctiva is congested or not, whether there is tearing, dryness, acid, The symptoms of swelling.
Ear: Check for tinnitus, ear nausea, and hearing loss.
Check the size of the eyelids and cheeks: Check if the nasolabial folds become shallow, disappear or deepen. Whether the cheeks are symmetrical, flat, thickened or twitched. Whether the face feels tight, stiff, numb or atrophy.
Mouth: Check whether the mouth angle is symmetrical, drooping, lifting or twitching; whether the lips are swollen and whether the person is skewed.
Tongue: Check if the taste is involved.
Exercise check
Eyebrow lift exercise: check the motor function of the frontal occipital muscle. Severe patient's forehead is flat, wrinkles generally disappear or become significantly shallower, and the outer side of the eyebrows is obviously drooping.
Frown: Check if the frowning muscles can move, and the amplitude of the eyebrows on both sides is consistent.
Closed eyes: When closing the eyes, you should pay attention to whether the mouth of the affected side has a lifting angle, whether the affected side can be closed, and the degree of closure.
Shrugging: Observe whether there is wrinkles in the nasal pressure muscles, and whether the upper lip movements on both sides are the same.
Show teeth: pay attention to observe the amplitude of the movement of the mouth on both sides, whether the mouth is deformed, the number and height of the upper and lower teeth.
Nuptula: Pay attention to whether the distance between the sides of the mouth and the person is the same, and whether the shape of the mouth is symmetrical.
Drumstick: Mainly check the movement function of the diaphragm muscle.
Diagnosis
Differential diagnosis
Facial paralysis is only a symptom or a sign. The cause must be carefully searched. If the cause can be found and treated in time, such as myasthenia gravis, sarcoidosis, tumor or sacral infection, the process of primary disease and facial paralysis can be changed. Facial paralysis may be an early symptom of some life-threatening neurological disorders, such as poliomyelitis or Guillian-Barre syndrome, which can save lives if diagnosed early.
The nasolabial fold is a surface sign of the human face. Everyone has it. The depth varies with individual differences. It gradually deepens with age. Generally, it begins to deepen at the age of 25, and then it will follow the face. The tissue is sagging and gradually increasing.
The clinical manifestations of facial paralysis are very special: most patients often find that one side of the cheeks is not working properly and the mouth is skewed when washing their face in the morning and gargle. In the side of the disease, the facial muscles are completely paralyzed, the forehead wrinkles disappear, the eye cracks expand, the nasolabial folds are flat, the mouth angles droop, and the mouth angles are hemiplegic to the healthy side when the teeth are exposed. The disease side can not be used for wrinkles, eyebrows, eyes closed, air and mouth. When the drumsticks and whistle are whistling, the affected side lips cannot be closed and leak. When eating, food residue often stays in the buccal space of the diseased side, and often has saliva from the side. As the punctum varus with the chin, the tears can not overflow as normal drainage.
It is divided into two types: peripheral and central. Among them, the incidence of peripheral facial paralysis is very high, and the most common one is facial neuritis or Bell's palsy. The facial paralysis that people often say, in most cases, refers to facial neuritis. Because facial paralysis can cause a very weird face, it is often referred to as "disfiguring disease."
