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Peripheral nerve injuries impair the patient's functional capacity, including those occurring in the facial nerve, which require effective medical treatment. Thus, we investigated the use of heterologous fibrin biopolymer (HFB) in the repair of the buccal branch of the facial nerve (BBFN) associated with photobiomodulation (PBM), using a low-level laser (LLLT), analyzing the effects on axons, muscles facials, and functional recovery. This experimental study used twenty-one rats randomly divided into three groups of seven animals, using the BBFN bilaterally (the left nerve was used for LLLT): Control group-normal and laser (CGn and CGl); Denervated group-normal and laser (DGn and DGl); Experimental Repair Group-normal and laser (ERGn and ERGl). The photobiomodulation protocol began in the immediate postoperative period and continued for 5 weeks with a weekly application. After 6 weeks of the experiment, the BBFN and the perioral muscles were collected. A significant difference (p < 0.05) was observed in nerve fiber diameter (7.10 ± 0.25 µm and 8.00 ± 0.36 µm, respectively) and axon diameter (3.31 ± 0.19 µm and 4.07 ± 0.27 µm, respectively) between ERGn and ERGl. In the area of muscle fibers, ERGl was similar to GC. In the functional analysis, the ERGn and the ERGI (4.38 ± 0.10) and the ERGI (4.56 ± 0.11) showed parameters of normality. We show that HFB and PBM had positive effects on the morphological and functional stimulation of the buccal branch of the facial nerve, being an alternative and favorable for the regeneration of severe injuries.

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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.

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Some dental treatments that are performed in the mandibular teeth involve manipulation of anatomical structures near the dental periapex, so it is likely to cause nerve damage due to the proximity of the inferior alveolar nerve with the apices of the mandibular teeth, mainly in the molar area. The aim of this study was to determine through Computed Tomography (CT) scan the existing distance between the mandibular canal and the anatomical structures adjacent to its path which will help to reduce the risk of injury to the inferior alveolar nerve during the different dental treatments developed in this zone. A cross-sectional study was performed where the study population consisted of 50 patients of both sexes, between 20 and 30 years with a full dentition mandible. Patients underwent a CT study of the mandible with coronal planes at 1.5 mm, the right side and the left side of each jaw were considered for the analysis and millimetric measuring was held of the distances of the mandibular canal (MC) from different anatomical structures. Subsequently, a statistical analysis was performed to obtain the mean and standard deviation of the distances between the mandibular canal and some adjacent anatomical structures. The distance from the alveolar nerve canal to the apex of the lower third molar in average was 1.49 mm on the right side and 1.69 mm on the left side, the distance between the mandibular canal and lingual cortical at the lower first molar level on average was 3.54 mm on the right side and 4.02 mm on the left side and the distance between the lingual cortical at the second molar level was on average 2.86 mm on the right side and 3.6 mm on the left side.

Algunos tratamientos dentales que se realizan en los dientes mandibulares implican la manipulación de estructuras anatómicas cercanas al periapice dental, por lo que existe la probabilidad de causar lesiones nerviosas debido a la cercanía del canal mandibular con los ápices de los dientes mandibulares, principalmente los molares. El objetivo de este estudio fue determinar a través de tomografía computarizada la distancia existente entre el canal mandibular a las estructuras anatómicas adyacentes a su trayecto lo que ayudará a disminuir el riesgo de lesiones del nervio alveolar inferior durante los diferentes tratamientos dentales desarrollados en esta zona. Se realizó un estudio transversal en donde la población de estudio estuvo compuesta por 50 pacientes de ambos sexos, entre 20 a 30 años con dentición completa en mandíbula. A los pacientes se les realizó un estudio de Tomografía Computarizada (TC) en mandíbula con cortes coronales a 1.5mm, se consideraron para el análisis el lado derecho y el lado izquierdo de cada mandíbula, y se realizó la medición milimétrica de las distancias que existen desde el CNAI a diferentes estructuras anatómicas. Posteriormente, se realizó un análisis estadístico para obtener Medias y Desviación Estándar de las distancias que existen entre el canal mandibular y algunas estructuras anatómicas adyacentes. La distancia del canal mandibular al ápice del tercer molar inferior en promedio fue de 1,49 mm del lado derecho y de 1,69 mm del lado izquierdo,la distancia entre el canal mandibular y la cortical lingual a nivel del primer molar inferior en promedio fue de 3,54 mm del lado derecho y de 4,02 mm del lado izquierdo y la distancia entre la cortical lingual a nivel del segundo molar fue en promedio de 2,86 mm del lado derecho y de 3,6 mm del lado izquierdo.

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Malignant atrophic papulosisis is a rare, multisystem obliterative vasculopathy of unknown etiology, occasionally involving the cranial nerve. We describe the first case of malignant atrophic papulosisis with cranial nerve and peripheral nerve involvement in China. A 47-year-old woman presented to our hospital with atrophic porcelain white papules over the trunk and extremities, numbness in the right calf, vision decrease and impaired movement of the right eye. She was diagnosed with malignant atrophic papulosisis, based on characteristic symptoms and histopathologic examination. The patient was treated with dipyridamole and aspirin for 9 months, but later died of gastrointestinal hemorrhage. We reviewed currently available case reports on cranial nerve involvement in malignant atrophic papulosisis and emphasized the importance of skin biopsy in diagnosing this disease.

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Documentar a incidência de lesões traumáticas da via óptica, assim como a etiologia traumática; correlacionar as lesões do nervo óptico com achados radiológicos (lesões cranianas e intracranianas); e estudar lesões múltiplas de nervos cranianos. Métodos: Dezoito pacientes admitidos no Serviço de Emergência da Santa Casa de Misericórdia de São Paulo com lesão traumática da via óptica foram incluídos. Os pacientes foram divididos em três grupos de acordo com o escore da Escalade Coma de Glasgow (ECG) em: trauma leve (ECG de 13 a 15), moderado(ECG de 9 a 12) e grave (ECG de 3 a 8), distribuição quanto a gênero, presença de fraturas, lesões intracranianas, fístulas liquóricas emecanismo de trauma. Resultados: Dos 18 casos, 17 lesões ocorreram em conjunto com outros nervos cranianos e em 1 caso houve lesão exclusiva do nervo óptico. Atropelamentos, acidentes automobilísticos, motociclísticos e ferimento por projétil de arma de fogo constituíram as causas mais frequentes de lesão do nervo óptico, de forma isolada, assim como nas lesões de múltiplos nervos. Hematomas extradurais e contusões cerebrais foram as lesões intracranianas mais frequentes e, quando presentes, as fraturas cranianas localizavam-se no teto orbitário ou na região frontal. Conclusão: Neuropatia traumática do óptico deve ser pesquisada à admissão do paciente (quando possível), pois é passívelde tratamento clínico (corticoides) ou cirúrgico. Achados sugestivos de neuropatia óptica traumática incluem fraturas do assoalho ou teto orbitário e traumas de alta energia cinética...

To register the incidence of the traumatic lesions to the optic nerve and its etiology; to correlate these lesions to the radiological findings (cranial and intracranial) and study multiple cranial nerve lesions.Methods: Eighteen patients admitted to the Emergency Service of Santa Casa de Misericórdia de São Paulo Hospital have been studied and lesions to the optic nerves were described. The patients were divided into 3 groups according to the Glasgow Coma Scale (GCS) in: mild trauma (GCS: 13 to 15), moderate (GCS: 9 to 12) and severe (GCS: 3 to 8), gender, fractures, intracranial lesions, CSF fistulas and type of trauma. Results: Posttraumatic single nerve lesion was observed in 1 patient and in 17patients multiple nerve lesions associated with the optic nerve lesion were documented. Running over, vehicle and motorcycle accidents and gunshot wounds were the main causes of these lesions (single nerve and multiple nerves). Extradural hematomas and cerebral contusions were the most frequent intracranial lesions. Whenever present, the cranial fractures involved the orbital roof or the frontal region. Conclusion: Traumatic optic neuropathy occurs must be searched on the patient admission (wheneverit is possible), because medical or surgical treatment can be proposed. Finding signs of traumatic optic neuropathy include fractures of the roof or floor of the orbit and traumas with high kinetic energy...

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OBJETIVO: Documentar a incidência de lesões traumáticas do nervo olfatório, assim como a etiologia traumática; correlacionar as lesões do nervo olfatório com achados radiológicos (lesões cranianas e intracranianas) e estudar lesões múltiplas de nervos cranianos. MÉTODOS: Vinte e quatro pacientes admitidos no Serviço de Emergência da Santa Casa de Misericórdia de São Paulo com lesão traumática do nervo olfatório foram incluídos. Os pacientes foram divididos em três grupos, de acordo com o escore da escala de coma de Glasgow (ECG): trauma leve (ECG de 13 a 15), moderado (ECG de 9 a 12) e grave (ECG de 3 a 8), assim como em diferentes graus de lesão do olfatório, como hiposmia, anosmia e parosmia, distribuição quanto a gênero, presença de fraturas, lesões intracranianas, fístulas liquóricas e mecanismo de trauma. RESULTADOS: Dos 24 casos, 15 lesões ocorreram em conjunto com outros nervos cranianos e em nove casos houve lesão exclusiva do nervo olfatório. O atropelamento foi a causa mais comum de lesão do nervo olfatório de forma isolada, assim como nas lesões de múltiplos nervos. Hematomas extradurais foram as lesões intracranianas mais frequentes e a ausência de fraturas predominou nos indivíduos estudados. CONCLUSÃO: Neuropatia traumática do olfatório deve ser pesquisada na admissão do paciente (quando possível), sobretudo quando houver evidência de traumas frontais ou occipitais.

OBJECTIVE: To register the incidence of the traumatic lesions to the cranial nerves and its etiology; to correlate the lesions to the radiological ndings (cranial and intracranial) and study multiple cranial nerve lesions. METHODS: Fifty-four patients admitted to the Emergency Service of Santa Casa de Misericórdia de São Paulo Hospital have been studied and lesions to the different cranial nerves were described. All patients were submitted do radiographic exams, computed tomography, and, when necessary, magnetic resonance imaging. The patients were divided into 3 groups according to the Glasgow Coma Scale (GCS) in: mild trauma (GCS: 13 to 15), moderate (GCS: 9 to 12) and severe (GCS: 3 to 8). RESULTS: Posttraumatic single nerve lesion was more frequent seen on olfactory, facial and oculomotor nerves.Running over was the main cause of these lesions (single nerve and multiple nerves). Contusions and extradural hematomas were the most frequent intracranial lesions. CONCLUSION: Traumatic cranial neuropathy occurs frequently and must be searched on the patient admission, because it can surgical decompression may necessary, such as decompression of the optic or facial nerves.

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Objetivo: Documentar a incidência de lesões traumáticas de nervos cranianos, assim como a etiologia traumática, correlacionar as lesões dos nervos cranianos com achados radiológicos (lesões cranianas e intracranianas) e estudar lesões múltiplas de nervos cranianos. Métodos: Cinquenta e quatro pacientes admitidos no Serviço de Emergência da Santa Casa de Misericórdia de São Paulo com lesões traumáticas nos diferentes nervos cranianos foram incluídos. Todos os pacientes foram submetidos à radiografia simples de crânio, tomografia computadorizada e, quando indicada, ressonância magnética de encéfalo. Os pacientes foram divididos em três grupos de acordo com o escore da Escala de Coma de Glasgow (ECG) em: trauma leve (ECG de 13 a 15), moderado (ECG de 9 a 12) e grave (ECG de 3 a 8). Resultados: Os nervos cranianos mais afetados de forma isolada foram olfatório, facial e oculomotor. O atropelamento foi a causa mais comum de lesão de nervos cranianos de forma isolada, assim como nas lesões de múltiplos nervos. Contusões e hematomas extradurais foram as lesões intracranianas mais frequentes. Conclusão: Neuropatia craniana de etiologia traumática ocorre frequentemente e deve ser pesquisada à admissão do paciente, pois pode exigir descompressão de estruturas nervosas importantes como nervo óptico e facial.

Objective: To register the incidence of the traumatic lesions to the cranial nerves and its etiology; to correlate the lesions to the radiological findings (cranial and intracranial) and study multiple cranial nerve lesions. Methods: Fifty-four patients admitted to the Emergency Service of Santa Casa de Misericórdia de São Paulo Hospital have been studied and lesions to the different cranial nerves were described. All patients were submitted do radiographic exams, computed tomography, and, when necessary, magnetic resonance imaging. The patients were divided into 3 groups according to the Glasgow Coma Scale (GCS) in: mild trauma (GCS: 13 to 15), moderate (GCS: 9 to 12) and severe (GCS: 3 to 8). Results: Posttraumatic single nerve lesion was more frequent seen on olfactory, facial and oculomotor nerves. Running over was the main cause of these lesions (single nerve and multiple nerves). Contusions and extradural hematomas were the most frequent intracranial lesions. Conclusion: Traumatic cranial neuropathy occurs frequently and must be searched on the patient admission, because it can surgical decompression may necessary, such as decompression of the optic or facial nerves.

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