Detail Article

Folia Medica Indonesiana

ISSN 0303-7932

Vol. 40 / No. 1 / Published : 2004-01

Order : 6, and page :25 - 27

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Original Article :

Facial nerve paralysis caused by birth trauma

Author :

  1. Rowena Ghazali Hoesin*1
  2. Rozalina Loebis*2
  1. Department of Ophthalmology Airlangga University School of Medicine Dr Soetomo Teaching Hospital, Surabaya
  2. Department of Ophthalmology Airlangga University School of Medicine Dr Soetomo Teaching Hospital, Surabaya

Abstract :

Objective: To report a patient with lagophtalmos, shortening of the eyelids and blinking reflex disorders caused by birth trauma. Methods: A case report of a two-months-old baby girl was referred to our outpatient department with the main complain of blinking disorders since she was born. From heteroanamnesis the baby was born aterm, helped by midwife with forceps extraction technique. After birth baby was referred to the hospital due to severe asphyxia. Two weeks after the baby discharged from the hospital, her parents realized that there was abnormality in the baby ‘s eyelids such as shortening of the eyelids, blinking reflex disorders, the eyelids cannot be closed properly and there is no tears when the baby cries. The suckling reflex was good, but the baby showed typical mask like face. From the physical examination revealed poor visual acuity, but light reflex and ocular motility were normal. There were lagophtalmos, exposure keratitis, nebula cornea and negative Schirmer test in both eyes. Direct ophtalmoscope examination was normal in both eyes. EEG and MRI were normal but EMG revealed negative blinking reflex in both eyes. The baby is treated with artificial tears eye ointment and underwent surgery procedure (ANTERIOR LAMELLA REPOSITION and LEVATOR RESSES) to protect the cornea. Results: Although the exposure keratitis has disappeared with the treatment, unfortunately negative blinking reflex and other sequale caused by facial nerve paralysis remains occurred. Conclusion: A rare and difficult case of facial nerve paralysis caused by birth trauma has been reported. The treatment has successfully decreased the exposure keratitis. But the treatment of facial nerve paralysis is not in the realm of any one specialty. The intracranial, intra temporal and extra temporal lesion of the facial nerve required the skill and cooperation of multidisciplinary team.

Keyword :

facial nerve paralysis, blinking reflex, lagophthalmos, anterior lamella reposition,

References :

Montandon D, Maillard GF, Morax S et al,(1990) Facial Nerve Paralysis. In: Plastic and Reconstructive Surgery of The Orbitopalpebral Region. 2nd edition Singapore : PG publishing

Baker DC,(1998) Facial Paralysis. In: Nesi FA, Lisman RD, Levine MR. Ophthalmic Plastic and Reconstructive Surgery.2nd edition New York : Mosby

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