Surgical Management of Facial Nerve Paralysis

.: PREFACE
PREFACE
ÖN SÖZ
Prof. Dr. Galip Zihni SANUSa, Assoc. Prof. Dr. Ayşegül BATIOĞLU KARAALTINb
aİstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Neurosurgery, İstanbul, Türkiye
bİstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Otolaryngology, İstanbul, Türkiye
Article Language: EN
''Man is by nature a political animal''
Aristotle

Man and society are in a two-way relationship. The cultural accumulation that the human mind has produced over the centuries was only possible when we came together as a community and established civilization. Each of us is a building stone of this civilization and man finds his place in this life as a part of the society. In this context; interacting with other people is not just a fulfillment of a necessity but it is simultaneously an expression of the human mind.

Although verbal transfer is the main tool of our expressiveness, our mind expresses its feelings and thoughts in some cases, simply with a facial expression or conveys many feelings and thoughts at once in one facial expression. But creating facial expression is a very complex process. Facial expression, which has a very important role in the functioning of the social structure as well as for each person, can only be possible with a well-functioning facial nerve.

In this book; the facial nerve, which holds an exceptional place among the cranial nerves, is examined by a multidisciplinary team. The Embryological development, anatomy, and functions of the facial nerve in normal individuals are detailed comprehensively. Subsequently, the diseases of the facial nerve and the diagnostic and treatment modalities of pathologies that can affect the nerve according to its anatomical positioning are discussed in different sections.

This work was put together both to increase the awareness of the facial nerve among younger generations and to guide them in preserving the concept of the face, which is crucial to human integrity. Experts in the field have examined the possible treatment options for restoring function and improving facial expression in cases of facial nerve damage, addressing the complex aspects of the facial nerve beyond being a single anatomical structure.

As editors, we would like to thank the authors for sharing their years of experience.

Prof. Dr. Galip Zihni SANUS
Editor
İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Neurosurgery, İstanbul, Türkiye

There are such diseases that require attention to treat the psycho-social impacts in addition to the medical and surgical ones. As an ENT physician, I can say that while managing patients with facial paralysis, I learned that I did not only dealt with a medical and surgical process, but also with its psycho-social aspect when I was managing a female patient with facial paralysis whom broke up with her husband. An other example was a beautiful young girl who had facial paralysis at after an unfortunate accident where the plazma TV fell on her head. As an otorhinolaryngologist, we worked with a patient group where the results of facial paralysis are more satisfactory with the chance of early intervention. Nevertheless, we realized that we are actually a part of a large team, including Neurology, Neurosurgery, Plastic and Reconstructive Surgery, Ophthalmology, Physical Therapy Physicians, whom encountered this patient group at different time lines and undertook their treatment. The crucial support of the Histology & Embryology, Pathology and Radiology Departments was undeniable in this disease, in which required the unity of mind of many medical disciplines. Based on this cooperation and solidarity, the idea for a book written by physicians interested in facial nerve and its surgery emerged. My special thanks to our editor Galip Zihni Sanus, who never hesitated to share his knowledge, network and off course for his entire collaborative work and support.

Electrophysiological evaluation of the facial nerve, surgical techniques in the approach to facial nerve pathologies and paralysis; late facial paralysis managements of Neurosurgery, Plastic Surgery, Otorhinolaryngology, and Ophthalmology where the contributors to this book to answer to all the questions that might rise in your mind. In addition to the sections where current reconstruction techniques were explained with descriptive surgical figures and the section that researchers who wanted to present experimental models for facial paralysis were you can use it as your primary source; non-surgical treatment modalities and protocols of facial paralysis were mentioned in detail , medicolegal, psychosocial and artistic perspectives were fruitfully discussed. As an editor I hope you an enjoyable and informative reading.

Assoc. Prof. Dr. Ayşegül BATIOĞLU KARAALTIN
Editor
İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Otolaryngology, İstanbul, Türkiye
''İnsan doğal yapısı gereği toplumsal bir varlıktır''
Aristotles

İnsan ve toplum iki yönlü bir ilişki içindedir. İnsan aklının yüzyıllar boyunca ürettiği kültür birikimi, ancak bir topluluk olarak bir araya gelip medeniyet kurmamızla mümkün oldu. Her birimiz bu medeniyetin bir yapı taşıyız ve insan, toplumun bir parçası olarak bu yaşamda kendine bir yer bulur. Bu bağlamda; diğer insanlarla etkileşimde bulunmak sadece bir ihtiyaç giderme işlevi değildir; eş zamanlı olarak insan zihninin bir dışavurumudur.

Sözlü aktarım ifade yetimizin temel aracı olsa da zihnimiz duygu ve düşüncelerini bazı durumlarda, basitçe, bir yüz ifadesi ile belirtir ya da bir yüz ifadesinde çokça duygu ve düşünceyi tek seferde aktarır. Ancak yüz ifadesini meydana getirmek çok karmaşık bir işlemdir. Her bir kişi için olduğu kadar toplumsal yapının işleyişinde de çok önemli bir rolü olan yüz ifadesi ancak iyi ve sağlıklı çalışan fasiyal sinir ile mümkün olabilir.

Bu kitapta; kraniyal sinirler arasında müstesna bir yere sahip olan fasiyal sinir, multidisipliner bir ekip hâlinde incelendi. Fasiyal sinirin embriyolojik gelişimi, anatomisi, normal bireylerdeki işlevleri ayrıntılı bir şekilde aktarıldı. Ardından; fasiyal sinirin hastalıkları ve anatomik yerleşimi itibariyle siniri etkileyebilecek patolojilerin tanı ve tedavi modaliteleri farklı bölümler hâlinde tartışıldı.

İnsanın bütünlüğünün sağlanmasında bu denli önemi olan yüz ifadesi kavramını korumak adına hem genç nesillerin fasiyal sinire dair farkındalığını arttırmak için hem de bu yolda kendilerine kılavuzluk edecek olan bu eser oluşturuldu. Alanında uzmanlaşmış yazarlar tarafından fasiyal sinirin hasar görmesi durumunda işlevinin yeniden kazanılması ve yüz ifadesinin düzeltilmesi için mümkün olan tedavi seçenekleri incelendi. Fasiyal sinirin tek bir anatomik yapıdan daha öte olan kompleks yanları ile ele alındı.

Editörler olarak; edinmesi yıllar süren tecrübelerini aktardıkları için yazarlara teşekkürlerimizi sunuyoruz.

Prof. Dr. Galip Zihni SANUS
Editör
İstanbul Üniversitesi-Cerrahpaşa, Cerrahpaşa Tıp Fakültesi, Beyin ve Sinir Cerrahisi AD İstanbul, Türkiye

Hastalıklar vardır ki medikal ve cerrahi tedavisi kadar, yarattığı psiko-sosyal izleri de tedavi gerektirir. Bir KBB hekimi olarak fasiyal paralizili hastaları yönetirken sadece medikal ve cerrahi bir süreçle uğraşmadığımı, fasiyal paralizisi nedeniyle eşinden ayrılan bir kadın hastam ve başına televizyon düşmesi ile küçük yaşta fasiyal paralizi ile tanışan güzel bir kız çocuğu ve ailesi ile birlikte öğrendim diyebilirim. KBB hekimleri olarak bizler; fasiyal paralizi sonuçlarının erken dönem müdahale şansı ile daha yüz güldürücü olduğu hasta grubuyla çalışıyoruz. Ancak bu hasta grubu ile farklı dönemlerde karşılaşan ve tedavisini üstlenen Nöroloji, Nöroşirurji, Plastik ve Rekonstrüktif Cerrahi, Göz Hastalıkları, Fizik Tedavi Anabilim Dallarının dâhil olduğu büyük bir ekibin parçasıyız aslında. Birçok branşın akıl birliği yapması gereken bu patolojide Histoloji ve Embriyoloji, Patoloji ve Radyoloji Anabilim Dallarının yeri ve yardımları yadsınamaz. İşte bu işbirliği ve dayanışmadan yola çıkarak 'fasiyal sinir' ortak noktasında buluşan ve bu konu ve hastaları ile birebir ilgilenen hekimlerin yer aldığı bir kitap fikri ortaya çıktı. Bu konudaki bilgi birikimi, ortak çalışmaya verdiği önem ve desteği ile editörümüz Sayın Galip Zihni Sanus Hocamıza teşekkürü bir borç bilirim.

Her bölümünü ilgi ile okuyacağınızı tahmin ettiğim bu kitapta; fasiyal sinirin elektrofizyolojik değerlendirilmesi, fasiyal sinir patolojileri ve paralizilerine yaklaşımda yer alan cerrahi teknikleri; Nöroşirürji, Plastik Cerrahi, KBB ve Göz Hastalıklarının geç dönem fasiyal paralizi yönetimleri, aklınızdaki tüm sorulara cevap vermeye adaydır. Ayrıca güncel rekonstrüksiyon tekniklerinin cerrahi resimlerle anlatıldığı bölümler ile deneysel fasiyal paralizi modeli çalışmak isteyen araştırmacıların heyecanla okuyacağı ve kaynak olarak kullanabileceği bölüme ek olarak fasiyal paralizilerin cerrahi dışı tedavileri, medikolegal, psikososyal ve sanatsal bakış açıları ile yüz felci her yönden ele alınmıştır

Keyifli ve bilgi dolu bir okuma dilerim.

Doç. Dr. Ayşegül BATIOĞLU KARAALTIN
Editör
İstanbul Üniversitesi-Cerrahpaşa, Cerrahpaşa Tıp Fakültesi, Kulak Burun Boğaz Hastalıkları AD İstanbul, Türkiye

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