Javiér Gavilán

Hospital Universitario La Paz

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Luis Lassaletta

Hospital Universitario La Paz

136

Alejandro Castro

Light Prescriptions Innovators (Spain)

César Gavilán

Hospital Universitari Sant Joan D'Alacant

Isabel Sánchez‐Cuadrado

Hospital Universitario La Paz

Jonas T. Johnson

Eye and Ear Foundation

Prabhat K Bhama

Providence Regional Medical Center Everett

Miryam Calvino

Hospital Universitario La Paz

Robert L. Witt

Thomas Jefferson University

Lex Vlantis

Mack L. Cheney

Massachusetts Eye and Ear Infirmary

Cooperative Institutions

Hospital Universitario La Paz

150

Universidad Autónoma de Madrid

Hospital La Paz Institute for Health Research

Medical University of Vienna

Instituto de Salud Carlos III

Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde

Harvard University

Neurological Surgery

Cochlear (Australia)

University of Antwerp

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Etiopatogenia de la parálisis facial periférica idiopática o de Bell

Revista de Neurología (2001)

Juan Ignacio de Diego M.P. Prim Javiér Gavilán

Bell's facial palsy is a common condition with an incidence varying between 11.5 and 40.2 cases per 100,000 persons per year. However, some aspects of its aetiopathogenesis are still not clear.Over the years four theories have been suggested to explain the disorder: vascular, immunological, compressive and viral. The vascular theory (the oldest) has been ruled out by various studies. Subsequently, the immunological and compressive theories were described almost simultaneously. The former established the mechanisms generating a neural inflammatory response, and the second the morphological basis which made the nerve sensitive to these mechanisms. Both theories suggested, amongst other agents, a virus as the agent triggering the process. Recently a virus of the herpes simplex family has been identified as the cause of the disease.At present there is broad general agreement that Bell s facial palsy is caused by reactivation of a latent infected with human herpes simplex virus, localized to the facial nerve.

10.33588/rn.3211.2000630

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Citations (7)

Cyclin D1 Expression and Facial Function Outcome After Vestibular Schwannoma Surgery

Otology & Neurotology (2010)

Luis Lassaletta Laura Del Rı́o Miguel Torres‐Martín Juan A. Rey Mercedes Patrón

The proto-oncogen cyclin D1 has been implicated in the development and behavior of vestibular schwannoma. This study evaluates the association between cyclin D1 expression and other known prognostic factors in facial function outcome 1 year after vestibular schwannoma surgery.Sixty-four patients undergoing surgery for vestibular schwannoma were studied. Immunohistochemistry analysis was performed with anticyclin D1 in all cases. Cyclin D1 expression, as well as other demographic, clinical, radiologic, and intraoperative data, was correlated with 1-year postoperative facial function.Good 1-year facial function (Grades 1-2) was achieved in 73% of cases. Cyclin D1 expression was found in 67% of the tumors. Positive cyclin D1 staining was more frequent in patients with Grades 1 to 2 (75%) than in those with Grades 3 to 6 (25%). Other significant variables were tumor volume and facial nerve stimulation after tumor resection. The area under the receiver operating characteristics curve increased when adding cyclin D1 expression to the multivariate model.Cyclin D1 expression is associated to facial outcome after vestibular schwannoma surgery. The prognostic value of cyclin D1 expression is independent of tumor size and facial nerve stimulation at the end of surgery.

10.1097/mao.0b013e3182001cc8

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Citations (2)

Contribution and safety of the side‐to‐end hypoglossal‐to‐facial transfer in multidisciplinary facial reanimation

Head & Neck (2022)

Teresa Mato Patino José Manuel Morales‐Puebla Susana Moraleda Isabel Sánchez‐Cuadrado Miryam Calvino

This study evaluates facial and tongue function in patients undergoing side-to-end hypoglossal-to-facial transfer (HFT) with additional techniques.Thirty-seven patients underwent a side-to-end HFT. Twelve had additional cross-face grafts, and 9 had an additional masseter-to-facial transfer. Facial was assessed with House-Brackmann (HB), Sunnybrook Facial Grading Scale (SFGS), and eFACE. Martins scale and the Oral-Pharyngeal Disability Index (OPDI) were used to assess tongue function.Ninety-four percent of cases reached HB grades III-IV. Mean total SFGS score improved from 16 ± 15 to 59 ± 11, while total eFACE score from 52 ± 13 to 80 ± 5. Dual nerve transfers were a predictor for a better eFACE total score p = 0.034, β = 2.350 [95% CI, 0.184-4.516]), as well as for a higher SFGS total score (p = 0.036, β = 5.412 [95% CI, 0.375-10.449]). All patients had Martin's grade I. Mean postoperative OPDI scores were 84 ± 17 (local physical), 69 ± 16 (simple and sensory motor components), 82 ± 14 (complex functions), and 73 ± 22 (psychosocial).The side-to-end HFT offers predictable facial function outcome and preserves tongue function in nearly all cases. Dual nerve transfers appear to improve the final outcome.

Facial muscles

Hypoglossal nerve

10.1002/hed.27076

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Citations (4)

Fine structure processing improves telephone speech perception in cochlear implant users

European Archives of Oto-Rhino-Laryngology (2012)

Javier Galindo Luis Lassaletta Rosa Pérez Mora Alejandro Castro Marta Bastarrica

Landline

Cochlear Implantation

10.1007/s00405-012-2101-9

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Citations (14)

Is There an Age Limit for Cochlear Implantation?

Annals of Otology Rhinology & Laryngology (2013)

Isabel Sánchez‐Cuadrado Luis Lassaletta Rosa Pérez‐Mora Mario Zernotti María Fernanda Di Gregorio

We evaluated the quality of life following cochlear implantation in elderly postlingually deaf adults.Data were studied concerning demographics and audiometric evaluation in postlingually deaf adults at least 60 years of age who underwent cochlear implantation in 3 institutions. The Glasgow Benefit Inventory was used to quantify the quality of life. The patients were divided into 2 groups (those less than 70 years of age and those at least 70 years of age), and the results were also compared to those of younger adult cochlear implant recipients (less than 60 years of age).Eighty-one patients were included in this study. The mean age at implantation was 68 years (range, 60 to 82 years). Cochlear implantation significantly improved the patients' audiometric outcomes (pure tone average and speech perception; p < 0.05). The Glasgow Benefit Inventory showed a benefit overall (+36) and on the individual subscales (+49, +20, and +1). The difference in quality of life was not significant between those less than 70 and those at least 70 years of age (p = 0.90). The results were similar to those of younger postlingually deaf implant recipients.Elderly cochlear implant users experience an improvement in their quality of life, with outcomes similar to those achieved in younger adults. Particular attention must be paid to the possibility of age-related conditions in the elderly that may increase the risks of surgery.

Cochlear Implantation

Demographics

Age limit

Age groups

10.1177/000348941312200402

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Citations (38)

Total Maxillectomy, Orbital Exenteration

UCT Libraries eBooks (2017)

Johan Fagan Kathy Taylor Ellen Bolding Mark de Groot Robert L. Witt

Source

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Citations (2)

Surgery for Intrathoracic (Retrosternal) Goitres

UCT Libraries eBooks (2017)

Johan Fagan Kathy Taylor Ellen Bolding Mark de Groot Robert L. Witt

Source

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Citations (1)

An update on the treatment of vestibular schwannoma

Acta Otorrinolaringologica (English Edition) (2009)

Luis Lassaletta Javiér Gavilán

Neurofibromatosis type 2

10.1016/s2173-5735(09)70116-4

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Citations (10)

[New method for recording human cochlear microphonic potentials].

PubMed (1998)

Gonzalo de los Santos Julio Sanjuán Javiér Gavilán

Microphonics

Tone (literature)

Human ear

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Citations (0)

Plastic & Reconstructive Surgery (2015)

Adel Fattah Dilnath A. Gurusinghe Javiér Gavilán Tessa A. Hadlock Jeff Marcus

Sir: We thank Alicandri-Ciufelli et al. for their communication and appreciate their comments, which we would like to address in a point-by-point fashion. First, we believe that in routine clinical practice, evaluation of a patient should be performed thoroughly by all health care professionals (not just physicians) but concede that the method used is at the discretion of the clinician. In our experience, but admittedly not quantified or researched specifically, the use of the Sunnybrook Facial Grading Scale takes a few minutes and is routinely performed by the facial therapist and the physician, allowing interrater comparison within a team. The rough facial grading system is very simplified in that it does not take into account the regional differences of facial palsy affecting specific divisions of the nerve. We also argue that it demonstrates good interrater reliability largely because the groups are so broadly defined. This is the same issue with the House-Brackmann scale, the most widely used system1 against which the rough facial grading system was validated. Indeed, Dr. Alicandri-Ciufelli et al. (and others) have previously stated that the broader the definitions of categories, the greater the interrater agreement.2,3 They also go on to argue that the broader these categories, the less informative any scale would be. We agree with this concept and suggest that the rough facial grading system is a step backward in that high interrater reliability does not necessarily confer sufficient information for a thorough facial nerve evaluation. For a scale to be of value, it needs to be specific, sensitive, and simple to use, and our objective analysis suggests that the Sunnybrook Facial Grading Scale best meets these criteria. The rough facial grading system is simple to use, with high interrater agreement, but is not specific or sensitive. Second, the idea that computer-based objective systems will supersede clinical examination has been around for a long time. We agree that as technology progresses, such objective analyses will become cheaper, faster, and more widespread. Our report evaluates the current state of facial nerve assessment, and although larger medical facilities in the developed world may be able to access such devices, it will be a long time before such technology is universally available. In addition, the objective assessment of facial animation omits one other important aspect of facial difference: the subjective assessment of appearance. This can be divided into subjective self-assessment (the realm of patient-reported outcome measures) and observer-based subjective assessment. The latter is automatically incorporated into the physician’s assessment and, some would argue, unconsciously biases their assessment, whatever facial grading scale they use. This is the human dynamic emotional interaction that will defy quantification for some time to come. In addition, whatever advanced computerized system is used, it will need to be validated against the current criterion standard, which is clinical examination. Third, we completely agree with the comment that the quality of life as reported by the patients is (perhaps) the most important measure of therapeutic benefit. The patient-reported outcome measures and the functional scoring systems are both required, providing a broader picture of patient wellness, and one need not exclude the other. Furthermore, the correlation between functional scores and patient-reported outcome measures is increasingly being recognized as nonlinear.4 As we state in our study, this has been addressed in another publication5 and was not the purpose of our report. We thank Alicandri-Ciufelli et al. for the opportunity to clarify these points and hope that our work will continue to stimulate debate among the different groups of health care professionals that manage patients with facial palsy. DISCLOSURE The authors have no commercial associations or financial disclosures that might pose or create a conflict of interest with any of the information presented in this communication. Adel Y. Fattah, Ph.D., F.R.C.S.(Plast.) Dilnath A. Gurusinghe, M.R.C.S.(Eng.) Facial Nerve Programme Regional Paediatric Burns and Plastic Surgery Service Alder Hey Children’s NHS Foundation Trust Liverpool, United Kingdom Javier Gavilan, M.D. Department of Otolaryngology La Paz University Hospital Madrid, Spain Tessa Hadlock, M.D. Harvard Medical School Massachusetts Eye and Ear Facial Nerve Center Boston, Mass. Jeff Marcus, M.D. Division of Plastic, Reconstructive, Oral, and Maxillofacial Surgery Duke University Medical Center Durham, N.C. Henri Marres, M.D., Ph.D. Radboud University Medical Center Nijmegen, The Netherlands Charles Nduka, M.A., M.D. Queen Victoria Hospital Foundation NHS Trust East Grinstead, West Sussex, United Kingdom William H. Slattery, M.D. University of Southern California House Institute Los Angeles, Calif. Alison Snyder-Warwick, M.D. Washington School of Medicine St. Louis, Mo. On behalf of the Sir Charles Bell Society

Inter-Rater Reliability

Grading (engineering)

Judgement

Grading scale

10.1097/prs.0000000000001183

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Citations (2)