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Scientific Oral Presentation to Present New Facial Nerve Injury Treatments

Attendees will be able to learn about new therapeutic strategies available in treating facial nerve injuries as part of scientific oral presentations in otology/neurotology taking place from 10:30 am-11:50 am today in West 208-209.

During “Effects of Gonadal Steroids and Electrical Stimulation on Cell Survival Following Intracranial Facial Nerve Injury,” participants will hear of a study that examined the differences between various sites of injury to the facial nerve, and whether treating an injured facial nerve with electrical stimulation and gonadal steroids proved effective.

“We basically compared how much cell loss there is when there is a crush injury at the intracranial segment of the facial nerve compared to a more distal injury in the intratemporal segment of the facial nerve,” said presenter Muhamad Amine, MD (PGY-5), Loyola University Medical Center. “What we found was that more proximal injuries result in more cell death and that combinatorial treatment of the injuries, with electrical stimulation and gonadal steroids, results in a higher rate of recovery.”

Other presenters include Gina N. Monaco; Ryan C. Burgette, MD; Brent J. Benscoter, MD; Sam J. Marzo, MD; and Eileen Foecking, PhD.

The purposes of this study were to assess the degree of motoneuron cell loss and the combinatorial effects of electrical stimulation (ES) and testosterone propionate (TP) on cell survival following an intracranial facial nerve crush injury, and to compare these results to distal injuries.

The study was a prospective, randomized, and controlled animal study. Sprague-Dawley rats were randomly divided into three groups: intracranial sham surgery or intracranial crush injury with or without ES and TP treatments. The intracranial sham group underwent exposure of the meatal segment of the right facial nerve. The intracranial crush groups underwent a crush of the meatal segment following exposure with or without ES and TP treatment immediately following the injury and were followed for eight weeks. Brain sections were thionin-stained, and facial motoneurons were counted using light microscopy. Results were compared to intratemporal and extracranial facial nerve crush injuries.

Intracranial crush injury resulted in a significant decrease in cell survival of 65.6 percent as compared to the sham group (99.4 percent). The treatments increased cell survival to 93.8 percent. The cell loss in the intracranial facial nerve injury is more substantial than the intratemporal (85.8 percent) and extracranial (103.3 percent) injuries.

In conclusion, intracranial injury results in a more profound cell loss compared to the distal injuries; however, combinatory treatments improve facial motoneuron survivability regardless of injury location. These data suggest the important clinical implication that this combinatorial treatment may significantly improve cell survival and therefore facial nerve function following even the most severe facial nerve injuries.

“Facial nerve injuries are devastating to patients and current therapies are limited,” Dr. Amine said. “If a surgeon can improve the chances of regaining facial function quicker and more completely, this type of therapy will quickly become adopted because it will make a difference in the patients’ quality of life.”

“We hope the attendees learn that the amount of injury to a facial nerve varies depending on where it is injured and that it’s exciting to see we can potentially make a difference in the outcome of these patients with novel therapies. Our research suggests that our therapy is promising.”