The stapedial reflex as a topographical marker of proximal involvement of the facial nerve in leprosy. A pilot study

Abstract

Summary This study aimed to determine the parameters necessary for a study of stapedial reflexes in leprosy patients to ascertain if the facial nerve is involved more proximally than the stylomastoid foramen. It involved leprosy patients with and without facial nerve involvement and non-leprosy controls. Clinical examination of the patients' ears, a tympanogram and audiogram to exclude conductive and sensorineural deafness, followed by the measurement of a stapedial reflex and the acoustic reflex threshold, were carried out. The number of absent reflexes and the acoustic reflex thresholds did not differ between the three groups of subjects. A definitive study would be logistically impossible. Suggestions are made as to more exact patient selection in order to demonstrate any stapedial reflex changes due to leprosy. The findings of this study do not suggest that facial nerve pathology extends proximally to the stylomastoid foramen, unless such proximal involvement is subclinical to the detection methods used.

Proposta e validação de um protocolo de triagem para identificar as manifestações fonoaudiológicas na hanseníase

“…Os problemas auditivos, encontrados no indivíduo com hanseníase, são consequência do comprometimento do nervo vestibulococlear, levando a sintomas de vertigem, tontura e/ou náusea, à perda auditiva neurossensorial com presença de zumbido e dificuldade de compreensão de fala (10) . Já um estudo de 1999 não demonstrou alterações do reflexo estapediano devido à lepra (11) .…”

“…Lemieux L, Cherian TA, Richard B (11) Leprosy Review Journal The stapedial reflex as a topographical marker of proximal involvement of the facial nerve in leprosy. A pilot study…”

Facial nerve and branch dysfunction in leprosy - a study from India

“…[5][6][7][8] A higher incidence of cases has been reported in borderline tuberculoid (BT) leprosy of up to 40%, with an average time to onset of facial palsy ranging from 4 weeks to 12 years, the interval being lower when in type 1 reaction (T1R). 3,7,[9][10][11] In a study conducted among 1226 paucibacillary leprosy patients, lagophthalmos was present in 45% of patients with both a facial patch and T1R, 26% of patients with facial patch alone and in 8% of patients in T1R without facial patches. 12 Previous studies have shown that nerve conduction studies (NCS) may detect peripheral nerve dysfunction in leprosy earlier than the appearance of clinical signs and symptoms of nerve function impairment (NFI).…”