Acta Scientific Otolaryngology (ASOL) (ISSN: 2582-5550)

Case Report Volume 3 Issue 2

Post-infectious Lymphedema Can Cause Facial Paralysis

Salvatore Bühling*

Department of Surgery (Section of Otolaryngology and Maxillofacial Surgery), Eberhard-Karls-University of Tübingen, Baden Württemberg, Germany

*Corresponding Author: Salvatore Bühling, Department of Surgery (Section of Otolaryngology and Maxillofacial Surgery), Eberhard-Karls-University of Tübingen, Baden Württemberg, Germany.

Received: December 25, 2020; Published: January 30, 2021

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Abstract

Background: Lymphedema (LE) as well as facial palsy´s (FP) are relatively common disease.

FP can be divided into idiopathic FP (Bell´s palsy) and secondary FP due to a determined reason like trauma. The most common reasons of secondary FP are metabolic disease, tumours, infections, neurological disorders, autoimmune disorders, trauma and surgical interventions.

LE is a high protein edema. The most common reasons for a secondary LE are lymphatic filariasis, irradiation and surgical interventions.

Report: A 51 year old male with uncontrolled diabetes mellitus and a hypersensitivity lung disease (HLD) presented with 3 days fever and cellulitis in his face. He developed a very extensive LE and becomes septic (in the cours, he needs pressors and intubation for airway protection). The rapid streptococcal test was positive.

In the examination, we diagnosed then a dense, painless facial nerve palsy in all branches on the left (except his marginal branch).

Conclusion: In our knowledge, this is the first publication which reports, that a LE causes a secondary FP.

Due to the fact, that both LE and FP are not so rarely seen disorders, our goal is to sensitise other physicians about the possibility of a casual coherence between them; that may be of important relevance for the outcome of the patients.

Keywords: Facial Paralysis; Bells Palsy; Lymphedema; Cellulitis; Infection Disease; Autoimmune Disease

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References

  1. Kim IS., et al. “Correlation between MRI and operative findings in Bell's palsy and Ramsay Hunt syndrome”. Yonsei Medical Journal6 (2007): 963-968.
  2. Stahl N and T Ferit. “Recurrent bilateral peripheral facial palsy”. Journal of Laryngology and Otology 1 (1989): 117-119.
  3. Kawiak W., et al. “Diagnostic difficulties in etiology of the lesion of peripheral neuron of the facial nerve during the growth of sialoma”. Annales Universitatis Mariae Curie-Sklodowska 48 (1993): 125-128.
  4. Valenca MM., et al. “Idiopathic facial paralysis (Bell's palsy): a study of 180 patients”. Arquivos de Neuro-Psiquiatria 59 (2001): 733-739.
  5. Cha CI., et al. “Comparison of facial nerve paralysis in adults and children”. Yonsei Medical Journal5 (2008): 725-734.
  6. Atzema C and RD Goldman. “Should we use steroids to treat children with Bell's palsy?” Canadian Family Physician 52 (2006): 313-314.
  7. Slavkin HC. “The significance of a human smile: observations on Bell's palsy”. Journal of the American Dental Association2 (1999): 269-272.
  8. Finsterer J. “Management of peripheral facial nerve palsy”. European Archives of Oto-Rhino-Laryngology 7 (2008): 743-752.
  9. Su Y., et al. “Nerve growth factor for Bell's palsy: A meta-analysis”. Experimental and Therapeutic Medicine 2 (2015): 501-506.
  10. Peitersen E. “Bell's palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies”. Acta Otolaryngology 549 (2002): 4-30.
  11. Axelsson S., et al. “Outcome of treatment with valacyclovir and prednisone in patients with Bell's palsy”. Annals of Otology, Rhinology, and Laryngology3 (2003): 197-201.
  12. Keane JR. “Bilateral seventh nerve palsy: analysis of 43 cases and review of the literature”. Neurology 7 (1994): 1198-1202.
  13. Ogundipe O and M Smith. “Bell's palsy during interferon therapy for chronic hepatitis C infection in patients with haemorrhagic disorders”. Haemophilia 2 (2000): 110-112.
  14. Zaky DA., et al. “Malignant external otitis: a severe form of otitis in diabetic patients”. American Journal of Medicine2 (1979): 298-302.
  15. Chen WL., et al. “Outcome of treatment 46 patients with Bell's palsy with aciclovir and prednisone”. Shanghai Kou Qiang Yi Xue6 (2005): 590-592.
  16. Holland NJ and GM Weiner. “Recent developments in Bell's palsy”. BMJ 7465 (2004): 553-557.
  17. Finsterer J., et al. “Neurotoxocariasis associated with lower motor neuron disease. Report of one case”. Revista medica de Chile 4 (2010): 483-486.
  18. Mylonas I., et al. “Idiopathic facial paralysis (Bell's palsy) in the immediate puerperium in a patient with mild preeclampsia: a case report”. Archives of Gynecology and Obstetrics 3 (2005): 241-243.
  19. Thomke F., et al. “Seventh nerve palsies may be the only clinical sign of small pontine infarctions in diabetic and hypertensive patients”. Journal of Neurology11 (2002): 1556-1562.
  20. Sood S., et al. “Hypoglossal-facial nerve anastomosis: assessment of clinical results and patient benefit for facial nerve palsy following acoustic neuroma excision”. Clinical Otolaryngology and Allied Sciences 3 (2000): 219-226.
  21. Salonen IS and R Uusitalo. “Birth injuries: incidence and predisposing factors”. Z Kinderchir3 (1990): 133-135.
  22. Allard P., et al. “Cerebral and pulmonary histiocytosis X. Neurologic manifestations disclosing a pseudotumoral formation on the floor of the 4th ventricle”. Revue de Pneumologie Clinique 5 (1984): 305-309.
  23. Ruza Paz-Curbera E and M Fernandez Benitez. “Melkersson-Rosenthal syndrome in a diabetic boy”. Allergologia et Immunopathologia 6 (1998): 291-293.
  24. Turk-Boru U., et al. “The efficacy of steroids in idiopathic facial nerve paralysis: an open, randomized, prospective controlled study”. Kulak Burun Bogaz Ihtis Derg 14 (2005): 62-66.
  25. Salinas RA., et al. “Corticosteroids for Bell's palsy (idiopathic facial paralysis)”. Cochrane Database System Review 3 (2010): CD001942.
  26. Sullivan FM., et al. “Early treatment with prednisolone or acyclovir in Bell's palsy”. The New England Journal of Medicine 16 (2007): 1598-1607.
  27. Sittel C., et al. “Bell's palsy: a 10-year experience with antiphlogistic-rheologic infusion therapy”. American Journal of Otology3 (2000): 425-432.
  28. Peitersen E. “Natural history of Bell's palsy”. Acta Otolaryngology 492 (1992): 122-124.
  29. Executive C. “The Diagnosis and Treatment of Peripheral Lymphedema: 2016 Consensus Document of the International Society of Lymphology”. Lymphology4 (2016): 170-184.
  30. Zampell JC., et al. “Regulation of adipogenesis by lymphatic fluid stasis: part I. Adipogenesis, fibrosis, and inflammation”. Plastic and Reconstructive Surgery4 (2012): 825-834.
  31. International Society of L. “The diagnosis and treatment of peripheral lymphedema. 2009 Concensus Document of the International Society of Lymphology”. Lymphology2 (2009): 51-60.
  32. Douglass J., et al. “Self-Care for Management of Secondary Lymphedema: A Systematic Review”. PLoS Neglected Tropical Diseases6 (2016): e0004740.
  33. Yuan Y., et al. “Modulation of Immunity by Lymphatic Dysfunction in Lymphedema”. Frontiers in Immunology 10 (2019): 76.
  34. Rockson SG. “Addressing the unmet needs in lymphedema risk management”. Lymphatic Research and Biology 1 (2006): 42-46.
  35. Alitalo K. “The lymphatic vasculature in disease”. Nature Medicine11 (2011): 1371-1380.
  36. Connell F., et al. “A new classification system for primary lymphatic dysplasias based on phenotype”. Clinical Genetics5 (2010): 438-452.
  37. Rockson SG. “Lymphedema”. American Journal of Medicine4 (2001): 288-295.
  38. Cormier JN., et al. “Lymphedema beyond breast cancer: a systematic review and meta-analysis of cancer-related secondary lymphedema”. Cancer 22 (2010): 5138-5149.
  39. Rockson SG and KK Rivera. “Estimating the population burden of lymphedema”. Annals of the New York Academy of Sciences 1131 (2008): 147-154.
  40. Armer JM and BR Stewart. “Post-breast cancer lymphedema: incidence increases from 12 to 30 to 60 months”. Lymphology3 (2010): 118-127.
  41. Lawenda BD., et al. “Lymphedema: a primer on the identification and management of a chronic condition in oncologic treatment”. CA: A Cancer Journal for Clinicians1 (2009): 8-24.
  42. Pinell XA., et al. “Manipulative therapy of secondary lymphedema in the presence of locoregional tumors”. Cancer4 (2008): 950-954.
  43. Murdaca G., et al. “Current views on diagnostic approach and treatment of lymphedema”. American Journal of Medicine2 (2012): 134-140.
  44. Carati CJ., et al. “Treatment of postmastectomy lymphedema with low-level laser therapy: a double blind, placebo-controlled trial”. Cancer 6 (2003): 1114-1122.
  45. Rockson SG., et al. “Pilot studies demonstrate the potential benefits of antiinflammatory therapy in human lymphedema”. JCI Insight 20 (20018).
  46. Tian W., et al. “Leukotriene B4 antagonism ameliorates experimental lymphedema”. Science Translational Medicine 389 (2017).
  47. Boyages J., et al. “Liposuction for Advanced Lymphedema: A Multidisciplinary Approach for Complete Reduction of Arm and Leg Swelling”. Annals of Surgery on Oncology 22 (2015): S1263-1270.
  48. Lin CH., et al. “Vascularized groin lymph node transfer using the wrist as a recipient site for management of postmastectomy upper extremity lymphedema”. Plastic and Reconstructive Surgery4 (2009): 1265-1275.
  49. Chang DW. “Lymphaticovenular bypass for lymphedema management in breast cancer patients: a prospective study”. Plastic and Reconstructive Surgery3 (2010): 752-758.
  50. Armer J., et al. “Lymphedema following breast cancer treatment, including sentinel lymph node biopsy”. Lymphology 2 (2004): 73-91.
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Citation

Citation: Salvatore Bühling. “Post-infectious Lymphedema Can Cause Facial Paralysis"..Acta Scientific Otolaryngology 3.2 (2020): 90-96.




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