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Surgical Treatment Outcome for Familial Melkersson-Rosenthal Syndrome

Patient: Female, 15-year-old Final Diagnosis: Melkersson-Rosenthal syndrome Symptoms: Fissured tongue • orofacial edema • recurrent facial nerve palsy Clinical Procedure:— Specialty: Otolaryngology OBJECTIVE: Congenital defects/diseases BACKGROUND: Recurrent facial nerve palsy, orofacial edema, and...

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Detalles Bibliográficos
Autores principales: Alencar, Tannara Nobile, Botelho, Marcela Machado, Carasek, Natália, Bahmad, Fayez
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9923774/
https://www.ncbi.nlm.nih.gov/pubmed/36755481
http://dx.doi.org/10.12659/AJCR.938670
Descripción
Sumario:Patient: Female, 15-year-old Final Diagnosis: Melkersson-Rosenthal syndrome Symptoms: Fissured tongue • orofacial edema • recurrent facial nerve palsy Clinical Procedure:— Specialty: Otolaryngology OBJECTIVE: Congenital defects/diseases BACKGROUND: Recurrent facial nerve palsy, orofacial edema, and fissured tongue are a triad of manifestations that characterize a rare disorder named Melkersson-Rosenthal syndrome. It is important to consider this syndrome when diagnosing atypical, unilateral, or bilateral facial palsies with characteristics of familial prevalence. There is no established outcome prediction for this disease and the syndrome does not have a specific duration or prospective timeline. Recurrent facial paralysis can require surgery and a multidisciplinary approach with regular follow-up. CASE REPORT: We describe a 38-year-old woman presenting with a third episode of facial paralysis and discuss her pedigree chart and the treatment course chosen. After conservative treatment with oral corticosteroids, antiviral therapy, and motor physical therapy with no significant improvements, the patient underwent facial nerve decompression surgery with outstanding results. Eight months after surgery and intense postoperative physical therapy, the patient improved from grade VI to grade II palsy on the House-Brackmann Scale. The patient’s older brother also presented a fissured tongue and had a history of 2 episodes of facial paralysis. The patient’s son, mother, and sister also presented tongue fissuring but did not have any other clinical signs of the syndrome. CONCLUSIONS: Despite being rare, Melkersson-Rosenthal syndrome is associated with a family inheritance and its diagnosis has prognostic implications. Therefore, it is of the utmost importance to have suspicion of this disorder in order to improve quality of care and target the treatment accordingly. Surgical treatment in these cases seems to be an excellent choice to treat current facial paralysis and prevent further episodes.