Meet the editors

Prof. Isam Jaber Al-Zwaini was born on January 4, 1963, in Baghdad, Iraq. After graduating from Al-Mustansiryia College of Medicine in 1987, he worked as a house officer in different hospitals in Baghdad for 15 months, followed by military services for 3 years. He started his pediatric studies in 1991 and gained Fellowship of the Iraqi Commission for Medical Specializations in 1996. He worked as a lecturer in the Department of Pediat-

rics, Al-Anbar Medical College, from 1996 to 2001, where he upgraded to assistant professor in 2008. In 2007, he gained associate membership of the Royal College of Paediatrics and Child Health, UK. He has been the head of the Pediatric Department in Al-Anbar and Al-Kindy Medical College for many years. He has published more than 30 scientific papers in different pediatric fields, and his special interests are pediatric hematology, neurology, and nutrition.

Prof. Mohammed Jalal Hussein was born on April 8, 1963, in Diayla, Iraq. After graduating from Al-Mustansiryia College of Medicine in 1987, he worked as a house officer in different hospitals in Baghdad for 15 months, followed by military services for 3 years. He started his pediatric studies in 1991 and gained Fellowship of the Iraqi Commission for Medical Specializations in 1995. He worked as a lecturer in the Department of Pediat-

rics, Tikrit Medical College, from 1996 to 1998, and has been working as a senior lecturer in Al-Kindy Medical College, Baghdad University, from 1998 until now. He upgraded to assistant professor in July 2000 and to professor in August 2008. In 2007, he gained associate membership of the Royal College of Paediatrics and Child Health, UK. He was the head of the pediatric department for many years and has been vice dean for Scientific Affairs in Al-Kindy Medical College since 2016. He has published more than 16 scientific papers in different pediatric fields and has a special interest in pediatric neurology.

**Preface III**

Introduction **1**

**Chapter 1 3**

Facial Nerve and Proprioception **13**

**Chapter 2 15**

Recent Advances in the Treatment of Facial Nerve Problem **29**

**Chapter 3 31**

**Chapter 4 41**

Introductory Chapter: Facial Nerve - An Overview *by Isam Jaber Al-Zwaini and Mohammed Jalal Hussein*

The Proprioception in the Muscles Supplied by the Facial Nerve

Treatment of Facial Nerve Palsy Based on Genetic Analysis of the

*by Juan L. Cobo, Antonio Solé-Magdalena, Sonsoles Junquera, Teresa Cobo,* 

**Section 1**

Contents

**Section 2**

**Section 3**

Facial Muscles *by Hiroshi Moriyama*

*José Antonio Vega and Juan Cobo*

The Use of Phototherapy for Bell's Palsy *by Diego Rothschild and Shu Yan Ng*

## Contents


Preface

The facial nerve (seventh cranial nerve) is the nerve of facial expression. It innervates all superficial muscles of the face and scalp, the contraction of which is responsible for all our numerous facial expressions like anger, pain, fear, smile, etc. Facial disfigurement resulting from facial nerve disorders can affect the physical, psychological, and emotional integrity of an individual. This might result in a social, occupational, and educational handicap. The facial nerve is one of the most common cranial nerves implicated by disorders. The content of this short book

The first chapter is an introductory chapter by the editors, in which a brief account is given of facial nerve anatomy and common disorders involving the facial nerve like Bell's palsy, tumors, hemifacial spasm, and blepharospasm. Furthermore, we discuss common investigations used to diagnose facial nerve disorders and their

In the second chapter, Juan L. Cobo et al. discuss the role of proprioception in the regulation and coordination of facial musculature and diverse reflexes. The skeletal muscles contain an intrinsic mechanosensory system, the proprioceptive system, which provides information to the central nervous system about static and dynamic conditions of joints and muscles. In muscles, the proprioceptive system originates in specialized sensory organ-denominated muscle spindles. Nevertheless, facial muscles lack muscle spindles but facial proprioception plays key roles in the regulation and coordination of facial musculature and diverse reflexes. Facial proprioception, emanating from the facial muscles, plays key roles in facial expression and coordination of facial movement, regulation of the masticatory force in conjunction with jaw muscles, oromotor behaviors and nonverbal facial communication, as well as orofacial reflexes related to speech, swallowing, coughing, vomiting, or breathing. Moreover, proprioceptive acuity of the orofacial muscles has been found to be more accurate than the jaw. The chapter also discusses the multiple communications between the facial and trigeminal nerves and their role in conveying proprioceptive impulses via the branches of the trigeminal nerve to the central nervous system.

Professor Hiroshi Moriyama in the third chapter presents his original article about the treatment of facial nerve palsy based on genetic analysis of the facial muscles. He performed a genetic analysis of facial muscle specimens from Japanese patients with moderate (House-Brackmann facial nerve grading system III) and severe (House-Brackmann facial nerve grading system V) dysfunction due to Bell's palsy, and in rats after facial nerve resection (total paralysis). Microarray analysis of gene expression was performed using specimens from both the healthy and affected sides, and gene expressions were compared. The author defined changes in gene expression as a palsy/healthy side ratio >2.0 or <0.5. Changes of gene expression were observed; in particular, genes for muscle, neuron, and energy function showed changes with the severity of facial nerve palsy. This study may aid the development of new treatments and diagnostic/prognostic markers based on the

consists of three sections involving four chapters.

clinical significance.

severity of palsy.
