Ultrasound echomyography of facial muscles in diagnosis and follow-up of facial palsy in children

Abstract

Background Ultrasonography is a reliable, non-invasive and painless tool for quantitative assessment of the static and dynamic changes of the facial muscles in adult patients with facial palsy. Therefore it would also be worthwhile to establish the method for quantitative analysis of facial muscles in children with facial palsy to improve and expand the diagnostics for paediatric facial palsy. Methods Eight children, aged 1-18 years, with facial palsy of different aetiology were scanned and their ultrasound-images analysed. Bilateral scans of the frontal, orbicularis oculi, zygomaticus major, orbicularis oris, depressor anguli oris, depressor labii inferioris, and mentalis muscle were performed at rest and if possible during contraction. Muscle cross-section area, muscle thickness and echo intensity were measured. Results All muscles of our investigation protocol for adults could also be reliably identified in children. On the paralyzed side of the face a reduction of muscle size in rest and contraction and higher echo intensity could be convincingly detected. Based on these observations, we were able to make well-founded treatment decisions and avoid painful electrophysiological examinations. Conclusion Ultrasonography of facial muscles is also feasible in children and facilitates diagnostics in children with facial palsy.