What is the role of topodiagnostic studies in the workup of congenital facial paralysis?

Updated: Jan 07, 2019
  • Author: Alan D Bruns, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Topodiagnostic studies: Not performed routinely in the workup for congenital facial paralysis.

  • Schirmer test: This test evaluates function of the greater superficial petrosal nerve (lacrimation). A reduction of more than 30% or less than 25 mm in 5 minutes is significant.

  • Stapedial reflex: If the lesion involves the nerve proximal to the branch to the stapedius muscle, the stapedius muscle does not contract and no change in impedance is evident when testing the acoustic reflex.

  • Salivary flow: Wharton papillae are cannulated, and salivary flow is measured in response to a gustatory stimulus. An abnormal result is a reduction of 25% in salivary flow compared with the noninvolved side.

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