Open AccessUltrasonic diagnosis of cosmetic injectable-induced neuropathy: Clinical cases
Author(s) -
И. Н. Бондаренко
Publication year - 2022
Publication title -
kubanskij naučnyj medicinskij vestnik
Language(s) - English
Resource type - Journals
eISSN - 2541-9544
pISSN - 1608-6228
DOI - 10.25207/1608-6228-2022-29-1-108-118
Subject(s) - medicine , soft tissue , ultrasound , radiology , facial nerve , surgery , anatomy
Background . Facial nerve injury, ller-induced compression or soft tissue inltrations are among the neuropathic complications of aesthetic injection procedures. The prospects of ultrasound imaging in neuropathy diagnosis are understudied. National and foreign literature does not describe facial soft tissues ultrasound in patients with cosmetic injectable-induced clinical neuropathy. Clinical Cases Description . Two clinical cases are presented of high resolution ultrasound (HRU)-empowered verication of injectable cosmetic procedures-induced neuropathy. Ultrasound imaging was proved necessary for differential neuropathic causes diagnosis via the clinical assessment of facial soft tissues, ller and thread depth, as well as topography relative to blood vessels and nerves. In the rst case, threads were visualised at a 4.6 and 5.8 mm depth from epidermis, which can coincide in location with large facial nerve branches usually running along vessels in deeper subcutaneous fat. Vessels were not detected in immediate proximity to threads along the entire trajectory from implantation to xation sites by colour Doppler imaging (CDI). The ultrasound pattern corresponded to dermal and soft tissue inltration. In the second case, ultrasound was applied to differentially diagnose a iatrogenic cause of neuropathy, considering a 3-year-past history of ller injection at temporal muscle projection. A ller bolus was revealed adjacent to a vessel in subaponeurotic fat of right temporal region, with inltrative signs of perifocal oedema around a piece of hyaluronic acid. Temporal soft tissue of the opposite facial half remained unchanged. According to HRU evidence, neuropathy developed due to nerve compression by facial soft tissue inltrative distortions after thread implantation in the rst case and by ller directly in the second. The HRU examination facilitated a correct diagnosis and choice of patient management. Conclusion . Ultrasonography is indicated in patients with cosmetic procedures-induced neuropathy for differential diagnosis of complication causes and current therapy monitoring.