Nerve injury ID'd after high-intensity focused ultrasound

(HealthDay)—High-intensity focused ultrasound (HIFU) treatment for skin laxity can cause facial nerve injury, according to a case study published online Nov. 22 in the Journal of Cosmetic Dermatology.

Angkana Sathaworawong, M.D., and Rungsima Wanitphakdeedecha, M.D., from Mahidol University in Bangkok, presented the case of a 33-year-old Thai female with facial nerve injury after HIFU treatment for skin laxity. The patient received HIFU treatment on both sides of the lower face for 200 lines at the highest energy setting.

The researchers found that the patient had mild facial erythema and edema immediately after the procedure. On the following day, she developed numbness and movement difficulties on the right side of the upper lip, resulting in asymmetrical lip movement and opening. Decreased sensation of the right side of upper and lower lips was seen on sensory nerve examination. In nerve conduction studies, comparable latencies and amplitudes of bilateral facial compound muscle action potentials recording were seen from the orbicularis oris muscle. Normal insertion activity, no spontaneous single-fiber discharge, some areas of normal size triphasic normal motor unit action potential (MUAP) durations with no motor unit dropout, and some areas of small to large complex and polyphasic increase MUAP durations with moderate motor unit dropout were observed with needle electromyography of the right orbicularis oris muscle.

"Dermatologists should be aware of potential adverse effects of HIFU treatment," the authors write.

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