Deviant facial nerve course in the middle ear cavity

Objective To perform an otopathologic analysis of temporal bones (TBs) with CHARGE syndrome. Study Design Otopathologic study of human TB specimens. Setting Otopathology laboratories. Methods From the otopathology laboratories at the University of Minnesota and Massachusetts Eye and Ear Infirmary, we selected TBs from donors with CHARGE syndrome. These TBs were serially sectioned at a thickness of 20 µm, and every 10th section was stained with hematoxylin and eosin. We performed otopathologic analyses of the external ear, middle ear (middle ear cleft, mucosal lining, ossicles, mastoid, and facial nerve), and inner ear (cochlea, vestibule, internal auditory canal, and cochlear and vestibular nerves). The gathered data were statistically analyzed. Results Our study included 12 TBs from 6 donors. We found a high prevalence of abnormalities affecting the ears. The most frequent findings were stapes malformation (100%), aberrant course of the facial nerve (100%) with narrow facial recess (50%), sclerotic and hypodeveloped mastoids (50%), cochlear (100%) and vestibular (83.3%) hypoplasia with aplasia of the semicircular canals, hypoplasia and aplasia of the cochlear (66.6%) and vestibular (91.6%) nerves, and narrowing of the bony canal of the cochlear nerve (66.6%). The number of spiral ganglion and Scarpa’s ganglion neurons were decreased in all specimens (versus normative data). Conclusions In our study, CHARGE syndrome was associated with multiple TB abnormalities that may severely affect audiovestibular function and rehabilitation.

Download Full-text

Using Tympanometry to Evaluate Middle Ear Function in Children and Adolescents with Signs of Peripheral Facial Nerve Palsy

Journal of Otology & Rhinology ◽

10.4172/2324-8785.1000318 ◽

2017 ◽

Vol 06 (03) ◽

Author(s):

Kopala W ◽

Kukwa A

Keyword(s):

Facial Nerve ◽

Children And Adolescents ◽

Middle Ear ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Peripheral Facial Nerve Palsy

Download Full-text

Hemifacial spasm secondary to middle ear cholesteatoma

Ear Nose & Throat Journal ◽

10.1177/014556131809700602 ◽

2018 ◽

Vol 97 (6) ◽

pp. E31-E32

Author(s):

Maheep Sohal ◽

Nicholas Karter ◽

Marc Eisen

Keyword(s):

Facial Nerve ◽

Middle Ear ◽

Hemifacial Spasm ◽

Final Diagnosis ◽

Computed Tomographic Angiography ◽

Vascular Compression ◽

Computed Tomographic ◽

Middle Ear Cholesteatoma ◽

Facial Spasm ◽

Tomographic Angiography

Hemifacial spasm is a peripheral myoclonus of the VIIth cranial nerve that is characterized by paroxysmal contraction of the muscles of facial expression. It exists in both primary and secondary forms. In rare cases, hemifacial spasm is caused by middle ear pathology. We describe the case of a 90-year-old man with recurrent cholesteatoma and tympanic segment fallopian canal dehiscence manifesting as right-sided hemifacial spasm. His history was significant for a right-sided tympanomastoidectomy for cholesteatoma 6 years earlier. Computed tomographic angiography performed to look for vascular compression of the facial nerve demonstrated a right middle ear opacification. Middle ear exploration revealed a completely dehiscent tympanic segment with cholesteatoma abutting the facial nerve. The overlying keratin debris and matrix were carefully dissected off, and facial nerve function was preserved. The final diagnosis was hemifacial spasm. During 14 months of postoperative follow-up, the patient experienced no further facial spasm.

Download Full-text

Middle ear osteoma causing progressive facial nerve weakness: a case report

Journal of Medical Case Reports ◽

10.1186/1752-1947-8-310 ◽

2014 ◽

Vol 8 (1) ◽

Cited By ~ 4

Author(s):

Kate Curtis ◽

Manohar Bance ◽

Michael Carter ◽

Paul Hong

Keyword(s):

Case Report ◽

Facial Nerve ◽

Middle Ear

Download Full-text

Hearing loss

10.1093/med/9780199568741.003.0051 ◽

2018 ◽

Author(s):

James Ramsden

Keyword(s):

Hearing Loss ◽

Facial Nerve ◽

Middle Ear ◽

Cranial Nerve ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Conductive Hearing Loss ◽

Ear Canal ◽

Eighth Cranial Nerve ◽

Conductive Hearing

Hearing loss must be divided into conductive hearing loss (CHL) and sensorineural hearing loss (SNHL). CHL is caused by sound not reaching the cochlear (abnormality of the ear canal, tympanic membrane, middle ear, or ossicles), whereas SNHL is a condition affecting the cochlear or auditory (eighth cranial) nerve. Hearing loss may be accompanied by other cardinal signs of ear disease, such as pain or discharge from the ear, vertigo, facial nerve palsy, and tinnitus, which guide the diagnosis. This chapter describes the approach to the patient with hearing loss.

Download Full-text

The optimal and safe intensity for facial nerve stimulation during intraoperative neuromonitoring in middle ear surgery

PLoS ONE ◽

10.1371/journal.pone.0221748 ◽

2019 ◽

Vol 14 (8) ◽

pp. e0221748

Author(s):

Euyhyun Park ◽

Hyunjung Kim ◽

Hye Min Han ◽

In Hak Choi ◽

Hak Hyun Jung ◽

...

Keyword(s):

Facial Nerve ◽

Middle Ear ◽

Nerve Stimulation ◽

Intraoperative Neuromonitoring ◽

Middle Ear Surgery ◽

Ear Surgery ◽

Facial Nerve Stimulation

Download Full-text

Middle Ear Adenoma and Adenocarcinoma

Otolaryngology ◽

10.1177/019459989310900516 ◽

1993 ◽

Vol 109 (5) ◽

pp. 871-876 ◽

Cited By ~ 25

Author(s):

Finn R. Amble ◽

Stephen G. Harner ◽

Louis H. Weiland ◽

Thomas J. McDonald ◽

George W. Facer

Keyword(s):

Facial Nerve ◽

Middle Ear ◽

Bone Erosion ◽

Carcinoid Tumors ◽

Initial Symptom ◽

Present Evidence ◽

Clinical Behavior ◽

Prognostic Sign ◽

Middle Ear Adenoma ◽

Aggressive Clinical Behavior

Adenomas and adenocarcinomas originating from the middle ear are few in number and have met with significant controversy in the literature. Our experience with 11 previously described patients is updated and five new cases are added. These tumors were seen in persons whose ages ranged from 7 to 77 years. The most common initial symptom was decreased hearing (11 cases), followed by otorrhea (4 cases), and otalgia (4 cases). At the time of diagnosis, facial nerve weakness was present in several patients (seven), and this was a poor prognostic sign. These glandular tumors engender controversy regarding histologic origin and the pathologic demarcation between adenoma and adenocarcinoma. In this review, we show that otorrhea, bone erosion, facial nerve involvement, and aggressive clinical behavior can be the result of lesions that appear microscopically benign. Furthermore, we present evidence of the similarity of these glandular lesions to paragangliomas and carcinoid tumors. Finally, pathologic data are presented to develop the previously unreported theory that the origin for this group of tumors is paraganglionic tissue.

Download Full-text

Unusual middle-ear mischief: trans-tympanic trauma from a hair grip resulting in ossicular, facial nerve and oval window disruption

The Journal of Laryngology & Otology ◽

10.1017/s0022215106001423 ◽

2006 ◽

Vol 120 (9) ◽

pp. 793-795 ◽

Cited By ~ 4

Author(s):

J D Snelling ◽

A Bennett ◽

P Wilson ◽

M Wickstead

Keyword(s):

Facial Nerve ◽

Tympanic Membrane ◽

Middle Ear ◽

Oval Window ◽

Delayed Presentation ◽

Stapes Footplate ◽

Horizontal Portion

A case of piercing of the tympanic membrane, resulting in unusual consequences, is described. This is the first reported case of the long process of a dislocated incus resulting in trauma to the horizontal portion of a dehiscent facial nerve. Simultaneous depression of the stapes footplate resulted in a perilymph leak, but with delayed presentation.

Download Full-text