Arachnoid cysts confined to the internal auditory canal or facial nerve canal

2011 ◽  
Vol 125 (10) ◽  
pp. 1053-1058 ◽  
Author(s):  
Q Zhang ◽  
K Kaga ◽  
M Sano ◽  
H Takegoshi
Keyword(s):  
Facial Nerve ◽  
Internal Auditory Canal ◽  
Case Series ◽  
Morphological Characteristics ◽  
Arachnoid Cysts ◽  
Variable Degree ◽  
Retrospective Case ◽  
Facial Nerve Canal ◽  
Nerve Dysfunction ◽  
Thin Walled

AbstractObjective:To illustrate the morphological characteristics and pathological significance of arachnoid cysts confined to the internal auditory canal or facial nerve canal.Design:Retrospective case series.Subjects:Three patients' cases were reviewed, and temporal bone sections examined histologically.Results:In this series, three intracanalicular arachnoid cysts were found in the internal auditory canal and one in the facial nerve canal. All lesions consisted of distinct, space-occupying cysts with a sharp boundary with surrounding tissues. They were thin-walled and compressed the surrounding nerve trunks to a variable degree. However, there was no indication that patients suffered meatal nerve dysfunction.Conclusion:Arachnoid cysts can develop within the internal auditory canal or facial nerve canal. In our series, they were asymptomatic, which is quite different from most intracanalicular arachnoid cysts encountered in clinical practice.

scholarly journals Decompression of the labyrinthine segment of the facial nerve in acoustic neuroma surgery: a consideration for minimizing postoperative delayed facial nerve dysfunction

1998 ◽  
Vol 5 (3) ◽  
pp. E11 ◽  
Author(s):  
Michael J. Holliday ◽  
Prakash Sampath
Keyword(s):  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Internal Auditory Canal ◽  
Acoustic Neuromas ◽  
Microsurgical Resection ◽  
Nerve Dysfunction ◽  
Group 2 ◽  
Acoustic Tumor ◽  
Group 1

Delayed facial nerve palsy, a condition characterized by spontaneous deterioration of facial nerve function in patients who had otherwise normal or near-normal facial function in the immediate postoperative period, has been reported in 15 to 29% of patients undergoing microsurgical resection of vestibular schwannomas. One putative mechanism for its occurrence suggests that edematous entrapment of the facial nerve in the meatal foramen (the narrowest segment of the internal auditory canal) may lead to nerve ischemia or necrosis and subsequent facial nerve dysfunction. To assess whether meatal decompression may help reduce the incidence of delayed facial nerve palsy during microsurgical resection of acoustic tumors, we compared 25 patients undergoing translabyrinthine removal of acoustic neuromas who received prophylactic decompression of the labyrinthine segment of the facial nerve (Group 1) with 40 patients who did not receive facial nerve decompression (Group 2). No patients in Group 1 had a delayed progressive facial paralysis with degeneration. In contrast, when Group 2 patients with larger, average-sized tumors were reviewed, eight patients (20%) developed delayed degeneration. These findings suggest that decompression of the labyrinthine segment may be of value in acoustic tumor surgery in reducing delayed facial nerve dysfunction. Further study is indicated in this important area.

Rhytidectomy After Parotidectomy

2017 ◽  
Vol 35 (2) ◽  
pp. 92-98
Author(s):  
Boris Paskhover ◽  
Benjamin C. Paul ◽  
David B. Rosenberg
Keyword(s):  
Patient Satisfaction ◽  
Facial Nerve ◽  
Intraoperative Complications ◽  
Case Series ◽  
Surgical Anatomy ◽  
Retrospective Case ◽  
Neck Lift ◽  
Parotid Surgery ◽  
History Of ◽  
Surgical Field

A history of prior parotidectomy is typically thought to substantially increase the risk of facial nerve injury for patients undergoing subsequent facelift surgery. For this reason, surgeons are often hesitant and may even elect not to perform facelift surgery on such patients. However, we have developed a safe and predictable operation for performing the post-parotidectomy rhytidectomy. Here, we present our rationale, approach, and results for performing this operation. This review is a retrospective case series. In total, 1200 facelifts from 2012 to 2016 performed by a single surgeon (D.B.R.) were reviewed. From these, 9 patients were identified as having had parotid surgery prior to rhytidectomy. Rhytidectomy was performed in 8 of 9 cases with a deep-plane, bilaminar approach. There were no intraoperative complications. One patient had a direct neck lift. There were no cases of revision. There were no cases of facial nerve damage including paresis or paralysis; 100% patient satisfaction was noted. Rhytidectomy with a deep-plane approach may be performed safely in patients who have undergone prior parotidectomy. Although there were no complications, revisions, postoperative asymmetry, or dissatisfaction in the patients in this study, it must be stressed that there is no substitute for a thorough appreciation of the surgical anatomy in combination with consideration of the changes to the surgical field that occur with parotid surgery.

Preoperative Radiographic Predictors of Hearing Preservation After Retrosigmoid Resection of Vestibular Schwannomas

2020 ◽  
pp. 019459982097824
Author(s):  
Yin Ren ◽  
Kareem O. Tawfik ◽  
Bill J. Mastrodimos ◽  
Roberto A. Cueva
Keyword(s):  
Internal Auditory Canal ◽  
Case Series ◽  
Hearing Preservation ◽  
Vestibular Schwannomas ◽  
Tumor Diameter ◽  
Retrospective Case ◽  
Tumor Extension ◽  
Younger Age ◽  
Hearing Outcomes ◽  
Radiographic Data

Objective To identify preoperative radiographic predictors of hearing preservation (HP) after retrosigmoid resection of vestibular schwannomas (VSs). Study Design Retrospective case series with chart review. Setting Tertiary skull base referral center. Methods Adult patients with VSs <3 cm and word recognition scores (WRSs) ≥50% who underwent retrosigmoid resection and attempted HP between February 2008 and December 2018 were identified. Pure tone average (PTA), WRS, and magnetic resonance imaging radiographic data, including tumor diameter and dimensional extension relative to the internal auditory canal (IAC), were examined. Results A total of 151 patients were included. The average tumor size was 13.8 mm (range, 3-28). Hearing was preserved in 41.7% (n = 63). HP rates were higher for intracanalicular tumors than tumors with cerebellopontine angle (CPA) components (57.6% vs 29.4%, P = .03). On multivariate analysis, maximal tumor diameter (odds ratio [OR], 0.892; P < .001) and preoperative PTA (OR, 0.974; P = .026) predicted HP, while mediolateral tumor diameter predicted postoperative PTA (OR, 1.21; P = .005) and WRS (OR, –1.89; P < .001). For tumors extending into the CPA, younger age (OR, 0.913; P = .012), better preoperative PTA (OR, 0.935; P = .049), smaller posterior tumor extension (OR, 0.862; P = .001), and smaller caudal extension relative to the IAC (OR, 0.844; P = .001) all predicted HP. Conclusion Rates of HP are highest in patients with small intracanalicular VSs and good preoperative hearing. For tumors extending into the CPA, greater posterior and caudal tumor extension relative to the IAC may portend worse hearing outcomes.

Jugular Bulb Anomalies Involving the Internal Auditory Canal: A Case Series

2021 ◽  
pp. 000348942199015
Author(s):  
Tiffany P. Hwa ◽  
Qasim Husain ◽  
Jason A. Brant ◽  
Anil K. Lalwani
Keyword(s):  
Magnetic Resonance Imaging ◽  
Internal Auditory Canal ◽  
Case Series ◽  
Jugular Bulb ◽  
Resonance Imaging ◽  
Retrospective Case ◽  
Long Term Follow Up ◽  
History Of

Objective: Jugular bulb abnormalities (JBA) such as high riding jugular bulb and jugular bulb diverticulum can extend or erode into the middle and inner ear. In this report, we report on a series of 6 patients with jugular bulb anomalies involving the internal auditory canal (IAC). Methods: A retrospective case series. Results: Six females, ages 6 to 63 presenting with myriad of otologic symptoms including hearing loss, tinnitus, balance disturbance, fullness, and otalgia were discovered to have JB eroding into IAC. Computerized tomography, but not Magnetic Resonance Imaging, was able to identify IAC erosion by a significantly enlarged JB. Conclusion: A significantly enlarged JB eroding into the IAC maybe congenital or acquired. It can present with a variety of common otologic symptoms. Long term follow-up is needed to determine the natural history of JB anomalies involving the IAC and need for intervention.

Retrospective case series of the imaging findings of facial nerve hemangioma

2014 ◽  
Vol 272 (9) ◽  
pp. 2497-2503 ◽  
Author(s):  
Yunlong Yue ◽  
Yanfang Jin ◽  
Bentao Yang ◽  
Hui Yuan ◽  
Jiandong Li ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Case Series ◽  
Imaging Findings ◽  
Retrospective Case ◽  
Retrospective Case Series

Determining Etiology of Facial Nerve Paralysis With MRI: Challenges in Malignancy Detection

2019 ◽  
Vol 128 (9) ◽  
pp. 862-868 ◽  
Author(s):  
Anthony M. Tolisano ◽  
Jacob B. Hunter ◽  
Mark Sakai ◽  
Joe Walter Kutz ◽  
William Moore ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Interrater Reliability ◽  
False Negative ◽  
Internal Auditory Canal ◽  
Final Diagnosis ◽  
Controlled Study ◽  
Facial Nerve Paralysis ◽  
Poor Agreement ◽  
Retrospective Case ◽  
Nerve Paralysis

Objective:Compare experts’ ability to differentiate malignant and benign causes of facial nerve paralysis (FNP) using the initial presenting magnetic resonance image (MRI) for each patient.Methods:This retrospective case-controlled study compared MRIs for 9 patients with a malignant cause for FNP, 8 patients with Bell’s palsy, and 9 cochlear implant patients serving as controls. The initial presenting MRI for each condition was used such that raters were evaluating real-world rather than optimal studies. Three blinded expert raters independently evaluated each segment of the facial nerve for abnormalities, provided a diagnosis, and graded MRI quality. Cohen’s and Light’s kappa were used to calculate interrater reliability and overall index of agreement, respectively.Results:MRI protocols for the malignancy group were universally suboptimal. There was poor agreement among raters for abnormalities of the facial nerve along the brainstem (0.13), geniculate (0.10), tympanic segment (0.12), and mastoid segment (0.13); moderate agreement along the cisternal segment (0.58) and internal auditory canal (0.55); and fair agreement along the labyrinthine segment (0.26) and extratemporal segment (0.36). Agreement regarding final diagnosis was fair (0.37) when compared to the true diagnosis. There were 2 false negative interpretations (failure to correctly identify malignancy) and 1 false positive interpretation.Conclusion:MRI for FNP is often initially performed with an incorrect protocol and thus may fail to reliably differentiate neoplastic from inflammatory FNP even when interpreted by experienced clinicians. Nevertheless, expert readers correctly diagnosed 87.5% of malignant causes of FNP despite these limitations.

Upfront Gamma Knife surgery for facial nerve schwannomas: retrospective case series analysis and systematic review

2018 ◽  
Vol 160 (5) ◽  
pp. 987-996 ◽  
Author(s):  
Jean-Nicolas Comps ◽  
Constantin Tuleasca ◽  
Beatrice Goncalves-Matoso ◽  
Luis Schiappacasse ◽  
Maud Marguet ◽  
...  
Keyword(s):  
Systematic Review ◽  
Facial Nerve ◽  
Gamma Knife ◽  
Case Series ◽  
Gamma Knife Surgery ◽  
Retrospective Case ◽  
Series Analysis ◽  
Retrospective Case Series

scholarly journals Ophthalmic Rosai–Dorfman disease: a multi-centre comprehensive study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tariq A. Alzahem ◽  
Antonio Augusto Cruz ◽  
Azza M. Y. Maktabi ◽  
Fernando Chahud ◽  
Hind Alkatan
Keyword(s):  
Systemic Disease ◽  
Combined Treatment ◽  
Case Series ◽  
Bone Destruction ◽  
Severe Form ◽  
Cystoid Macular Oedema ◽  
Variable Degree ◽  
Retrospective Case ◽  
Rosai Dorfman Disease ◽  
Males And Females

Abstract Background To provide basic demographic information and clinicopathologic features of ophthalmic Rosai–Dorfman disease (RDD) with a literature review. Methods A multi-centre retrospective case series reviewing all patients with histopathologically confirmed ophthalmic RDD at three tertiary eye care centres between January 1993 and December 2018. Results Eleven eyes of eight patients with histopathologically confirmed ophthalmic RDD were included, with equal numbers of males and females. The median age was 40.25 years (range: 26.6–72.4). Two patients had familial RDD. The orbit was the most commonly involved site (90.9% eyes). One patient (one eye) presented with a scleral nodule, anterior uveitis and cystoid macular oedema. Visual acuity ranged from 20/25 to light perception. Six patients had an extra-nodal ophthalmic disease, and the remaining two had an associated submandibular lymphadenopathy (nodal RDD). Conclusions Ophthalmic RDD can be the only manifestation of this systemic disease, with the orbit being the most commonly involved site, exhibiting bone destruction, intracranial and/or sinus involvement and variable degree of visual loss. Ophthalmic familial RDD represent a severe form with a malignant course. Steroid monotherapy may be inadequate to control orbital RDD; thus, combined treatment is usually necessary. A comprehensive approach to assessment and management is recommended.

scholarly journals Management of transmodiolar and transmacular cochleovestibular schwannomas with and without cochlear implantation

HNO ◽  
2020 ◽  
Author(s):  
S. K. Plontke ◽  
P. Caye-Thomasen ◽  
C. Strauss ◽  
S. Kösling ◽  
G. Götze ◽  
...  
Keyword(s):  
Word Recognition ◽  
Cochlear Implantation ◽  
Internal Auditory Canal ◽  
Case Series ◽  
Auditory Brainstem ◽  
Auditory Brainstem Responses ◽  
Retrospective Case ◽  
Hearing Rehabilitation ◽  
Secondary Invasion ◽  
Monosyllabic Words

Abstract Introduction Hearing rehabilitation with cochlear implants has attracted increasing interest also for patients with cochleovestibular schwannoma. The authors report their experience with the surgical management of tumors with rare transmodiolar or transmacular extension and outcomes after cochlear implantation (CI). Methods This retrospective case series included nine patients with either primary intralabyrinthine tumors or secondary invasion of the inner ear from the internal auditory canal. The primary endpoint with CI, performed in six patients, was word recognition score at 65 dB SPL (sound pressure level). Secondary endpoints were intra- and postoperative electrophysiological parameters, impedance measures, the presence of a wave V in the electrically evoked (via the CI) auditory brainstem responses, the specifics of postoperative CI programming, and adverse events. Results Hearing rehabilitation with CI in cases of transmodiolar tumor growth could be achieved only with incomplete tumor removal, whereas tumors with transmacular growth could be completely removed. All six patients with CI had good word recognition scores for numbers in quiet conditions (80–100% at 65 dB SPL, not later than 6 to 12 months post CI activation). Four of these six patients achieved good to very good results for monosyllabic words within 1–36 months (65–85% at 65 dB SPL). The two other patients, however, had low scores for monosyllables at 6 months (25 and 15% at 65 dB SPL, respectively) with worsening of results thereafter. Conclusions Cochleovestibular schwannomas with transmodiolar and transmacular extension represent a rare entity with specific management requirements. Hearing rehabilitation with CI is a principal option in these patients.

scholarly journals Retrospective Study of Facial Nerve Function following Temporomandibular Joint Arthroplasty Using the Endaural Approach

2015 ◽  
Vol 8 (2) ◽  
pp. 88-93 ◽  
Author(s):  
Frederick Liu ◽  
Helen Giannakopoulos ◽  
Peter D. Quinn ◽  
Eric J. Granquist
Keyword(s):  
Facial Nerve ◽  
Temporomandibular Joint ◽  
Nerve Injury ◽  
Total Joint Replacement ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Retrospective Case ◽  
Facial Nerve Injury ◽  
Nerve Dysfunction

The aim of this retrospective case–control study is to evaluate the incidence of facial nerve injury associated with temporomandibular joint (TMJ) arthroplasty using the endaural approach for the treatment of TMJ pathology. The sample consisted of 36 consecutive patients who underwent TMJ arthroplasty. A total of 39 approaches were performed through an endaural incision. Patients undergoing total joint replacement and/or with preexisting facial nerve dysfunction were excluded from the study. Five patients were lost to follow-up and were excluded from the study. Facial nerve function of all patients was clinically evaluated by resident physicians preoperatively, postoperatively, and at follow-up appointments. Facial nerve injury was determined to have occurred if the patient was unable to raise the eyebrow or wrinkle the forehead (temporalis branch), completely close the eyelids (zygomatic branch), or frown (marginal mandibular branch). Twenty-one of the 36 patients or 22 of the 39 approaches showed signs of facial nerve dysfunction following TMJ arthroplasty. This included 12 of the 21 patients who had undergone previous TMJ surgery. The most common facial nerve branch injured was the temporal branch, which was dysfunctional in all patients either as the only branch injured or in combination with other branches. By the 18th postoperative month, normal function had returned in 19 of the 22 TMJ approaches. Three of the 22 TMJ approaches resulted in persistent signs of facial nerve weakness 6 months after the surgery. This epidemiological study revealed a low incidence of permanent facial nerve dysfunction. A high incidence of temporary facial nerve dysfunction was seen with TMJ arthroplasty using the endaural approach. Current literature reveals that the incidence of facial nerve injury associated with open TMJ surgery ranges from 12.5 to 32%. The temporal branch of the facial nerve was most commonly affected, followed by 4 of the 22 approaches with temporary zygomatic branch weakness. Having undergone previous TMJ surgery did not increase the incidence of facial nerve injury using the endaural approach. This information is important for patients and surgeons in the postoperative period, as a majority of patients will experience recovery of nerve function.

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