Hearing loss and facial palsy as presenting symptoms of a schwannoma of the jugular foramen

2004 ◽  
Vol 2 (2) ◽  
pp. 131-133
Author(s):  
Domenico Leonardo Grasso ◽  
Francesco Carinci ◽  
Stefano Pelucchi ◽  
Calzolari Ferdinando ◽  
Alessandro Martini
Keyword(s):  
Hearing Loss ◽  
Facial Palsy ◽  
Jugular Foramen ◽  
Presenting Symptoms

Sudden Bilateral Hearing Loss, Tinnitus, and Vertigo as Presenting Symptoms of Chronic Myeloid Leukemia

2018 ◽  
Vol 127 (10) ◽  
pp. 731-734 ◽  
Author(s):  
Nathan D. Cass ◽  
Samuel P. Gubbels ◽  
Cory D. F. Portnuff
Keyword(s):  
Hearing Loss ◽  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Sudden Onset ◽  
Patient Case ◽  
Unique Case ◽  
Bilateral Hearing Loss ◽  
Presenting Symptoms ◽  
Minimal Improvement ◽  
Wbc Count

Objectives: The objective was to describe a unique case of sudden bilateral hearing loss, tinnitus, and vertigo presenting as the first symptoms of chronic myeloid leukemia (CML). Methods: A patient case is discussed along with a review of associated literature. Results: A patient presented with sudden onset hearing loss, tinnitus, and vertigo, and was diagnosed with CML with an initial white blood cell (WBC) count of 555 000 per microliter. The proposed etiology of otologic symptoms is hyperleukocytosis. Serial audiograms showed minimal improvement in hearing despite reduction of WBC. Conclusion: In cases of bilateral, sudden onset sensorineural hearing loss, evaluation for systemic causes of otologic symptoms, including CML, should be considered.

A New Application of Gelatin Sponge in the Treatment of Hemifacial Spasm by Microvascular Decompression: A Technical Note

2021 ◽  
Author(s):  
Bowen Chang ◽  
Yinda Tang ◽  
Xiangyu Wei ◽  
Shiting Li
Keyword(s):  
Hearing Loss ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Facial Palsy ◽  
Poor Response ◽  
Technical Note ◽  
Gelatin Sponge ◽  
Group Differences ◽  
Success Rates

Abstract Objectives Microvascular decompression (MVD) for facial nerve remains the highly efficient hemifacial spasm (HFS) treatment. Nonetheless, a variety of cases have poor response to MVD. Using Teflon plus gelatin sponge in MVD seems to be a good solution. No existing study has examined the efficacy of using Teflon combined with gelatin sponge during MVD for HFS. Therefore, this study aimed to compare the efficacy of Teflon combined with gelatin sponge in HFS patients relative to that of Teflon alone. Patients and Methods We retrospectively compared the follow-up results of patients treated with Teflon and gelatin sponge with those treated with Teflon alone previously. Six hundred and eighty-eight primary HFS patients undergoing surgery from January 2010 to January 2018 were retrospectively analyzed. Three hundred and forty-seven cases received simple Teflon, while 342 cases underwent Teflon combined with gelatin sponge. Results In the Teflon plus gelatin sponge group, the incidences of facial palsy and hearing loss at 1 day, 1 year, and 2 years following surgery was significantly lower than those in the simple Teflon group. Differences in the success rates between Teflon plus gelatin sponge and the simple Teflon group were not statistically significant at 1 day, 1 year, and 2 years after surgery. The recurrence rate in the Teflon plus gelatin sponge group was significantly lower at 2 years. Conclusion For HFS patients undergoing MVD, using Teflon plus gelatin sponge can remarkably reduce the incidence of recurrence, facial palsy, and hearing loss compared with those using Teflon alone.

ENT emergencies

2019 ◽  
pp. 441-464
Author(s):  
Rogan Corbridge ◽  
Nicholas Steventon
Keyword(s):  
Hearing Loss ◽  
Blood Loss ◽  
Facial Palsy ◽  
Foreign Bodies ◽  
Sudden Hearing Loss ◽  
Severe Epistaxis ◽  
Nose And Throat

This chapter outlines the management of common ear, nose, and throat (ENT) emergencies. The assessment of blood loss and its treatment in the context of severe epistaxis or post-tonsillectomy haemorrhage are detailed. Protocols for dealing with fractured noses, sudden hearing loss, sudden facial palsy, and foreign bodies are discussed.

scholarly journals Diagnostic Yield of MRI for Sensorineural Hearing Loss – An Audit

2020 ◽  
Vol 47 (5) ◽  
pp. 656-660
Author(s):  
Helen Wong ◽  
Yaw Amoako-Tuffour ◽  
Khunsa Faiz ◽  
Jai Jai Shiva Shankar
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Diagnostic Yield ◽  
Internal Auditory Canal ◽  
Auditory Brainstem ◽  
Sensorineural Hearing ◽  
Vestibular Evoked Myogenic Potentials ◽  
Clinical Indication ◽  
Presenting Symptoms ◽  
Brainstem Response

ABSTRACT:Purpose:Contrast-enhanced magnetic resonance imaging (CEMRI) of the head is frequently employed in investigations of sensorineural hearing loss (SNHL). The yield of these studies is perceptibly low and seemingly at odds with the aims of wise resource allocation and risk reduction within the Canadian healthcare system. The purpose of our study was to audit the use and diagnostic yield of CEMRI for the clinical indication of SNHL in our institution and to identify characteristics that may be leveraged to improve yield and optimize resource utilization.Materials and methods:The charts of 500 consecutive patients who underwent CEMRI of internal auditory canal for SNHL were categorized as cases with relevant positive findings on CEMRI and those without relevant findings. Demographics, presenting symptoms, interventions and responses, ordering physicians, and investigations performed prior to CEMRI testing were recorded. Chi-squared test and t-test were used to compare proportions and means, respectively.Results:CEMRI studies revealed relevant findings in 20 (6.2%) of 324 subjects meeting the inclusion criteria. Pre-CEMRI testing beyond audiometry was conducted in 35% of those with relevant positive findings compared to 7.3% of those without (p < 0.001). Auditory brainstem response/vestibular-evoked myogenic potentials were abnormal in 35% of those with relevant CEMRI findings compared to 6.3% of those without (p < 0.001).Conclusion:CEMRI is a valuable tool for assessing potential causes of SNHL, but small diagnostic yield at present needs justification for contrast injection for this indication. Our findings suggest preferred referral from otolaryngologists exclusively, and implementation of a non-contrast MRI for SNHL may be a better diagnostic tool.

scholarly journals Myelopathy and adult T-cell leukemia associated with HTLV-1 in a young patient with hearing loss as the initial manifestation of disease

2009 ◽  
Vol 42 (3) ◽  
pp. 336-337 ◽  
Author(s):  
Denise Utsch Gonçalves ◽  
Lílian Felipe ◽  
Anna Bárbara Carneiro-Proietti ◽  
Antônio Carlos Guedes ◽  
Olindo Assis Martins-Filho ◽  
...  
Keyword(s):  
Hearing Loss ◽  
T Cell ◽  
Neurological Examination ◽  
Facial Palsy ◽  
Peripheral Blood ◽  
Cervical Lymphadenopathy ◽  
Young Male ◽  
Cell Leukemia ◽  
Initial Manifestation ◽  
Adult T Cell Leukemia

A young male developed hearing loss, vertigo, headache and facial palsy. Neurological examination did not show any abnormalities. Two years later, cervical lymphadenopathy, hepatosplenomegaly and atypical lymphocytes in peripheral blood revealed leukemia. At the same time, acquired ichthyosis was observed. Subsequently, neurological abnormalities revealed myelopathy associated with HTLV-1, due to vertical transmission.

Epidermoid Cysts and Cholesterol Granulomas Centered on the Posterior Fossa: Twenty Years of Diagnosis and Management

Neurosurgery ◽  
1987 ◽  
Vol 21 (6) ◽  
pp. 798-805 ◽  
Author(s):  
Howard Ian Sabin ◽  
Lorenzo Tommaso Bordi ◽  
Lindsay Symon
Keyword(s):  
Posterior Fossa ◽  
Diagnostic Procedures ◽  
Jugular Foramen ◽  
Neurological Deficits ◽  
Petrous Apex ◽  
Epidermoid Cysts ◽  
Diagnosis And Management ◽  
Presenting Symptoms ◽  
Review Period ◽  
Contrast Ventriculography

Abstract The clinical features, diagnosis, and management of 23 posterior fossa epidermoid cysts and 9 petrous apex lesions presenting to one unit over a period of 20 years are summarized. Of the epidermoid cysts, 13 were entirely infratentorial, but the other 10 had an additional supratentorial component. Presenting symptoms and signs were usually long-standing and at onset had often been vague and nonspecific. With time, however, a variety of neurological deficits that depended on the site of the lesion developed. These were generally combinations of cerebellopontine (CP) angle and jugular foramen syndromes, deafness, facial palsy, and motor weakness. Diagnostic procedures have changed greatly over the review period. Computed tomography and magnetic resonance imaging have replaced air encephalography and contrast ventriculography. The better preoperative localization of these lesions allows rational planning of the surgical approach required for optimal tumor exposure, which is essential for any attempt at total excision, considering the large size of the majority of these tumors when diagnosed. We favor operation through a posterior fossa craniectomy for those tumors restricted to the CP angle or 4th ventricle, but routinely use a combined supra- and infratentorial approach if the lesion has a more rostral component. The infiltrating nature of epidermoid cysts within the cranium compromises the extent of excision if neurological deficit is not to be increased, but we attempt as complete an excision of tumor and capsule as possible in the hope that many years will pass before symptoms recur. Cholesterol granulomas seem to respond well to simple cavity drainage and have shown no tendency to recur.

Outcome following retrosigmoid microvascular decompression of the facial nerve for hemifacial spasm

2005 ◽  
Vol 119 (10) ◽  
pp. 779-783 ◽  
Author(s):  
D A Moffat ◽  
V S P Durvasula ◽  
A Stevens King ◽  
R De ◽  
D G Hardy
Keyword(s):  
Hearing Loss ◽  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Retrospective Review ◽  
Facial Palsy ◽  
Complete Resolution ◽  
Symptom Control ◽  
Short Term

This paper evaluates the outcome of retrosigmoid microvascular decompression of the facial nerve in a series of patients suffering from hemifacial spasm who had been referred to the skull-base team (comprising senior authors DAM and DGH). The paper is a retrospective review of 15 patients who underwent retrosigmoid microvascular decompression of the facial nerve at Addenbrooke's Hospital between 1985 and 1995. In this series it was possible to obtain complete resolution of hemifacial spasm in 93.3 per cent of cases in the short term and in 80 per cent in the long term. Twelve patients (80 per cent) were symptom-free post-operatively. Two patients had minor recurrence of symptoms occurring within six months of the procedure. One patient with no identifiable vascular impingement of the facial nerve had no improvement following surgery. Three patients suffered sensorineural hearing loss. Two patients complained of post-operative tinnitus, and transient facial palsy was noted in one patient.Retrosigmoid microvascular decompression of the facial nerve provides excellent long-term symptom control in a high percentage of patients with hemifacial spasm.

scholarly journals Cerebellopontine angle meningiomas: postoperative outcomes in a modern cohort

2013 ◽  
Vol 35 (6) ◽  
pp. E10 ◽  
Author(s):  
Vijay Agarwal ◽  
Ranjith Babu ◽  
Jordan Grier ◽  
Owoicho Adogwa ◽  
Adam Back ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Medical Records ◽  
Cerebellopontine Angle ◽  
Jugular Foramen ◽  
Vestibular Schwannomas ◽  
Categorical Variables ◽  
Tumor Type ◽  
Tumor Extension ◽  
Duration Of Symptoms ◽  
Internal Acoustic Canal

Object Tumors of the cerebellopontine angle (CPA) have always proven difficult for neurosurgeons to optimally manage. Studies investigating the natural history and treatment of vestibular schwannomas have dominated the literature in this regard. Distinguishing meningiomas from schwannomas in this location carries particular importance as each tumor type has certain prognostic and surgical considerations. In this study, the authors have characterized the outcomes of 34 patients surgically treated for CPA meningiomas and have investigated various factors that may affect postoperative neurological function. Methods The medical records of patients with CPA meningiomas who underwent surgery from 2005 to 2013 at the Duke University Health System were reviewed. Various patient, clinical, and tumor data were gathered from the medical records including patient demographics, pre- and postoperative neurological examinations, duration of symptoms, procedural details, tumor pathology and size, and treatment characteristics. Differences in continuous variables were then analyzed using the Student t-test while categorical variables were evaluated using the chi-square test. Results A total of 34 patients underwent surgical treatment for CPA meningiomas during the 8-year period. Jugular foramen invasion was seen in 17.6% of tumors, with nearly half (41.2%) extending into the internal acoustic canal. The most common presenting symptom was hearing loss (58.8%), followed by headache (52.9%) and facial numbness/pain (50.0%). The most common cranial nerve (CN) affected was CN X (11.8%), followed by CNs VI and VII (5.9%). Postoperatively, no patients experienced a decrease in hearing, with only 5.9% of patients experiencing facial nerve palsies. Patients with tumors larger than 3 cm had a significantly higher incidence of permanent CN deficits than those with smaller tumors (45.5% vs 5.9%, respectively; p = 0.011). Also, tumor extension into the jugular foramen was associated with the occurrence of lower CN deficits, none of which occurred in tumors without jugular foramen invasion. Internal acoustic canal tumor extension was not seen to be associated with postoperative complications or CN deficits. Conclusions Meningiomas of the CPA are challenging lesions to treat surgically. However, the risk of facial palsy and hearing loss is significantly lower when compared with vestibular schwannomas. Novel methods for preoperative differentiation are needed to appropriately counsel patients on surgical risks. Also, due to the significant potential for neurological deficits, further studies are needed to investigate the utility of radiotherapy for these lesions.

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