Facial nerve palsy as the presenting feature of metastatic prostatic cancer in the temporal bone

Introduction: The most common mechanism of post-traumatic facial nerve palsy are road accidents and falls. Treatment schemes as well as proper timing of surgery are still controversial. Purpose: The aim of the study was the evaluation of the effects of surgical treatment in patients with post-traumatic facial nerve palsy. Treatment results were correlated with epidemiological factors, mechanism of injury, level of nerve damage, time of surgery and its extent. Material and methods: 9 patients with facial nerve palsy after head trauma were analyzed. In all patients complete paresis of the VII nerve occurred immediately after the injury. In 5 patients the nerve was damaged in the course of the longitudinal fracture of the temporal bone, in 3 as a result of its transverse fracture while in one woman there was no evident fracture line. In all cases, surgical treatment was performed between 4 days and 13 weeks after the trauma. In all cases transmastoid approach was used. Edema lesions of the nerve dominated in 6 patients, in two cases a bone fragment was noted along its course, in one person nerve was disrupted but primary reconstruction was not possible - the man was excluded from further analysis. The results of treatment were assessed by House'a-Brackmann (HB) scale 12 months after the procedure. Results: Very good (HBI) or good (HBII) recovery of facial nerve function was achieved in 2 and 4 out of 8 patients respectively. Surgical timing, the extent of surgery, patient’s age, mechanism of injury and level of nerve damage had no effect on the final outcome. Conclusions: The management of post-traumatic facial nerve palsy should be individual. The commonly accepted recommendation on surgical treatment is to undertake it in patients with immediate-onset and complete paralysis. Patients who, due to their severe general condition, cannot undergo early facial nerve decompression may benefit from delayed treatment for up to 3 months after the injury. KEY WORDS: facial nerve palsy, facial nerve decompression, craniofacial injury, temporal bone fracture

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Multiple paragangliomas of the head and neck - a case report

Polski Przegląd Otorynolaryngologiczny ◽

10.5604/01.3001.0012.1452 ◽

2018 ◽

Vol 7 (2) ◽

pp. 53-57

Author(s):

Tomasz Wojciechowski ◽

Adrian Drożdż ◽

Kazimierz Niemczyk

Keyword(s):

Nervous System ◽

Case Report ◽

Autonomic Nervous System ◽

Facial Nerve ◽

Head And Neck ◽

Temporal Bone ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Malignant Tumors ◽

Current Knowledge

Paragangliomas are rare, most commonly non-malignant tumors of the autonomic nervous system. Their location within the head is rather an exception than a rule, similarly as their multifocal prevalence. The authors of this paper present a case of a patient with bi-focal paraganglioma. The first symptom of illness was facial nerve palsy, diagnosed for the period of about 3 years. After making the initial diagnosis of tympanic paraganglioma, the tumor was operated. During the next 7 years, there was a reccurence within the temporal bone. What is more, periodic imaging examination showed a second foci within the neck, moreover asymptomatic. The authors discuss the natural development of paragangliomas in the region of head and neck and present the current knowledge about management of patients with a suspicion, diagnosis and treatment of this disease.

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Recurrent phosphaturic mesenchymal tumour of the temporal bone causing deafness and facial nerve palsy

The Journal of Laryngology & Otology ◽

10.1017/s0022215112000989 ◽

2012 ◽

Vol 126 (7) ◽

pp. 721-724 ◽

Cited By ~ 5

Author(s):

M I Syed ◽

M Chatzimichalis ◽

M Rössle ◽

A M Huber

Keyword(s):

Case Report ◽

Connective Tissue ◽

Facial Nerve ◽

Temporal Bone ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Early Recognition ◽

Mesenchymal Tumour ◽

Radiological Investigation ◽

Phosphaturic Mesenchymal Tumour

AbstractObjective:We describe the first reported case of a phosphaturic mesenchymal tumour, mixed connective tissue variant, invading the temporal bone.Case report:A female patient presented with increasing deafness. On examination there appeared to be a mass behind an intact tympanic membrane. Further radiological investigation showed a vascular mass occupying the middle ear, mastoid and internal auditory meatus. This was surgically resected and revealed to be a benign phosphaturic mesenchymal tumour, mixed connective tissue variant. The tumour recurred a year later, presenting as facial nerve palsy. A revision procedure was carried out; the tumour was excised with the sacrifice of a segment of the facial nerve, and a facial-hypoglossal nerve anastomosis was performed.Conclusion:This case report highlights the occurrence of this benign but sometimes aggressive tumour, of which both clinicians and pathologists should be aware. Early recognition of the condition remains of utmost importance to minimise the debilitating consequences of long-term osteomalacia in affected patients, and to prevent extracranial and intracranial complications caused by the tumour.

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Congenital internal auditory canal stenosis

The Journal of Laryngology & Otology ◽

10.1258/002221503770716205 ◽

2003 ◽

Vol 117 (10) ◽

pp. 784-787 ◽

Cited By ~ 20

Author(s):

Seung Kuk Baek ◽

Sung Won Chae ◽

Hak Hyun Jung

Keyword(s):

Hearing Loss ◽

High Resolution ◽

Facial Nerve ◽

Ct Scan ◽

Sensorineural Hearing Loss ◽

Temporal Bone ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Internal Auditory Canal ◽

Canal Stenosis

Congenital internal auditory canal stenosis is a rare cause of sensorineural hearing loss in children. A retrospective analysis including clinical manifestation and radiological findings was made for seven patients who were diagnosed with congenital internal auditory canal stenosis from 1996 to 2002. Chief presenting symptoms were hearing loss, facial nerve palsy, dizziness, and tinnitus. Hearing loss including deafness was found in five cases, vestibular function loss in four cases, and profound functional loss of facial nerve in two cases. In all cases, the diameter of the internal auditory canal was less than 2 mm on high-resolution temporal bone computed tomography (CT) scan. Two cases revealed bilateral internal auditory canal stenosis, and others were unilaterally involved cases. Congenital internal auditory canal stenosis can be an important cause of sensorineural hearing loss, facial nerve palsy, and vestibular dysfunction. High resolution temporal bone CT scan and magnetic resonance (MR) imaging were important tools for diagnosis.

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