scholarly journals Atypical tumors of the facial nerve: case series and review of the literature

2013 ◽  
Vol 34 (3) ◽  
pp. E2 ◽  
Author(s):  
Lindsey Ross ◽  
Doniel Drazin ◽  
Paula Eboli ◽  
Gregory P. Lekovic
Keyword(s):  
Facial Nerve ◽  
Relevant Literature ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Neurofibromatosis Type ◽  
Operative Management ◽  
Preoperative Imaging ◽  
Diagnostic Features ◽  
Facial Nerve Schwannoma

Object The authors present a series of 4 patients with rare facial nerve tumors. The relevant literature is reviewed and is discussed regarding diagnostic features, the role of operative management, and surgical approach. Methods A retrospective chart review was conducted for patients with tumors of the facial nerve that were treated between 2008 and 2011. Patients undergoing observation with serial MRI and those who were treated with up-front radiosurgery and for whom tissue diagnosis was not available were excluded. In addition, patients with suspected vestibular schwannoma, facial nerve schwannoma, neurofibromatosis Type 2, and metastatic disease were also excluded. The charts of 4 patients (2 men and 2 women) with “atypical” tumors were reviewed and analyzed. Results A total of 12 patients with tumors of the facial nerve were identified during the study period. Patient characteristics, preoperative imaging, operative approach, tumor histology, and outcomes are described. Conclusions Atypical facial nerve tumors must be distinguished from the more common facial nerve schwannoma. How the authors of this study treat rare facial nerve tumors is based on their experience with the more common facial nerve schwannomas, characterized by a slow progression of symptoms and growth. Less is known about the rare lesions, and thus a conservative approach may be warranted. Open questions include the role of radiosurgery, facial nerve decompression, and indications for resection of tumor and cable grafting for these rare lesions.

Overview of the Relevant Literature on the Possible Role of Acupuncture in Treating Male Sexual Dysfunction

2014 ◽  
Vol 32 (5) ◽  
pp. 406-410 ◽  
Author(s):  
Ming-Yen Tsai ◽  
Chun-Ting Liu ◽  
Cheng-Chieh Chang ◽  
Shih-Yu Chen ◽  
Sheng-Teng Huang
Keyword(s):  
Sexual Dysfunction ◽  
Premature Ejaculation ◽  
Relevant Literature ◽  
Case Series ◽  
Sham Acupuncture ◽  
Risk Of Bias ◽  
Inclusion Criteria ◽  
Male Sexual Dysfunction ◽  
Randomised Controlled

Objective To systematically review scientific reports on the effectiveness of acupuncture to treat male sexual dysfunction. Methods The Medline database was searched for published clinical trials of acupuncture for erectile dysfunction (ED) and premature ejaculation (PE) with English abstracts. Risk of bias was assessed for randomised controlled trials (RCTs). Results Seven studies on two conditions of male sexual dysfunction met the inclusion criteria. Three out of four RCTs were patient-blinded, but all had a high risk of bias. Three suggested that acupuncture has a therapeutic effect as compared with sham acupuncture. Comparisons with paroxetine were inconsistent. Other uncontrolled studies and case series suggested satisfactory improvements of ED and PE after acupuncture. Conclusions Acupuncture appears to have promise for treating male sexual dysfunction, but in view of the small number of studies and their variable quality, doubts remain about its effectiveness. Further studies are justified.

scholarly journals Management Dilemmas of Intraparotid Facial Nerve Schwannoma: Report of Four Cases and Review of Relevant Literature

2019 ◽  
Vol 10 (1) ◽  
pp. 101-106 ◽  
Author(s):  
Roshan K. Verma ◽  
Neemu Hage ◽  
Amit Bahl ◽  
Amanjeet Bal ◽  
Naresh K. Panda
Keyword(s):  
Facial Nerve ◽  
Relevant Literature ◽  
Facial Nerve Schwannoma

The Role of Demineralized Allograft Subchondral Bone in the Treatment of Talar Cystic OCD Lesions That Have Failed Microfracture

2014 ◽  
Vol 7 (5) ◽  
pp. 377-386 ◽  
Author(s):  
Stephen A. Brigido ◽  
Nicole M. Protzman ◽  
Melissa M. Galli ◽  
Scott T. Bleazey
Keyword(s):  
Subchondral Bone ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Osteochondral Lesions ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Medial Malleolar Osteotomy ◽  
And Function ◽  
Bone Plug

Cystic talar shoulder defects are particularly challenging osteochondral lesions. A retrospective chart review was performed on 13 adults that previously failed microfracture, presented with medial cystic osteochondral lesions of the talus, and were treated with malleolar osteotomy and subchondral allograft reconstruction. The aim of the study was to evaluate the effect of a medial malleolar osteotomy and allograft subchondral bone plug on pain and function. We hypothesized that following surgery, pain and function would significantly improve. Compared with preoperative measures, pain (first step in the morning, during walking, at the end of the day) and function (descending the stairs, ascending the stairs, and ambulating up to 4 blocks) improved postoperatively at 6 and 12 months ( P ≤ .001). During each activity, pain improved postoperatively from 6 to 12 months ( P ≤ .006). Postoperatively, from 6 to 12 months, the level of disability improved while descending the stairs ( P = .004), and the level of disability experienced while ascending the stairs and ambulating up to 4 blocks was maintained ( P ≥ .02). Multiple regression analyses identified body mass index as a predictor of preoperative function ( R2 = .34, P = .04). No variables were identified as significant predictors of postoperative pain or function. With all osteotomies healing, no graft rejection, and a single deep venous thrombosis, allograft subchondral plugs appear to successfully treat osteochondral lesions of the talus with improvements in pain and function as well as an acceptable complication rate. Level of Evidence: Therapeutic, Level IV: Retrospective Case Series.

scholarly journals Schwannomas along Different Segments of Facial Nerve: Case Series with Review of Literature

2011 ◽  
Vol 2 (2) ◽  
pp. 103-108 ◽  
Author(s):  
Deepa Nair ◽  
Prathamesh S Pai ◽  
Shawn T Joseph ◽  
Aliasgar V Moiyadi
Keyword(s):  
Facial Nerve ◽  
English Literature ◽  
Case Series ◽  
Review Of Literature ◽  
Delay In Diagnosis ◽  
Clinical Presentations ◽  
Early Imaging ◽  
Facial Nerve Schwannoma ◽  
High Degree ◽  
Work Up

ABSTRACT Facial nerve schwannomas are rare conditions which can mimic many other conditions. A series of patients with facial nerve schwannomas were treated in our department, all of whom had a delay in diagnosis resulting in a significant morbidity. This prompted us to present this rare case series of schwannomas along different segments of facial nerve and also review the literature on such tumors—the different presentations, work-up issues in management and rehabilitation. A wide text and PubMed English literature-based search was done on the existing literature on facial nerve schwannomas and the summary presented. Facial nerve schwannomas can have multiple clinical presentations with or without a facial paresis. Only a high degree of clinical suspicion and early imaging can lead to this diagnosis. An early diagnosis of facial nerve schwannoma is important as the morbidity associated with the condition as well as the surgery increases with the delay in diagnosis.

Pediatric Sialendoscopy for Recurrent Salivary Gland Swelling: Workup, Findings, and Outcomes

2019 ◽  
Vol 128 (4) ◽  
pp. 338-344 ◽  
Author(s):  
Javan Nation ◽  
Bharat Panuganti ◽  
Alexander Manteghi ◽  
Seth Pransky
Keyword(s):  
Salivary Gland ◽  
Pediatric Population ◽  
Balloon Dilation ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Ct Imaging ◽  
Preoperative Imaging ◽  
Parotid Glands ◽  
First Line ◽  
Submandibular Glands

Introduction: Recurrent salivary gland swelling of the parotid and submandibular glands results in painful swelling in the pediatric population. There is no defined algorithm for workup and treatment of these disorders, resulting in wide heterogeneity and in some cases overuse of computed tomography (CT) imaging. Sialendoscopy (SE) is an interventional option for recurrent swelling of both glands; however, its effectiveness in the pediatric population is still being determined. Objectives: To assess preoperative imaging utilization and benefit in the workup of recurrent pediatric sialadenitis, intraoperative SE findings, and postoperative outcomes after intervention with SE. Methods: Case-series with a 5-year retrospective chart review on children undergoing SE for recurrent sialadenitis. Results: Forty-nine SE procedures were performed on 38 parotid glands (PG) and 11 submandibular glands (SMGs) in 29 children. CT imaging findings were useful for identifying a stone or stricture and guiding surgical management in 45.5% of SMGs versus 2.6% of PGs ( P < .001). A stone was found in 45.5% of SMGs and none in PG ( P < .001). SE intervention such as balloon dilation or stone removal was performed in 54.6% of SMGs and 5.3% of PGs ( P < .001). 74% of parotid patients undergoing SE responded to 1 intervention with a cessation of recurrent gland swelling, while 26% required additional interventions. One hundred percent of SMG patients responded to first intervention. There was no improvement in the beneficial effect of SE with steroid injection ( P = .897) regardless of steroid used ( P = .082). Conclusion: CT findings were found to be low yield for recurrent parotid swelling, and ultrasound is a recommended first-line step for PG pathology. SE is a recommended first-line intervention for SMG and parotid sialadenitis as demonstrated by 100% and 74% response rate to initial SE, respectively.

A case of adult α-type spinal deformity with spinal cord rotation greater than 90°

2020 ◽  
Vol 33 (4) ◽  
pp. 502-506
Author(s):  
Sean N. Neifert ◽  
Lauren K. Grant ◽  
Jonathan J. Rasouli ◽  
Ian Thomas McNeill ◽  
Samuel K. Cho ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cobb Angle ◽  
Spinal Deformity ◽  
3D Modeling ◽  
Case Series ◽  
Operative Management ◽  
Neurological Status ◽  
Preoperative Imaging ◽  
Single Patient

This report describes a 42-year-old man who presented with an α-type spinal deformity with a Cobb angle of 224.9° and associated spinal cord rotation greater than 90°. Preoperative imaging revealed extensive spinal deformity, and 3D modeling confirmed the α-type nature of his deformity. Intraoperative photography demonstrated spinal cord rotation greater than 90°, which likely contributed to the patient’s poor neurological status. Reports of patients with Cobb angles ≥ 100° are rare, and to the authors’ knowledge, there have been no published cases of adult α-type spinal deformity. Furthermore, very few cases or case series of spinal cord rotation have been published previously, with no single patient having rotation greater than 90° to the authors’ knowledge. Given these two rarities presenting in the same patient, this report can provide important insights into the operative management of this difficult form of spinal deformity.

Utility of sodium fluorescein for achieving resection targets in glioblastoma: increased gross- or near-total resections and prolonged survival

2020 ◽  
Vol 132 (3) ◽  
pp. 914-920 ◽  
Author(s):  
Gennadiy A. Katsevman ◽  
Ryan C. Turner ◽  
Ogaga Urhie ◽  
Joseph L. Voelker ◽  
Sanjay Bhatia
Keyword(s):  
Median Survival ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Treated Group ◽  
Gross Total Resection ◽  
Sodium Fluorescein ◽  
Total Resection ◽  
Teaching Institution ◽  
Systemic Side Effects

OBJECTIVEIt is commonly reported that achieving gross-total resection of contrast-enhancing areas in patients with glioblastoma (GBM) improves overall survival. Efforts to achieve an improved resection have included the use of both imaging and pharmacological adjuvants. The authors sought to investigate the role of sodium fluorescein in improving the rates of gross-total resection of GBM and to assess whether patients undergoing resection with fluorescein have improved survival compared to patients undergoing resection without fluorescein.METHODSA retrospective chart review was performed on 57 consecutive patients undergoing 64 surgeries with sodium fluorescein to treat newly diagnosed or recurrent GBMs from May 2014 to June 2017 at a teaching institution. Outcomes were compared to those in patients with GBMs who underwent resection without fluorescein.RESULTSComplete or near-total (≥ 98%) resection was achieved in 73% (47/64) of fluorescein cases. Of 42 cases thought not to be amenable to complete resection, 10 procedures (24%) resulted in gross-total resection and 15 (36%) resulted in near-total resection following the use of sodium fluorescein. No patients developed any local or systemic side effects after fluorescein injection. Patients undergoing resection with sodium fluorescein, compared to the non–fluorescein-treated group, had increased rates of gross- or near-total resection (73% vs 53%, respectively; p < 0.05) as well as improved median survival (78 weeks vs 60 weeks, respectively; p < 0.360).CONCLUSIONSThis study is the largest case series to date demonstrating the beneficial effect of utilizing sodium fluorescein as an adjunct in GBM resection. Sodium fluorescein facilitated resection in cases in which it was employed, including dominant-side resections particularly near speech and motor regions. The cohort of patients in which sodium fluorescein was utilized had statistically significantly increased rates of gross- or near-total resection. Additionally, the fluorescein group demonstrated prolonged median survival, although this was not statistically significant. This work demonstrates the promise of an affordable and easy-to-implement strategy for improving rates of total resection of contrast-enhancing areas in patients with GBM.

scholarly journals Surgical Approaches to First Branchial Cleft Anomaly Excision: A Case Series

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Lourdes Quintanilla-Dieck ◽  
Frank Virgin ◽  
Chistopher Wootten ◽  
Steven Goudy ◽  
Edward Penn
Keyword(s):  
Surgical Treatment ◽  
Facial Nerve ◽  
Surgical Approach ◽  
Case Series ◽  
High Rate ◽  
Preoperative Imaging ◽  
Surgical Approaches ◽  
Complete Surgical Excision ◽  
Clinical Presentations ◽  
Branchial Cleft

Objectives. First branchial cleft anomalies (BCAs) constitute a rare entity with variable clinical presentations and anatomic findings. Given the high rate of recurrence with incomplete excision, identification of the entire tract during surgical treatment is of paramount importance. The objectives of this paper were to present five anatomic variations of first BCAs and describe the presentation, evaluation, and surgical approach to each one.Methods. A retrospective case review and literature review were performed. We describe patient characteristics, presentation, evaluation, and surgical approach of five patients with first BCAs.Results. Age at definitive surgical treatment ranged from 8 months to 7 years. Various clinical presentations were encountered, some of which were atypical for first BCAs. All had preoperative imaging demonstrating the tract. Four surgical approaches required a superficial parotidectomy with identification of the facial nerve, one of which revealed an aberrant facial nerve. In one case the tract was found to travel into the angle of the mandible, terminating as a mandibular cyst. This requireden blocexcision that included the lateral cortex of the mandible.Conclusions. First BCAs have variable presentations. Complete surgical excision can be challenging. Therefore, careful preoperative planning and the recognition of atypical variants during surgery are essential.

scholarly journals Case Series-Intraparotid Facial Nerve Schwannoma: Our Experience in 5 Cases

2021 ◽  
Vol 3 (5) ◽  
pp. 70-75
Author(s):  
Nitin Gupta ◽  
Shashikant Anil Pol ◽  
Surinder K Singhal ◽  
Himanshu Chhagan Bayad ◽  
Ranjeev Bhagat ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Case Series ◽  
Facial Nerve Schwannoma

scholarly journals Management of Facial Nerve Schwannoma: A Multicenter Study of 50 Cases

2018 ◽  
Vol 80 (04) ◽  
pp. 352-356 ◽  
Author(s):  
Adrien A. Eshraghi ◽  
Natalie Oker ◽  
Emre Ocak ◽  
Benjamin Verillaud ◽  
Thomas Babcock ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Tumor Resection ◽  
Retrospective Chart Review ◽  
Treatment Modalities ◽  
Tumor Control ◽  
Management Options ◽  
Multiple Treatment ◽  
Facial Nerve Schwannoma

Objective In the management of facial nerve schwannoma (FNS), surgical tumor resection is now often being replaced with more conservative approaches, such as observation with serial imaging or stereotactic radiosurgery (SRS). Given the scarcity of these lesions, determining the optimal management of FNS remains challenging and subject of debate with multiple treatment approaches supported in the literature. Methods A retrospective chart review was performed in two academic centers for patients diagnosed with FNS between 1996 and 2017. The clinical presentation, treatment modalities employed, tumor control rates, and facial nerve function (FNF) outcomes (House–Brackmann system) were assessed and analyzed. Results The study comprised 50 adult patients. Initial treatment modalities included observation with serial clinicoradiologic review in 27 patients (54%), surgery in 17 patients (34%), and SRS in 6 patients (12%). The FNF were decreased in more than half of the patients who had surgery. Nonetheless, more than 80% of the patients who were initially managed with observation or SRS had stable or improved FNF. Conclusion A prevailing trend toward more conservative treatment modalities for FNS has evolved over time, providing relatively long-term preservation of FNF. As there are multiple management options available, it is of paramount importance that the treating physician be familiar with all treatment modalities and outcomes and counsel patients appropriately. The surgery should be reserved for large tumors and poor FNF at initial presentation or follow-up while watchful observation with imaging is the treatment of choice for rest of the patients.

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