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.

scholarly journals Long-Term Facial Nerve Outcomes after Microsurgical Resection of Vestibular Schwannomas in Patients with Preoperative Facial Nerve Palsy

2017 ◽  
Vol 79 (03) ◽  
pp. 309-313 ◽  
Author(s):  
Michael Mooney ◽  
Benjamin Hendricks ◽  
Christina Sarris ◽  
Robert Spetzler ◽  
Randall Porter ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Tumor Diameter ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Microsurgical Resection ◽  
Grade Iii

Objectives This study aimed at evaluating facial nerve outcomes in vestibular schwannoma patients presenting with preoperative facial nerve palsy. Design A retrospective review. Setting Single-institution cohort. Participants Overall, 368 consecutive patients underwent vestibular schwannoma resection. Patients with prior microsurgery or radiosurgery were excluded. Main Outcome Measures Incidence, House–Brackmann grade. Results Of 368 patients, 9 had confirmed preoperative facial nerve dysfunction not caused by prior treatment, for an estimated incidence of 2.4%. Seven of these nine patients had Koos grade 4 tumors. Mean tumor diameter was 3.0 cm (range: 2.1–4.4 cm), and seven of nine tumors were subtotally resected. All nine patients were followed up clinically for ≥ 6 months. Of the six patients with a preoperative House–Brackmann grade of II, two improved to grade I, three were stable, and one patient worsened to grade III. Of the three patients with grade III or worse, all remained stable at last follow-up. Conclusions Preoperative facial nerve palsy is rare in patients with vestibular schwannoma; it tends to occur in patients with relatively large lesions. Detailed long-term outcomes of facial nerve function after microsurgical resection for these patients have not been reported previously. We followed nine patients and found that eight (89%) of the nine patients had either stable or improved facial nerve outcomes after treatment. Management strategies varied for these patients, including rates of subtotal versus gross-total resection and the use of stereotactic radiosurgery in patients with residual tumor. These results can be used to help counsel patients preoperatively on expected outcomes of facial nerve function after treatment.

Congenital internal auditory canal stenosis

2003 ◽  
Vol 117 (10) ◽  
pp. 784-787 ◽  
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.

scholarly journals Post parotidectomy facial nerve palsy: A retrospective analysis

2019 ◽  
Vol 36 (2) ◽  
Author(s):  
Dr. Atif Hafeez Siddiqui ◽  
Saad Shakil ◽  
Danish ur Rahim ◽  
Irfan Ahmed Shaikh
Keyword(s):  
Facial Nerve ◽  
Retrospective Analysis ◽  
Pleomorphic Adenoma ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Sampling Technique ◽  
Female Ratio ◽  
Creative Commons ◽  
Parotid Surgery ◽  
Nerve Dysfunction

Background & Objectives: Transient paralysis of facial nerve is seen to vary from 15 % to 66 % in post-parotid surgery. The objective of this study was to find out the complications in post-parotidectomy with regards to facial nerve dysfunction since it is a vital structure encountered in parotid surgeries. Methods: This was a retrospective study through non probability convenient sampling technique carried from September 2010 to January 2019 in the Department of Otorhinolaryngology, Dow University of Health Sciences, Dr. Ruth K.M.Pfau Civil Hospital, Karachi. Clinical data were recorded from 75 patients and out of them 70 patients had undergone surgery with parotid gland tumours and were reported on the morphology, age, sex, surgical procedure and complications, particularly facial nerve dysfunctions. In most cases ante-grade technique was performed to identify the facial nerve, whereas retrograde technique was used in recurring tumours, and in difficult cases. The stimulator of the nerve has not been used. The nature or severity of Facial nerve dysfunction was assessed in terms of either it is, permanent or temporary, total or incomplete in respect to its branches. Results: Among total 75 patients; the mean age was 38.75 ± 9.26 years with male to female ratio of 1:1. Majority of the patients were diagnosed as pleomorphic adenoma, i.e. 78.6% after which 12% were diagnosed as mucoepidermoid carcinoma. 88.6% of patients had superficial parotidectomy and 11.4% of patients had total parotidectomy. About 75% of patients had no complications. 5(7.1%) patients had complete facial nerve palsy. Damage to the mandibular, buccal and temporozygomatic branch was observed in 10(14%), 2(3%) and 1(1.4%) patients respectively. Conclusion: The most prevalent benign parotid tumour in this study was pleomorphic adenoma. After performing parotid surgery, it was predicted that the rate of complications related to the facial nerve injury was reduced as compared to the previous studies. doi: https://doi.org/10.12669/pjms.36.2.1706 How to cite this:Siddiqui AH, Shakil S, Danish-ur-Rahim, Shaikh IA. Post parotidectomy facial nerve palsy: A retrospective analysis. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.1706 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals THE EFFECTIVENESS OF PHYSICAL REHABILITATION COMPLEX FOR FACIAL NERVE PALSY

2019 ◽  
Author(s):  
Yevheniia Nevedomska ◽  
Yaroslav Pendrak
Keyword(s):  
Electric Field ◽  
Facial Nerve ◽  
High Frequency ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Physical Rehabilitation ◽  
Therapeutic Massage ◽  
High Frequency Electric Field ◽  
Nerve Dysfunction ◽  
Frequency Electric Field

The issue of treatment and rehabilitation of patients with facial nerve palsy is still unresolved. An essential role in functional recovery of the facial nerve during its lesion can play physical rehabilitation methods. The objective – to establish the effectiveness of the physical rehabilitation complex for facial nerve palsy. Methods. 40 patients with severe facial nerve dysfunction (grade V of House-Brackmann facial nerve grading system). Treatment was carried out in accordance with existing regulatory documents. The complex of physical rehabilitation included morning hygienic gymnastics, vocal gymnastics, mimic gymnastics, therapeutic massage of the neck and collar zone, paraffin wax applied to the affected face side, therapeutic facial massage, therapeutic massage of the hairy part of the head, ultra high frequency electric field (UHF) to the facial nerve branching zone and face self-massage. The course of the treatment and rehabilitation required 10-12 procedures of each physiotherapeutic procedure carried out daily. Results. After 14 days of physical rehabilitation, in 60% of cases (24/40) a moderate severe dysfunction is recorded, and in 40% of cases (16/40), a moderate facial nerve dysfunction is observed with all patients initially diagnosed with a severe nerve dysfunction. The symmetry of nasolabial folds, normal lachrymation and salivation also rehabilitate. Conclusions. The use of a complex of physical rehabilitation including vocal gymnastics, mimic gymnastics, massage and instrumental physiotherapy can significantly improve the clinical conditions of patients with facial nerve palsy.facial nerve palsy, physical rehabilitation, gymnastics, massage, paraffin, ultra high frequency electric field

scholarly journals Delayed facial nerve palsy after vestibular schwannoma surgery

2018 ◽  
Vol 20 (1) ◽  
pp. 84-88
Author(s):  
Walter J. Fagundes Pereyra ◽  
Alonso Luis De Sousa ◽  
Karlo Faria Nunes ◽  
Deborah Nunes De Angeli
Keyword(s):  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Surgical Removal ◽  
Electromyographic Activity ◽  
Immunological Study ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Nerve Dysfunction

Background: Facial nerve dysfunction may occur immediately after vestibular schwanoma surgery. Electromyographyc monitoring of motor cranial nerves during cerebellopontine angle surgery has become an essential tool. Although delayed onset of facial nerve dysfunction hours to months following vestibular schwanoma surgery are rare. Case description: We describe the case of a 70-years-old male who was admitted with a left side tinnitus and hearing loss of the last 3 years. Magnetic resonance imaging (MRI) T1-weighted demonstrated an isointensity lesion, 30mm in diameter, at the left cerebello-pontine angle with a small portion in the internal auditory canal. The patient was surgically treated by means of a standart suboccipital retrosigmoid approach. The facial nerve was monitored by continuously during surgery. Surgical removal was macroscopically complete. The facial nerve was well-preserved during surgery and showed at the end of the procedure normal electromyographic activity. The patient did well postoperatively and was discharged at the 4th postoperative day and facial function was normal (House-Brackmann grade I). On the 10th postoperative day he notices difficult closing his left eye that progressed to complete facial nerve palsy (House-Brackmann grade III). Steroid therapy was performed for five days associated with physical therapy. One month later his facial nerve function had completely recovered. After six months, the patient remains asymptomatic and neurologically intact. MRI obtained at the 16th postoperative day showed intense enhancement of the intracranial facial nerve segment and also demonstrated no residual tumor. Immunological study at the time of onset showed herpes simplex virus antibody titer normal as well as those for herpes zoster virus. Conclusions: Delayed facial nerve palsy remains an under reported and consequently not very known phenomenon in the neurosurgical practice and literature. Because of the 2009favorable rate of recovery, patients should be reassured in the interim and should not undergo any corrective surgical procedures to improve facial nerve function. Delayed facial nerve palsy is uncommon after vestibular schwannoma surgery. Excellent recovery of facial nerve function to the original postoperative status nearly always occurs in those circumstances.

Acute, Temporary, Unilateral Facial Nerve Palsy After Dermatologic Surgery: A Report of 3 Cases

2017 ◽  
Vol 21 (5) ◽  
pp. 445-448
Author(s):  
Jacquelyn Majerowski ◽  
Yaohui G. Xu
Keyword(s):  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Rare Complication ◽  
Good Prognosis ◽  
Dermatologic Surgery ◽  
Mandibular Angle ◽  
High Anxiety ◽  
Facial Surgery ◽  
Nerve Dysfunction

Facial nerve dysfunction can be functionally and cosmetically debilitating and is commonly associated with high anxiety for patients. We report 3 cases of temporary, unilateral facial nerve palsy following dermatologic surgery under local anaesthesia over the preauricular cheek and mandibular angle, which, to our knowledge, has not been reported in the literature. Given its frightening presentation mimicking a stroke, it is essential for dermatologists to become aware of this complication to inform their patients more thoroughly. Thus, when performing facial surgery over these regions, we recommend that dermatologists include this rare complication and its good prognosis in the consenting process to minimise anxiety for those who experience it intra- or postoperatively.

scholarly journals Long-Term Facial Nerve Outcomes Following Microsurgical Resection of Vestibular Schwannomas in Patients with Preoperative Facial Nerve Palsy

2017 ◽  
Vol 78 (S 01) ◽  
pp. S1-S156
Author(s):  
Michael Mooney ◽  
Christina Sarris ◽  
Benjamin Hendricks ◽  
Randall Porter ◽  
Robert Spetzler ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Vestibular Schwannomas ◽  
Microsurgical Resection

scholarly journals Bilateral Internal Auditory Canal (IAC) Duplication with Congenital Sensorineural Hearing Loss (SNHL)-A Case Report

2021 ◽  
Vol 20 (4) ◽  
Author(s):  
Nik Adilah Nik Othman ◽  
Nur Saadah Mohamad ◽  
Ahmad Aizuddin Mohamad Jamali ◽  
Mohd Shafie Abdullah ◽  
Mohd Khairi Md Daud
Keyword(s):  
Hearing Loss ◽  
Down Syndrome ◽  
Facial Nerve ◽  
Sensorineural Hearing Loss ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Internal Auditory Canal ◽  
Sensorineural Hearing ◽  
Image Finding ◽  
Suitable Treatment

Duplication of the internal auditory canal is a rare entity. It can be unilateral or bilateral involvement and usually found during an investigation of sensorineural hearing loss or facial nerve palsy. We report this image finding in a child with Down syndrome with bilateral profound sensorineural hearing loss. There was no facial nerve palsy. We highlight the rarity of this image finding and the importance of imaging for detection of middle and inner ear abnormality in a case of congenital sensorineural hearing loss as it helps in decision making for the suitable treatment. Keywords: Duplicate IAC; Bilateral Duplicate IAC; sensorineural hearing loss; Down syndrome

Duplicate internal auditory canals with facial and vestibulocochlear nerve dysfunction

2011 ◽  
Vol 126 (1) ◽  
pp. 66-71 ◽  
Author(s):  
T Y Kew ◽  
A Abdullah
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Facial Nerve ◽  
Clinical Presentation ◽  
Facial Nerve Palsy ◽  
Internal Auditory Canal ◽  
Resonance Imaging ◽  
Radiological Findings ◽  
Vestibulocochlear Nerve ◽  
Nerve Dysfunction

AbstractObjective:We report an extremely rare case of duplication of the internal auditory canal associated with dysfunction of both the facial and vestibulocochlear nerves. We also review the literature regarding the integrity of the facial and vestibulocochlear nerves in such cases.Case report:A 34-year-old man presented with unilateral, right-sided, sensorineural hearing loss and facial nerve palsy since childhood. Facial nerve function was observed to be House–Brackmann grade III. Computed tomography and magnetic resonance imaging demonstrated ipsilateral duplicate, vacant internal auditory canals. Based on the clinical presentation, we interpreted these radiological findings as aplasia of the vestibulocochlear nerve and severe hypoplasia of the facial nerve.Conclusion:To our best knowledge, this is the first report of vestibulocochlear nerve aplasia and severe facial nerve hypoplasia in a case of ipsilateral duplication of the internal auditory canal. High resolution gradient echo magnetic resonance imaging sequences are advocated for assessment of neural integrity in patients with an abnormal internal auditory canal and facial and/or vestibulocochlear nerve dysfunction.

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