The widened transcochlear approach to jugular foramen tumors

1988 ◽  
Vol 69 (6) ◽  
pp. 887-894 ◽  
Author(s):  
William Pellet ◽  
Maurice Cannoni ◽  
André Pech
Keyword(s):  
Facial Nerve ◽  
Temporomandibular Joint ◽  
Petrous Bone ◽  
Jugular Foramen ◽  
Content Type ◽  
Zygomatic Process ◽  
Fine Print

✓ The authors describe a widened transcochlear approach for large tumors of the jugular foramen with intrapetrous, intracranial, and infratemporal extensions. This approach complements the transcochlear and infratemporal approaches by enlarging the route of access to the region with disinsertion of the sternocleido-mastoid, digastric, and stylohyoid muscles, by removing petrous bone in order to displace the facial nerve, by resection of the auditory canal, and by subluxation of the temporomandibular joint and zygomatic process. The use of this approach is described in seven patients.

En bloc petrosectomy using a Gigli saw for petroclival lesions

1995 ◽  
Vol 83 (3) ◽  
pp. 559-560 ◽  
Author(s):  
Tomio Sasaki ◽  
Makoto Taniguchi ◽  
Ichiro Suzuki ◽  
Takaaki Kirino
Keyword(s):  
Facial Nerve ◽  
Semicircular Canals ◽  
Petrous Bone ◽  
New Technique ◽  
En Bloc ◽  
Content Type ◽  
A New Technique ◽  
Transtentorial Approach ◽  
Fine Print

✓ The authors report a new technique for en bloc petrosectomy using a Gigli saw as an alternative to drilling the petrous bone in the combined supra- and infratentorial approach or the transpetrosal—transtentorial approach. It is simple and easy and avoids postoperative cosmetic deformity. This technique has been performed in 11 petroclival lesions without injuring the semicircular canals, the cochlea, or the facial nerve.

Posterior petrous meningiomas: 82 cases

2005 ◽  
Vol 102 (2) ◽  
pp. 284-289 ◽  
Author(s):  
Zhe Bao Wu ◽  
Chun Jiang Yu ◽  
Shu Sen Guan
Keyword(s):  
Facial Nerve ◽  
Clinical Manifestations ◽  
Petrous Bone ◽  
Type I ◽  
Type Ii ◽  
Posterior Surface ◽  
Total Resection ◽  
Content Type ◽  
Functional Preservation ◽  
Fine Print

Object. The aim of this study was to discuss posterior petrous meningiomas—their classification, clinical manifestations, surgical treatments, and patient outcomes. Methods. A retrospective analysis was performed in 82 patients with posterior petrous meningiomas for microsurgery. According to the anatomical relationship with the posterior surface of the petrous bone and with special reference to the internal auditory canal (IAC), posterior petrous meningiomas were classified into three types: Type I, located laterally to the IAC (28 cases); Type II, located medially to the IAC, which might extend to the cavernous sinus and clivus (32 cases); and Type III, extensively attached to the posterior surface of the petrous bone, which might envelop the seventh and eighth cranial nerves (22 cases). Sixty-eight (83%) of 82 cases involved total resection. The rate of anatomical preservation of facial nerve was 97.5%, whereas the functional preservation rate was 81%. The rate of hearing preservation was 67%. All Type I tumors were completely resected, and the rate of anatomical preservation of facial nerve was 100% and functional preservation was 93%. Regarding Type II lesions, 75% of 32 cases involved total resection; the rate of anatomical preservation of facial nerve was 97% and functional preservation was 75%. For Type III lesions, 73% of 22 cases were totally resected. The rate of anatomical preservation of facial nerve in patients with this tumor type was 95%, whereas functional preservation was 73%. Conclusions. Clinical manifestations and surgical prognoses are different among the various types of posterior petrous meningiomas. It is more difficult for Types II and III tumors to be resected radically than Type I lesions, and postoperative functional outcomes are significantly worse accordingly. The primary principles in dealing with this disease entity include preservation of vital vascular and central nervous system structures and total resection of the tumor as much as possible.

Facial nerve preservation during surgery for removal of acoustic nerve tumors

1982 ◽  
Vol 57 (6) ◽  
pp. 739-746 ◽  
Author(s):  
Richard H. Lye ◽  
John Dutton ◽  
Richard T. Ramsden ◽  
Joseph V. Occleshaw ◽  
Iain T. Ferguson ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Petrous Bone ◽  
Ct Scans ◽  
Facial Weakness ◽  
Content Type ◽  
Nerve Preservation ◽  
Increased Risk ◽  
Acoustic Nerve ◽  
Facial Function ◽  
Fine Print

✓ A series of 33 patients with 35 acoustic nerve tumors is reviewed. Tumor size was estimated from computerized tomography (CT) scans, and its influence on anatomical and functional preservation of the facial nerve was assessed. Six tumors (one invading the petrous bone, three medium and two large tumors) were not detected on CT scans. The translabyrinthine approach was used in seven instances (one small and six medium tumors) and the suboccipital transmeatal approach for 28 tumors (seven medium and 21 large tumors). Anatomical preservation of the facial nerve was achieved in 83% of operations for tumor removal, two of which were subtotal. A further two patients underwent subtotal removal, but the facial nerve was destroyed. Large tumors carried an increased risk of damage to the facial nerve, but even in this group the nerve was preserved anatomically intact in 70% of cases. Damage to the facial nerve occurred more frequently in patients with preoperative evidence of facial weakness; however, this factor did not appear to influence functional recovery of the facial nerve, provided that the nerve was intact at the end of the operation. A simple grading system for facial nerve function is described. Only 76% of anatomically intact facial nerves showed any evidence of function 1 month after surgery. Postoperatively, facial function improved with time. At the latest review, 45% of these patients had normal facial function or mild facial weakness (Grades I and II).

Neurinomas of the facial nerve

1975 ◽  
Vol 43 (5) ◽  
pp. 608-613 ◽  
Author(s):  
Fabian Isamat ◽  
Federico Bartumeus ◽  
Antonio M. Miranda ◽  
Jaime Prat ◽  
Luis C. Pons
Keyword(s):  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Petrous Bone ◽  
The Other ◽  
Bone Area ◽  
Content Type ◽  
Fine Print

✓ Three cases of neurinomas of the facial nerve are reported. Two of them originated from the labyrinthine portion of the nerve and the other from the vertical portion. Neurinomas of the first part of the facial nerve can be suspected preoperatively since they seem to give rise to specific clinical and radiological manifestations that can be distinguished from tumors of other portions of the nerve, the petrous bone area, or the cerebellopontine angle. The reported cases of neurinomas of the facial nerve are reviewed and analyzed.

Brain and bone scans in primary Ewing's sarcoma of the petrous bone

1976 ◽  
Vol 44 (5) ◽  
pp. 608-612 ◽  
Author(s):  
Pete M. Fitzer ◽  
William R. Steffey
Keyword(s):  
Bone Scan ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Petrous Bone ◽  
Diagnosis And Treatment ◽  
Content Type ◽  
Brain Scan ◽  
Bone Scans ◽  
The Right ◽  
Fine Print

✓ The authors present a case in which primary Ewing's sarcoma of the right petrous pyramid in a 9-year-old girl showed no uptake on a 99mTc-pertechnetate nuclide angiogram. Intense uptake was present on a 99mTc-polyphosphate bone scan, but a static brain scan was only minimally abnormal. The diagnosis and treatment of Ewing's sarcoma are reviewed.

Alternative to tarsorrhaphy in peripheral facial nerve palsy with expectation of functional recovery

1984 ◽  
Vol 61 (2) ◽  
pp. 405-406 ◽  
Author(s):  
Eduardo Fernandez ◽  
Roberto Pallini ◽  
Giulio Maira
Keyword(s):  
Facial Nerve ◽  
Functional Recovery ◽  
Nerve Palsy ◽  
Simple Technique ◽  
Facial Nerve Palsy ◽  
Nerve Function ◽  
Content Type ◽  
Peripheral Facial Nerve Palsy ◽  
Opening And Closing ◽  
Fine Print

✓ A simple technique is described for protecting the cornea in patients with peripheral facial nerve palsy while waiting for recovery of nerve function. The application of an adhesive strip to the superior eyelid permits opening and closing of the eye, and provides good protection of the cornea.

Hemifacial spasm

1982 ◽  
Vol 57 (6) ◽  
pp. 753-756 ◽  
Author(s):  
Tsutomu Iwakuma ◽  
Akihisa Matsumoto ◽  
Nishio Nakamura
Keyword(s):  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Nerve Root ◽  
Posterior Inferior Cerebellar Artery ◽  
Content Type ◽  
Stylomastoid Foramen ◽  
Root Exit Zone ◽  
Selective Neurectomy ◽  
Fine Print

✓ Patients with hemifacial spasm were treated by three different surgical procedures: 1) partial sectioning of the facial nerve just distal to the stylomastoid foramen; 2) selective neurectomy of facial nerve branches; and 3) microvascular decompression. A retromastoid craniectomy with microvascular decompression was most effective in relieving hemifacial spasm and synkinesis. In a postmorten examination on one patient, microscopic examination of the facial nerve, which was compressed by an arterial loop of the posterior inferior cerebellar artery at the cerebellopontine angle, revealed fascicular demyelination in the nerve root. On the basis of surgical treatment, electromyography, and neuropathological findings, the authors conclude that compression of the facial nerve root exit zone by vascular structures is the main cause of hemifacial spasm and synkinesis.

Intraoperative monitoring of the facial nerve during decompressive surgery for hemifacial spasm

1991 ◽  
Vol 74 (2) ◽  
pp. 254-257 ◽  
Author(s):  
Stephen J. Haines ◽  
Fernando Torres
Keyword(s):  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Intraoperative Monitoring ◽  
Circumstantial Evidence ◽  
Etiological Factor ◽  
Content Type ◽  
Abnormal Response ◽  
Facial Nerve Decompression ◽  
Fine Print

✓ In 11 consecutive patients, intraoperative electromyographic (EMG) recordings were made from the facial muscles during microvascular decompression for hemifacial spasm. In one patient, recordings could not be obtained for technical reasons, and two patients had no abnormality. In the remaining eight patients, the abnormal response resolved before decompression in two, resolved immediately at the time of decompression in five, and failed to resolve in one. All patients were relieved of their hemifacial spasm. In the five patients whose abnormalities resolved at the time of decompression, there was a precise intraoperative correlation between decompression of the nerve and disappearance of the abnormal EMG response. In three cases, this was a useful guide to the need to decompress more than one vessel. These results confirm the findings of Mailer and Jannetta, support the use of this technique for intraoperative monitoring of facial nerve decompression procedures, and provide strong circumstantial evidence that vascular cross-compression is an important etiological factor in hemifacial spasm.

Compartmentation of the jugular foramen

1972 ◽  
Vol 36 (3) ◽  
pp. 340-343 ◽  
Author(s):  
Robert Shapiro
Keyword(s):  
Jugular Foramen ◽  
Complete Separation ◽  
Content Type ◽  
Radiographic Features ◽  
Fine Print

✓ The radiographic anatomy of the jugular foramen is described. Normal variations in size and configuration are discussed and principal pathological configurations listed. The radiographic features of complete separation of the jugular foramen into separate neural and vascular components are presented.

Percutaneous radiofrequency facial nerve coagulation in the management of facial spasm

1981 ◽  
Vol 54 (5) ◽  
pp. 655-658 ◽  
Author(s):  
Tomokatsu Hori ◽  
Takanori Fukushima ◽  
Hideo Terao ◽  
Kintomo Takakura ◽  
Keiji Sano
Keyword(s):  
Facial Nerve ◽  
Age Of Onset ◽  
Facial Weakness ◽  
Content Type ◽  
Operative Results ◽  
Stylomastoid Foramen ◽  
Blunt Needle ◽  
Facial Spasm ◽  
Fine Print

✓ The authors have developed a fluoroscopy-assisted technique of percutaneous radiofrequency facial nerve coagulation at or near the stylomastoid foramen for management of facial spasm. The details of the procedure and the operative results in the initial series of 27 cases of facial spasm are described. The series included six men and 21 women, aged from 16 to 73 years. Twenty-four patients had classical, intractable, persistent hemifacial spasm, one had an unusual bilateral facial spasm, and one a postparalytic facial spasm. The age of onset varied from 16 years to 70 years. The duration of the symptoms ranged from 3 months to 11 years. Ten patients had undergone previous blunt-needle compression of the facial nerve from one to 10 times. The operative results in the 27 patients have so far been excellent. The longest follow-up has been 1½ years. Although partial facial weakness was present in 60% of the cases, it invariably disappeared within 1 to 4 months. Only three patients experienced recurrence of spasm. In two of them, recurrence followed lowtemperature coagulation. The procedure is simple, easy to perform, and extremely effective. It can be performed under local anesthesia in the outpatient clinic.

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