Primary facial nerve tumors within the skull

1990 ◽  
Vol 72 (1) ◽  
pp. 1-8 ◽  
Author(s):  
T. T. King ◽  
A. W. Morrison
Keyword(s):  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Nerve Repair ◽  
Petrous Bone ◽  
Surgical Removal ◽  
Content Type ◽  
Radiological Features ◽  
Acoustic Nerve ◽  
Relationship Of ◽  
Characteristic Relationship

✓ In a series of 527 cerebellopontine angle tumors, there were 416 cases of acoustic nerve tumors and 14 cases of primary tumor of the facial nerve in the petrous bone or intracranial cavity. Six additional patients were presumed to have facial tumors, although they were not operated on. Of the 14 verified facial nerve tumors, all but two were neurinomas and 11 had important intracranial extensions into the middle and/or the posterior fossa. In most of these 14 cases, surgical removal was performed via the translabyrinthine route, which is advantageous in that it displays the characteristic relationship of the tumor to the facial nerve, and facilitates nerve repair. The clinical and radiological features of these facial nerve lesions are discussed and also the indications for surgical treatment which, as the unoperated cases illustrate, is not always necessary.

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.

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.

Recurrence of acoustic neurilemoma as a malignant spindle-cell neoplasm

1990 ◽  
Vol 73 (6) ◽  
pp. 946-950 ◽  
Author(s):  
Catriona A. McLean ◽  
John D. Laidlaw ◽  
David S. B. Brownbill ◽  
Michael F. Gonzales
Keyword(s):  
Cerebellopontine Angle ◽  
Spindle Cell ◽  
Positive Staining ◽  
Nerve Sheath Tumor ◽  
Content Type ◽  
Spindle Cell Neoplasm ◽  
Nerve Sheath ◽  
Cell Neoplasm ◽  
Acoustic Nerve ◽  
S 100

✓ A 75-year-old man presented with a right cerebellopontine angle tumor 11 months after complete macroscopic resection of a right acoustic neurilemoma. Histological examination of the recurrent tumor showed a malignant spindle-cell neoplasm with positive staining for S-100 protein. The patient had no stigmata of von Recklinghausen's disease. It is proposed that this recurrence represents progression from a benign to a malignant acoustic nerve-sheath tumor, an event that is extremely rare outside the clinicopathological context of neurofibromatosis.

Facial Nerve Repair in Cerebellopontine Angle Surgery

1978 ◽  
Vol 87 (6) ◽  
pp. 772-777 ◽  
Author(s):  
Derald E. Brackmann ◽  
William E. Hitselberger ◽  
Jerald V. Robinson
Keyword(s):  
Facial Nerve ◽  
Brain Stem ◽  
Cerebellopontine Angle ◽  
Nerve Repair ◽  
Nerve Graft ◽  
Tumor Removal ◽  
Stylomastoid Foramen ◽  
Substitution Procedure ◽  
The Brain ◽  
Facial Function

Facial nerve continuity was restored during cerebellopontine angle tumor removal in nine cases. The distal facial nerve was rerouted from the stylomastoid foramen into the cerebellopontine angle. Direct suture was accomplished in seven cases while two required interposition of a greater auricular nerve graft. There was excellent return of facial function in eight of the nine cases. Overall results are superior to nerve substitution techniques. The facial nerve should be inspected for continuity following tumor removal. If one is not certain the nerve is intact, the proximal facial stump should be identified at the brain stem and facial nerve continuity reestablished. A nerve substitution procedure should be resorted to at a later time only when the proximal facial stump is not identifiable.

Facial nerve repair accomplished by the interposition of a collagen nerve guide

2000 ◽  
Vol 93 (1) ◽  
pp. 113-120 ◽  
Author(s):  
Américo Kiyoshi Kitahara ◽  
Yoshihiko Nishimura ◽  
Yasuhiko Shimizu ◽  
Katsuaki Endo
Keyword(s):  
Horseradish Peroxidase ◽  
Facial Nerve ◽  
Electrophysiological Study ◽  
Nerve Repair ◽  
The Other ◽  
Great Promise ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Content Type ◽  
Fine Print

Object. Facial nerve paralysis due to a surgical procedure or trauma is a frequently observed complication. The authors evaluated facial nerve repair achieved by the interposition of a collagen nerve guide.Methods. Ten cats were divided into three groups. Group 1 consisted of six animals in which a 5-mm facial nerve segment on one side was resected and replaced by a collagen tube that was sutured to bridge both nerve stumps. On the opposite side a 5-mm segment of facial nerve was resected, reversed 180°, and sutured to the stumps as an autograft nerve. Group 2 consisted of two cats in which the collagen nerve guide was interposed on one side and the nerve on the other side was left intact. Group 3 consisted of two cats in which a reversed autograft nerve was placed on one side and the nerve on the other side was left intact. Histological, electrophysiological, and horseradish peroxidase labeling examinations were performed starting 3 weeks after surgery.Light and electron microscopic examinations of collagen tube—implanted specimens revealed a well-vascularized regenerated nerve. The electrophysiological study confirmed the recovery of electrical activity in regenerated axons. Horseradish peroxidase labeling also confirmed restoration of the whole facial nerve tract.Conclusions. The collagen nerve guide shows great promise as a nerve conduit.

New technique of side-to-end hypoglossal—facial nerve attachment with translocation of the infratemporal facial nerve

1999 ◽  
Vol 90 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Vincent Darrouzet ◽  
Jean Guerin ◽  
Jean-Pierre Bébéar
Keyword(s):  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Functional Results ◽  
Clinical Results ◽  
New Technique ◽  
Complete Disappearance ◽  
Content Type ◽  
Analytic Scoring ◽  
Grade Iii ◽  
Fine Print

Object. The goal of this study was to assess the clinical results of hypoglossal-facial nerve attachment (HFA), which was primarily performed in patients following excision of tumors of the cerebellopontine angle. In six of the patients a new side-to-end procedure was used.Methods. The authors have performed a retrospective study of 33 patients who underwent HFA, including 24 classic end-to-end, three May, and six side-to-end procedures. For the latter procedure, a hemihypoglossal—facial nerve attachment was performed by rerouting the intratemporal facial nerve; this avoided the jump-cable graft used in May's technique. The goal of the new procedure is to reduce the incidence of morbidity due to hemilingual paralysis (difficulty in chewing, speaking, and swallowing). The incidence of hemilingual paralysis was evaluated based on the findings of a questionnaire that was completed by the patients. The patient's facial mobility was assessed using the House and Brackmann grading system and the author's analytic scoring system.Conclusions. The HFA offers good functional results. Of the 28 cases evaluated, nine had House and Brackmann Grade III, 17 Grade IV, and only two Grade V at 18 months. When the new technique of side-to-end hemihypoglossal—facial nerve attachment was used, there was considerable reduction, if not complete disappearance, of lingual morbidity and the facial functional results were constant and satisfactory: there were five patients with House and Brackmann Grade III and one with Grade IV, and their mean percentage of facial mobility was 43.3%.

Hypoglossal-facial nerve anastomosis for facial nerve palsy following surgery for cerebellopontine angle tumors

1992 ◽  
Vol 77 (5) ◽  
pp. 724-731 ◽  
Author(s):  
Luis F. Pitty ◽  
Charles H. Tator
Keyword(s):  
Facial Nerve ◽  
Facial Palsy ◽  
Cerebellopontine Angle ◽  
Surgical Techniques ◽  
Content Type ◽  
Factors Affecting ◽  
Cerebellopontine Angle Tumors ◽  
Nerve Anastomosis ◽  
Fair Poor ◽  
Fine Print

✓ Hypoglossal-facial nerve anastomosis is one of the procedures frequently performed to restore function after facial palsy secondary to surgery for removal of cerebellopontine angle tumors. The published results of hypoglossal-facial nerve anastomosis have been variable, and there are still questions about the indications, timing, and surgical techniques for this procedure. The goals of the present retrospective analysis of 22 cases of hypoglossal-facial nerve anastomosis were to assess the extent of the functional recovery and to analyze the factors affecting this recovery. The 22 cases of complete facial palsy were gleaned from a series of 245 cases of cerebellopontine angle tumors treated surgically by one of the authors. Twenty patients had an acoustic neuroma (average size 3.5 cm), one patient had a petrous meningioma, and one patient had a facial neuroma. The average age of the patients was 47.3 years (range 19 to 69 years). The average interval from tumor surgery to hypoglossal-facial nerve anastomosis was 6.4 months (range 12 days to 17 months), and the average follow-up period after the procedure was 65 months. The results were graded as good, fair, poor, or failure according to a new method of classifying facial nerve function after hypoglossal-facial nerve anastomosis. The results were good in 14 cases (63.6%), fair in three (13.6%), and poor in four (18.2%); one (4.5%) was a failure. Good and fair results occurred with higher frequency in younger patients who were operated on within shorter intervals, although these relationships were not statistically significant. There were no surgical complications. Good or fair results were achieved in 17 (77.3%) of the 22 cases, and thus hypoglossal-facial nerve anastomosis is considered an effective procedure for most patients with facial palsy after surgery for cerebellopontine angle tumors.

Extradural neurenteric cyst of the cerebellopontine angle

2004 ◽  
Vol 100 (6) ◽  
pp. 1091-1093 ◽  
Author(s):  
Tomohiro Inoue ◽  
Nobutaka Kawahara ◽  
Junji Shibahara ◽  
Tomohiko Masumoto ◽  
Kenichi Usami ◽  
...  
Keyword(s):  
Cerebellopontine Angle ◽  
Internal Auditory Canal ◽  
Bone Destruction ◽  
Petrous Bone ◽  
Neurenteric Cyst ◽  
Imaging Features ◽  
Pathological Findings ◽  
Mr Images ◽  
Content Type ◽  
Temporal Bone Tumor

✓ Neurenteric cyst is a developmental malformation found mainly in the spinal canal. The authors report on a 47-year-old man with a neurenteric cyst of the cerebellopontine angle (CPA) who presented with progressive hearing disturbance and facial palsy. The tumor was located extradurally with marked destruction of the petrous bone around the internal auditory canal and demonstrated irregular and heterogeneous high-intensity signals on T1- and T2-weighted on MR images, which is atypical for neurenteric cysts. The pathological findings in samples obtained after resection disclosed a single epithelial layer (a feature of neurenteric cyst), which was accompanied by marked xanthogranulomatous changes. Although several neurenteric cysts have been reported in the CPA, extradural lesions with unusual imaging features and marked bone destruction have not been reported previously. This benign developmental lesion should be considered, although it is extremely rare, in patients harboring an extradural temporal bone tumor around the CPA.

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