scholarly journals Acoustic Neurinoma with Synchronous Ipsilateral Cerebellopontine Angle Lipoma: A Case Report and Review of the Literature

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 120
Author(s):  
Takahiro Kanaya ◽  
Yasuo Murai ◽  
Kanako Yui ◽  
Shun Sato ◽  
Akio Morita
Keyword(s):  
Hearing Loss ◽  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Cranial Nerves ◽  
Internal Auditory Canal ◽  
Surgical Removal ◽  
Acoustic Neurinoma ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Nerve Preservation

Lipomas of the cerebellopontine angle (CPA) and internal auditory canal (IAC) are relatively rare tumors. Acoustic neurinoma is the most common tumor in this location, which often causes hearing loss, vertigo, and tinnitus. Occasionally, this tumor compresses the brainstem, prompting surgical resection. Lipomas in this area may cause symptoms similar to neurinoma. However, they are not considered for surgical treatment because their removal may result in several additional deficits. Conservative therapy and repeated magnetic resonance imaging examinations for CPA/IAC lipomas are standard measures for preserving cranial nerve function. Herein, we report a case of acoustic neurinoma and CPA lipoma occurring in close proximity to each other ipsilaterally. The main symptom was hearing loss without facial nerve paralysis. Therefore, facial nerve injury had to be avoided. Considering the anatomical relationships among the tumors, cranial nerves, and CPA/IAC lipoma, we performed total surgical removal of the acoustic neurinoma. We intentionally left the lipoma untreated, which enabled facial nerve preservation. This report may be a useful reference for the differential diagnosis of similar cases in the future.

Diagnosis and treatment of cavernous hemangioma of the internal auditory canal

2016 ◽  
Vol 124 (3) ◽  
pp. 639-646 ◽  
Author(s):  
Wei Dong Zhu ◽  
Qi Huang ◽  
Xi Ye Li ◽  
Hong Sai Chen ◽  
Zhao Yan Wang ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Facial Nerve ◽  
Cavernous Hemangioma ◽  
Cranial Nerves ◽  
Internal Auditory Canal ◽  
Middle Cranial Fossa ◽  
Surgical Removal ◽  
Translabyrinthine Approach ◽  
History Of ◽  
Cranial Fossa

OBJECT Cavernous hemangioma of the internal auditory canal (IAC) is an extremely rare type of tumor, and only 50 cases have been reported in the literature prior to this study. The aim in this study was to describe the symptomatology, radiological features, and surgical outcomes for patients with cavernous hemangioma of the IAC and to discuss the diagnostic criteria and treatment strategy for the disease. METHODS The study included 6 patients with cavernous hemangioma of the IAC. All patients presented with sensorineural hearing loss and tinnitus, and 2 also suffered from vertigo. Five patients reported a history of facial symptoms with hemispasm or palsy: 3 had progressive facial weakness, 1 had a hemispasm, and 1 had a history of recovery from sudden facial paresis. All patients underwent CT and MRI to rule out intracanalicular vestibular schwannomas and facial nerve neuromas. Five patients had their tumors surgically removed, while 1 patient, who did not have facial problems, was followed up with a wait-and-scan approach. RESULTS All patients had a presurgical diagnosis of cavernous hemangioma of the IAC, which was confirmed pathologically in the 5 patients who underwent surgical removal of the tumor. The translabyrinthine approach was used to remove the tumor in 4 patients, while the middle cranial fossa approach was used in the 1 patient who still had functional hearing. Tumors adhered to cranial nerves VII and/or VIII and were difficult to dissect from nerve sheaths during surgeries. Complete hearing loss occurred in all 5 patients. In 3 patients, the facial nerve could not be separated from the tumor, and primary end-to-end anastomosis was performed. Intact facial nerve preservation was achieved in 2 patients. Patients were followed up for at least 1 year after treatment, and MRI showed no evidence of tumor regrowth. All patients experienced some level of recovery in facial nerve function. CONCLUSIONS Cavernous hemangioma of the IAC can be diagnosed preoperatively through analysis of clinical features and neuroimaging. Early surgical intervention may preserve the functional integrity of the facial nerve and provide a better outcome after nerve reconstruction. However, preservation of functional hearing may not be achieved, even with the retrosigmoid or middle cranial fossa approaches. The translabyrinthine approach seems to be the most appropriate approach overall, as the facial nerve can be easily located and reconstructed.

scholarly journals Temporal Bone and Cerebellopontine Angle Epidermoid Resulting in Facial Nerve Paralysis: Resection and Facial Nerve Coaptation

2018 ◽  
Vol 80 (S 03) ◽  
pp. S314-S315
Author(s):  
Alexander G. Bien ◽  
Christine S. Kim ◽  
Tyler J. Kenning
Keyword(s):  
Facial Nerve ◽  
Temporal Bone ◽  
Cerebellopontine Angle ◽  
Tumor Resection ◽  
Internal Auditory Canal ◽  
Semicircular Canals ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Tertiary Center ◽  
End To End

Objectives Demonstrate the utilization of a transcochlear approach for resection of an epidermoid involving the temporal bone and cerebellopontine angle (CPA) with end-to-end facial nerve coaptation. Designs Single case-based operative video. Setting Tertiary center with dedicated skull base team. Participants The patient is a 50-year-old left handed male with a history of a remote left Bell's palsy, left sudden sensorineural hearing loss, and a rapidly progressive facial nerve paralysis. His balance was impaired, and his videonystagmography showed a significant left sided peripheral vestibular weakness. Computed tomography (CT) scan showed an erosive lesion of his left temporal bone involving the cochlea and semicircular canals, and magnetic resonance imaging (MRI) showed a T2 hyperintense lesion with restricted diffusion and no enhancement on postcontrast T1 sequences. Main Outcome Measures Gross total resection of the epidermoid, recovery of facial nerve function, balance improvement. Results The patient underwent resection via a transcochlear approach. The tumor involved the epitympanum and eroded the semicircular canals, vestibule, and basal turn of the cochlea. Gross total tumor resection was attained. The facial nerve was isolated in the mastoid and tympanic segments, traced proximally to the geniculate ganglion, and then into the internal auditory canal (IAC). The nerve was discontinuous in the distal IAC and a reactive neuroma was resected. The facial nerve was mobilized and an end-to-end coaptation was performed in the CPA using a collagen tubule. The 3-month postoperative MRI showed no residual or recurrent disease. His postoperative balance was improved. Partial facial nerve recovery is not expected prior to 9 to 12 months.The link to the video can be found at: https://youtu.be/C6N8qPwBt2Y.

scholarly journals Facial nerve palsy as the first sign of late breast cancer metastasis to the temporal bone

2021 ◽  
pp. 40-40
Author(s):  
Zoran Dudvarski ◽  
Nenad Arsovic ◽  
Milovan Dimitrijevic ◽  
Sasa Jakovljevic ◽  
Novica Boricic ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hearing Loss ◽  
Facial Nerve ◽  
Temporal Bone ◽  
Cancer Metastasis ◽  
Metastatic Breast ◽  
Breast Cancer Metastasis ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Radiological Diagnostics

Introduction. Late metastases of malignant tumors in the temporal bone are very rare lesions. They can be asymptomatic for a long time, and usually manifest themselves in the form of hearing loss, dizziness, tinnitus, and paralysis of the facial nerve. Modern radiological diagnostics and explorative surgery with biopsy are essential for diagnosis. Case report. We present a rare and unusual case of a 66-year-old female patient with a facial nerve paralysis that appeared as the first sign of metastatic breast cancer in the temporal bone 10 years after treatment. A sudden hearing loss and dizziness occurred six months later and value of CA 15-3 was elevated. Scintigraphy pointed to susceptible metastatic deposits of the axial skeleton, without lesions in the temporal bone. Finally, repeated computerized tomography revealed osteolytic changes of the temporal bone six months after that. Immunohistochemical analysis of mastoid tissue samples confirmed that it was a breast cancer metastasis. One year after palliative radiotherapy and oral hormone therapy, a patient has a good general condition with better function of the facial nerve. Conclusion. A high degree of clinical suspicion sometimes requires repeated radiological diagnostics in order to detect osteolytic metastatic changes in the temporal bone, but also in other bone structures within the hematogenous dissemination of the malignant disease.

Acoustic Schwannoma Presenting as a Tumor of the External Auditory Canal

1987 ◽  
Vol 96 (4) ◽  
pp. 415-418 ◽  
Author(s):  
Patrice Tran Ba Huy ◽  
Jean Michel Hassan ◽  
Michel Wassef ◽  
Jacqueline Mikol ◽  
Claude Thurel
Keyword(s):  
Hearing Loss ◽  
External Auditory Canal ◽  
Cerebellopontine Angle ◽  
Internal Auditory Canal ◽  
Unilateral Hearing Loss ◽  
Acoustic Neurinoma ◽  
History Of ◽  
Acoustic Schwannoma ◽  
Initial Episode ◽  
Central Compensation

An acoustic neurinoma involving the internal auditory canal, the vestibule, the cochlea, the middle ear, and extending into the cerebellopontine angle and the external auditory canal, is described in a 56-year-old woman. An initial episode of vertigo was followed by a 27-year history of progressive unilateral hearing loss leading to complete deafness and areflexia with central compensation. The tumor was removed by a two-step surgical procedure, and the histologic features were those of a schwannoma.

Masseter-to-Facial Cranial Nerve Anastomosis: A Report of 30 Cases

2020 ◽  
Vol 19 (5) ◽  
pp. 502-509
Author(s):  
Alexander V Zotov ◽  
Jamil A Rzaev ◽  
Sergey V Chernov ◽  
Alexander B Dmitriev ◽  
Anton V Kalinovsky ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Postoperative Recovery ◽  
Facial Nerve Paralysis ◽  
Tumor Surgery ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Nerve Paralysis ◽  
Cerebellopontine Angle Tumor ◽  
Facial Reanimation

Abstract BACKGROUND Facial nerve paralysis (FP) is a possible complication of cerebellopontine angle tumor surgery. Several donor nerves have been used in the past for facial reanimation. We report the results of 30 cases of masseter-to-facial anastomosis. OBJECTIVE To prospectively evaluate the efficacy of V to VII anastomosis after FP. METHODS In a prospective study, we included 30 consecutive patients with FP (20 women and 10 men) whose mean age was 48.8 yr (32-76 yr). In almost all cases, FP developed after cerebellopontine angle tumor surgery (29 patients), whereas in one case, FP occurred after skull base trauma. Pre- and postoperative evaluation of facial nerve function was performed using the House-Brackmann (HB) scale and the Sokolovsky scale, as well as by electromyography. Follow-up ranged from 11 to 51 mo and averaged 22 mo. RESULTS All patients achieved functional recovery of the facial nerve from VI to either III or IV HB degree. Patients with short time FP showed significantly better postoperative recovery. CONCLUSION The results of the V to VII anastomosis demonstrate a significant improvement of facial nerve function and virtually no complications.

scholarly journals Cochlear implant surgery at the Clinical Center of Vojvodina - ten-year experience

2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 25-31
Author(s):  
Dragan Dankuc ◽  
Darja Segan ◽  
Zoran Komazec ◽  
Ljiljana Vlaski ◽  
Slobodanka Lemajic-Komazec ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Facial Nerve ◽  
Cochlear Implant ◽  
Surgical Procedures ◽  
Cochlear Implantation ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Implant Surgery ◽  
Clinical Center ◽  
Cochlear Implant Surgery

Introduction. The first cochlear implant surgery was performed at the Center for Cochlear Implantation of the Department of Ear, Nose and Throat Diseases, Clinical Center of Vojvodina in 2002 after long preparations and that was the first successful cochlear implantation in Serbia. Material and Methods. Over the period from November 2002 to November 2013, 99 patients underwent surgical procedures and 100 cochlear implants were placed. Results. The analysis encompassed 99 patients, the youngest and the oldest one being 1 year and 61 years old, respectively. Prelingual and postlingual deafness developed in 84 (84.9%) and in 15 (15.1%), respectively. Postlingual deafness was observed in all 11 adult patients. The prelingual deafness was diagnosed in 84 (95.4%) children, whereas in four (4.6%) children it occurred after the development of speech between 6 and 8 years of age. Progressive hearing loss was observed in 11 patients - seven adults and four children. The majority of our patients, i.e. 74 (74.75%) manifested idiopathic deafness of unknown cause. A range of usually reported hearing loss etiologies included ototoxic medications in seven (7.07%), hereditary factor in six (6.06%), and bacterial meningitis in four (4.04%) patients. Somewhat less common causes were perinatal hypoxia in three (3.03%), premature birth in three (3.03%), Down syndrome in one (1.01%), and chronic otitis media in one (1.01%) patient. Conclusion. Both intraoperative and postoperative complications were analyzed in the investigated patient population. The complications developed in 11 patients, i.e. in 10.5% of 105 surgical procedures. The majority of procedures (89.5%) were not accompanied by any post-surgical complications. Unsuccessful implantation in a single-step procedure and transient facial nerve paralysis can be considered most frequent among our patients, whereas cochlear ossification and transient ataxia occurred more rarely. Stimulation of facial nerve, intraoperative perilymph liquid gusher, device failure and late infections were recorded extremely rarely.

S230 – MRI Findings in Delayed Facial Palsy after Stapedectomy

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P152-P152 ◽  
Author(s):  
Marc Cohen ◽  
Claudia Kirsch ◽  
Abie Mendelsohn ◽  
Akira Ishiyama
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
Facial Palsy ◽  
Rare Complication ◽  
Internal Auditory Canal ◽  
Facial Nerve Paralysis ◽  
Mri Findings ◽  
Nerve Paralysis ◽  
Oral Corticosteroids ◽  
Magnetic Resonance Imaging Mri

Objectives 1) To retrospectively review the pathophysiology and radiologic features of delayed facial palsy after stapedectomy. 2) To discuss the management strategy of this unusual problem. Methods 450 stapedectomies performed at our institution were retrospectively reviewed from 1997 to 2007. A total of 2 patients in this series developed a delayed facial paralysis postoperatively. The clinical presentation, radiographic characteristics on magnetic resonance imaging (MRI), and the management of these patients are presented. Results A total of 2 patients out of 450 stapedectomies within a 10-year period developed the rare complication of delayed facial paralysis (postoperative days 12 and 41, respectively). Both patients developed rapidly progressive complete facial nerve paralysis preceded by periauricular pain and dysguesia. No sign of infection was present in the operated ear. MRI with gadolinium of the internal auditory canal demonstrated gadolinium enhancement of the labyrinthine portion of the facial nerve as seen in Bell's palsy. Both patients were treated with oral corticosteroids and antiviral medications. Subsequent imaging revealed decreased enhancement of the facial nerve with complete resolution of facial paralysis. Conclusions In the rare complication of delayed facial paralysis after stapedectomy, MR imaging is a useful diagnostic tool to dictate the treatment strategy. Delayed facial paralysis following stapedectomy can be treated medically when the MRI scan demonstrates enhancement of the facial nerve in the labyrinthine segment.

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