Internal auditory canal hypoplasia associated with bilateral vestibulocochlear nerve aplasia and deviant facial nerve course: A case report and MRI findings

Cavernous haemangiomas are rare lesions of the cerebello-pontine angle that can mimic the more commonly occurring vestibular schwannoma. A case report involving a patient with a cavernous haemangioma of the internal auditory canal (IAC) highlights this as a diagnostic possibility for lesions of the IAC by comparing and contrasting the clinical and radiological findings with the more commonly occurring vestibular nerve and facial schwannomas.Symptoms such as hearing loss and facial paralysis that are disproportionate to the size of the lesion or fluctuate with hormonal changes such as those seen in pregnancy are suggestive of haemangioma. Radiological imaging demonstrating a lesion enchancing with gadolinium and containing areas of calcification is also suggestive of haemangioma. It is important to consider the possible diagnosis of haemangioma as early recognition of this entity may improve the chances of preserving the functional integrity of the facial nerve.

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S230 – MRI Findings in Delayed Facial Palsy after Stapedectomy

Otolaryngology ◽

10.1016/j.otohns.2008.05.405 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P152-P152 ◽

Cited By ~ 1

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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Decompression of the internal auditory canal via the retrosigmoid approach in a patient with Camurati-Engelmann disease: illustrative case

Journal of Neurosurgery: Case Lessons ◽

10.3171/case2039 ◽

2021 ◽

Vol 1 (4) ◽

Author(s):

Salah-Eddine Achahbar ◽

Thomas Somers ◽

Tony Van Havenbergh

Keyword(s):

Facial Nerve ◽

Skull Base ◽

Internal Auditory Canal ◽

Vestibular Function ◽

Retrosigmoid Approach ◽

Foraminal Stenosis ◽

Illustrative Case ◽

Vestibulocochlear Nerve ◽

Cranial Neuropathies ◽

Engelmann Disease

BACKGROUNDCamurati-Engelmann disease (CED) is a rare condition characterized by hyperostosis of the long bones and skull base. Symptoms include contractures and pain in affected extremities but can also include manifestations of cranial hyperostosis such as intracranial hypertension, Chiari malformation, exophthalmia, frontal bossing, and several cranial neuropathies due to cranial foraminal stenosis.OBSERVATIONSThis report describes a 27-year-old patient with suspected CED who developed progressive intermittent facial nerve paresis, hemifacial spasms, and a decrease in hearing. There were no symptoms of increased intracranial pressure or vertigo. Radiological evaluation showed a significant thickening of the skull base with serious bilateral internal auditory canal stenosis. Because of the progressive nature of the aforementioned cranial neuropathies in combination with the correlating severe radiological compression, a surgical decompression of the facial nerve and vestibulocochlear nerve was performed via a retrosigmoid approach with intraoperative monitoring. Postoperative facial nerve function was intact. Hearing and vestibular function were unchanged. There were no more episodes of facial nerve palsy or spasm.LESSONSTo the authors’ knowledge, this is the first report to describe decompression of the internal auditory canal via a retrosigmoid approach for symptomatic facial and cochlear nerve compression in a patient with CED.

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Facial nerve neuroma in the geniculate ganglion extending into the internal auditory canal: A case report

Auris Nasus Larynx ◽

10.1016/j.anl.2017.09.010 ◽

2018 ◽

Vol 45 (3) ◽

pp. 648-652 ◽

Cited By ~ 2

Author(s):

Mohamed Aboshanif ◽

Eigo Omi ◽

Shinsuke Suzuki ◽

Teruyuki Sato ◽

Koh Koizumi ◽

...

Keyword(s):

Case Report ◽

Facial Nerve ◽

Internal Auditory Canal ◽

Geniculate Ganglion

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Narrow internal auditory canal syndrome: parasaggital reconstruction

The Journal of Laryngology & Otology ◽

10.1258/0022215001905661 ◽

2000 ◽

Vol 114 (5) ◽

pp. 392-394 ◽

Cited By ~ 24

Author(s):

Yang-Sun Cho ◽

Dong Gyu Na ◽

Jae Yun Jung ◽

Sung Hwa Hong

Keyword(s):

Magnetic Resonance ◽

High Resolution ◽

Facial Nerve ◽

Temporal Bone ◽

Magnetic Resonance Image ◽

Internal Auditory Canal ◽

The Other ◽

Vestibulocochlear Nerve ◽

Computed Tomographic ◽

Canal Syndrome

Narrow internal auditory canal (IAC) syndrome is a malformation of the temporal bone, that is defined as an IAC diameter of only 1–2 mm on high-resolution computed tomographic scans (HRCT). This syndrome is known to be caused by the absence (aplasia or hypoplasia) of the vestibulocochlear nerve. We present a case of unilateral narrow IAC syndrome which was diagnosed by HRCT. The aplasia of the vestibulocochlear nerve was confirmed using parasigittal reconstruction magnetic resonance image (MRI). The IAC was composed of two separate canals, one of which contained a facial nerve and the other was empty with aplasia of the vestibulocochlear nerve.

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Combined use of diffusion tensor tractography and multifused contrast-enhanced FIESTA for predicting facial and cochlear nerve positions in relation to vestibular schwannoma

Journal of Neurosurgery ◽

10.3171/2014.11.jns14988 ◽

2015 ◽

Vol 123 (6) ◽

pp. 1480-1488 ◽

Cited By ~ 13

Author(s):

Masanori Yoshino ◽

Taichi Kin ◽

Akihiro Ito ◽

Toki Saito ◽

Daichi Nakagawa ◽

...

Keyword(s):

Facial Nerve ◽

Vestibular Schwannoma ◽

Diffusion Tensor ◽

Internal Auditory Canal ◽

Cochlear Nerve ◽

Diffusion Tensor Tractography ◽

Vestibulocochlear Nerve ◽

Contrast Enhanced ◽

Combined Use ◽

Single Modality

OBJECT The authors assessed whether the combined use of diffusion tensor tractography (DTT) and contrast-enhanced (CE) fast imaging employing steady-state acquisition (FIESTA) could improve the accuracy of predicting the courses of the facial and cochlear nerves before surgery. METHODS The population was composed of 22 patients with vestibular schwannoma in whom both the facial and cochlear nerves could be identified during surgery. According to DTT, depicted fibers running from the internal auditory canal to the brainstem were judged to represent the facial or vestibulocochlear nerve. With regard to imaging, the authors investigated multifused CE-FIESTA scans, in which all 3D vessel models were shown simultaneously, from various angles. The low-intensity areas running along the tumor from brainstem to the internal auditory canal were judged to represent the facial or vestibulocochlear nerve. RESULTS For all 22 patients, the rate of fibers depicted by DTT coinciding with the facial nerve was 13.6% (3/22), and that of fibers depicted by DTT coinciding with the cochlear nerve was 63.6% (14/22). The rate of candidates for nerves predicted by multifused CE-FIESTA coinciding with the facial nerve was 59.1% (13/22), and that of candidates for nerves predicted by multifused CE-FIESTA coinciding with the cochlear nerve was 4.5% (1/22). The rate of candidates for nerves predicted by combined DTT and multifused CE-FIESTA coinciding with the facial nerve was 63.6% (14/22), and that of candidates for nerves predicted by combined DTT and multifused CE-FIESTA coinciding with the cochlear nerve was 63.6% (14/22). The rate of candidates predicted by DTT coinciding with both facial and cochlear nerves was 0.0% (0/22), that of candidates predicted by multifused CE-FIESTA coinciding with both facial and cochlear nerves was 4.5% (1/22), and that of candidates predicted by combined DTT and multifused CE-FIESTA coinciding with both the facial and cochlear nerves was 45.5% (10/22). CONCLUSIONS By using a combination of DTT and multifused CE-FIESTA, the authors were able to increase the number of vestibular schwannoma patients for whom predicted results corresponded with the courses of both the facial and cochlear nerves, a result that has been considered difficult to achieve by use of a single modality only. Although the 3D image including these prediction results helped with comprehension of the 3D operative anatomy, the reliability of prediction remains to be established.

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Duplicate internal auditory canals with facial and vestibulocochlear nerve dysfunction

The Journal of Laryngology & Otology ◽

10.1017/s0022215111002258 ◽

2011 ◽

Vol 126 (1) ◽

pp. 66-71 ◽

Cited By ~ 4

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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