ABSTRACT
When a surgeon fails to save intracranial segement of the facial nerve and can not identify the proximal segment of the facial nerve due to severe adhesion or severe brain stem compression by the tumor, the interpositional graft has no place in helping this patient. Hypoglossal-facial nerve (XII-VII) direct side to end anastomosis is the effective facial reanimation technique used in such a case. This technique compensates for the drawbacks of classical XII-VII anastomosis, and the bothersome strong mass movement and hemiparalysis of the tongue. We recently experienced a case where XII-VII direct side-to-end anastomosis was applied. We report our case with literature review.
Subject(s)
Humans , Brain Stem , Facial Nerve , Facial Paralysis , Hypoglossal Nerve , Tongue , TransplantsABSTRACT
We report the CT findings of four cases of squamous cell carcinoma, paying special attention to the epicenter of the lesion and the pattern of bony destruction. All four patients had a past history of chronic otitis media. Squamous cell carcinoma affected mainly the hypotympanum and inferior wall of the external auditary canal, and in all cases revealed an irregular pattern of bony destruction. Irregular destruction of the tegmen tympani occurred in two cases. In cases of squamous cell carcinoma, CT findings suggesting involvement of the promontary are usually noted.
Subject(s)
Humans , Carcinoma, Squamous Cell , Otitis Media , Temporal BoneABSTRACT
Papilloma is a benign neoplasm confined almost exclusively to the sinonasal tract. And rare cases involving middle ear or external auditory canal, usually extended or contaminated from nasal cavity have been reported. We recently experienced a case of squamous papilloma involving middle ear, external auditory canal, and infratemporal fossa without any evidence of involving sinonasal tract. We present a review of literature and discuss the pathophysiology of the papilloma.
Subject(s)
Ear Canal , Ear, Middle , Nasal Cavity , PapillomaABSTRACT
BACKGROUND AND OBJECTIVES: The transposition of the facial nerve is an essential procedure to obtain optimal surgical field and to remove the lesion completely when the tumor is located medial to the facial nerve. However, we frequently encounter postoperative facial palsy after transposition. The aim of the study is to find out how to treat the facial nerve in order to reduce the incidence and the degrees of postoperative facial palsy after anterior transposition of the facial nerve. MATERIAL AND METHODS: Facial nerve function after anterior transposition of the facial nerve were analyzed retrospectively in 10 cases with skull base tumor using the House-BracKJCann grading system. The minimum follow-up period was 12 months. RESULTS: Favorable outcome was noted when the fallopian canal was exposed as widely as possible, and soft tissues were preserved at stylomastoid foramen. Postoperative facial palsy was recovered completely when the facial nerve was not involved by disease. The final House-BracKJCann grades were I, II, III in three cases in which tumor was involved with the facial nerve. The immediate postoperative function of the facial nerve is influenced by surgical procedure and surgeon's skill, and the final status of the facial nerve function depends on the involvement of tumor in the nerve. CONCLUSION: In order to obtain favorable postoperative facial nerve function, no attempt was made to dissect the facial nerve, and all the soft tissue that were attached to the facial nerve through the stylomastoid foramen were sharply elevated and traspositioned together with the facial nerve.
Subject(s)
Facial Nerve , Facial Paralysis , Follow-Up Studies , Incidence , Retrospective Studies , Skull BaseABSTRACT
We report the imaging features of three cases of tuberculous otitis media. All three patients underwenttemporal bone CT scanning, and in two, additional MRI scanning was performed. The three cases showed soft tissuedensity in the external auditory canal, and in two, destruction of the trabeculation and internal cortex of themastoid bone was noted. In two patients with facial palsy, erosion of the facial canal was seen. On MRI, abundantgranulomatous tissue was noted in the middle ear cavity and mastoid air cells. In one case, abnormal enhancementof the cochlea, and of the facial and eighth cranial nerve in the internal acoustic canal was seen. Another caseshowed enhancement of the vestibule and lateral semicircular canal. If radiologic evaluation of chronic otitismedia reveals destruction of the tegmen and trabeculation of the mastoid bone, together with abundant granulationtissue and enhancement of the internal ear, tuberculous otitis media may be included in the differentialdiagnosis.