3 T MR 3D fast imaging employing steady state acquisition demonstrating branches of intraparotid facial nerve, parotid duct, and relation with parotid tumors / 中华放射学杂志

Objective To investigate the usefulness of 3 T MRI 3D-FIESTA in the evaluation of the intraparotid components of the facial nerve and parotid duct, and compare them with surgical findings. Methods Twenty-two cases with parotid benign tumors were scanned with conventional and 3D-FIESTA sequences on 3 T MRI scanner. Postprocessed multiplanar images were obtained with the workstation. Parotid ducts and facial nerves and tumors were identified on these images. The relationship of the tumors to the facial nerves and Parotid ducts was confirmed at surgery. Results Various types of parotid benign tumors had their characteristics on 3 T MR imaging. Parotid benign tumors mainly showed hypo-intensity on T_1WI in 21 cases, and hyper-intensity on T_2WI in 22 cases. But on 3D-FIESTA images, they appeared hypo-intensity (10 cases) or high intensity (12 cases) due to different types. Facial nerves in parotid appeared as linear structures with hypo-inteusity. The indication of the main trunks were 16 and 18 cases for T_1WI and T_2WI images, while on 3D-FIESTA images, the main trunks and cervicofacial and temporofacial divisions of the facial nerves were found in 22, 21,22 cases. Parotid ducts appeared as structures with hypo-intensity on T_1WI and hyper-intensity on multiplanar images (14, 20, 22 cases). Compared with surgical results, the main trunks of the facial nerve were correctly showed by 3D-FIESTA images in 20 cases. However, in 2 cases they were not located in the operation because of shifting. Conclusion 3 T MR 3D-FIESTA imaging could depict the extracranial facial nerve and the parotid duct in the parotid gland, which is useful for preoperative evaluation of parotid gland tumors.

Modified parapetrosal presigmoid approach to facial nerve canal decompression of facial nerve palsy / 中华创伤杂志

Objective To discuss the surgical outcome and operative technique of the modified trans-petrosal presigmoid approach in treating cases with facial nerve palsy after petral bone fracture trea- ted with facial nerve canal decompression method.Methods A total of 15 cases with facial nerve pal- sy were treated with traumatic facial nerve canal decompression technique with the trans-petrosal presig- mold approach combined with high-dose hormone therapy,whereas 12 cases were treated with traditional Chinese medicine.The clinical data were analysed and compared retrospectively according to House- Brackmann facial nerve grading scale.Results At acute stage,eight(53.3%)out of 15 cases recov- ered to levelⅠ(P＜0.05),with no significant postoperative complications such as CSF leakage. Conclusions This approach is simple and safe and can expose extensively the facial nerve bone canal and effectively alleviate the edemous facial nerve aided by high-dose hormone therapy.Therefore,it is suitable for surgical treatment of acute facial nerve palsy after petral bone fractures.

Intratemporal and Extratemporal Facial Nerve Schwannoma:CT and MRI Findings

PURPOSE: To analyze the characteristics of CT and MRI findings of facial nerve schwannoma in ten patients. MATERIALS AND METHODS: Ten patients with pathologically confirmed facial nerve schwannoma, underwent physical and radiologic examination. The latter involved MRI in all ten and CT scanning in six. We analyzed the location (epicenter), extent and number of involved segments of tumors, tumor morphology, and changes in adjacent bony structures. RESULTS: The major symptoms of facial nerve schwannoma were facial nerve paralysis in seven cases and hearing loss in six. Epicenters were detected at the intraparotid portion in five cases, the intracanalicular portion in two, the cisternal portion in one, and the intratemporal portion in two. The segment most frequently involved was the mastoid (n=6), followed by the parotid (n=5), intracanalicular (n=4), cisternal (n=2), the labyrinthine/geniculate ganglion (n=2) and the tympanic segment (n=1). Tumors affected two segments of the facial nerve in eight cases, only one segment in one, and four continuous segments in one. Morphologically, tumors were ice-cream cone shaped in the cisternal segment tumor (1/1), cone shaped in intracanalicular tumors (2/2), oval shaped in geniculate ganglion tumors (1/1), club shaped in intraparotid tumors (5/5) and bead shaped in the diffuse-type tumor (1/1). Changes in adjacent bony structures involved widening of the stylomastoid foramen in intraparotid tumors (5/5), widening of the internal auditary canal in intracanalicular and cisternal tumors (3/3), bony erosion of the geniculate fossa in geniculate ganglion tumors (2/2), and widening of the facial nerve canal in intratemporal and intraparotid tumors (6/6). CONCLUSION: The characteristic location, shape and change in adjacent bony structures revealed by facial schwannomas on CT and MR examination lead to correct diagnosis.

The Surgical Treatment of The Benign Parotid Tumors / 昆明医科大学学报

The paper reports 214 cases of the bening parotid tumors which were treated by the parotidectomy of preserving the facial nerves during 1970-1987. Superficial parotidectomy was done in 30 cases, and total parotidectomy in 184 cases. The result of the follow-up survey of 176 cases was gained. No permanent facial paralysis and recurrence occured after the parotidetomy.