ABSTRACT
OBJECTIVES: To evaluate the causes, treatment modalities and recovery rate of paediatric facial nerve paralysis. MATERIALS AND METHODS: We analysed 24 cases of paediatric facial nerve paralysis diagnosed in the otolaryngology department of Gachon University Gil Medical Center between January 2001 and June 2006. RESULTS: The most common cause was idiopathic palsy (16 cases, 66.7 per cent). The most common degree of facial nerve paralysis on first presentation was House-Brackmann grade IV (15 of 24 cases). All cases were treated with steroids. One of the 24 cases was also treated surgically with facial nerve decompression. Twenty-two cases (91.6 per cent) recovered to House-Brackmann grade I or II over the six-month follow-up period. CONCLUSION: Facial nerve paralysis in children can generally be successfully treated with conservative measures. However, in cases associated with trauma, radiological investigation is required for further evaluation and treatment.
Subject(s)
Facial Paralysis/etiology , Facial Paralysis/therapy , Adolescent , Age Factors , Bell Palsy/complications , Bell Palsy/etiology , Bell Palsy/therapy , Child , Child, Preschool , Facial Paralysis/diagnostic imaging , Female , Fractures, Bone/complications , Herpes Zoster Oticus/complications , Humans , Male , Physical Therapy Modalities , Radiography , Retrospective Studies , Sex Factors , Steroids/therapeutic use , Temporal Bone/injuriesABSTRACT
The head tilt suppression test has been known to be a diagnostic tool to distinguish between centrally originating dizziness and peripheral vertigo, as the latter enhances the natural spontaneous firing rate of the velocity storage system and decreases the time constant; however, the otolith organ is now considered to be a cause of head tilting effect. Therefore we questioned whether the head tilt suppression test is still worth differential diagnostic tool. We measured the time constant and initial eye velocity of pre- and post-rotatory nystagmus in a velocity step test in nine healthy adults. The time constant was significantly affected by head tilting (p = 0.001), pre- and post-rotatory nystagmus (p = 0.020) and the compounding interaction between them (p < 0.000). The initial eye velocity was also significantly affected by pre- and post-rotatory nystagmus (p = 0.016) and the compounding interaction (p < 0.000), but not by head tilting (Wilks' Lambda = 0.054). The head tilt suppression test is a useful method for the differential diagnosis of vertiginous patients. It is affected by pre- and post-rotatory nystagmus and their interaction, however, other central parameters in vestibular function testing should also be considered in order to obtain an exact differential diagnosis.
Subject(s)
Head/physiology , Movement/physiology , Vertigo/diagnosis , Adult , Aged , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Nystagmus, Optokinetic/physiology , Nystagmus, Pathologic , Prospective StudiesABSTRACT
BACKGROUND: Malignant triton tumor is usually an aggressive sarcoma consisting of a malignant schwannoma with rhabdomyoblastic differentiation. However, malignant triton tumor of the nasal cavity is very rare. METHODS: A case report of a 38-year-old woman with polypoid mass, which bled easily in the right nasal cavity, and nasal obstruction is presented with a review of the literature pertaining to this unusual case. RESULTS: The malignant triton tumor was treated with wide surgical excision followed by radiation therapy. Histopathological diagnosis of the malignant triton tumor was made on the surgical specimen. The patient's postoperative course was unremarkable, and follow-up at 5 years reveals no evidence of disease. CONCLUSIONS: A malignant triton tumor in the nasal cavity is a rare disease. Head and neck surgeons should recognize the possibility of malignant triton tumor occurring in the nasal cavity.
