Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.654
Filtrar
1.
Neurosurg Rev ; 47(1): 83, 2024 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-38363437

RESUMO

Fully endoscopic microvascular decompression (MVD) of the facial nerve is the main surgical treatment for hemifacial spasm. However, the technique presents distinct surgical challenges. We retrospectively analyzed prior cases to consolidate surgical insights and assess clinical outcomes. Clinical data from 16 patients with facial nerve spasms treated at the Department of Neurosurgery in the First Affiliated Hospital of Bengbu Medical College, between August 2020 and July 2023, were retrospectively examined. Preoperatively, all patients underwent magnetic resonance angiography to detect any offending blood vessels; ascertain the relationship between offending vessels, facial nerves, and the brainstem; and detect any cerebellopontine angle lesions. Surgery involved endoscopic MVD of the facial nerve using a mini Sigmoid sinus posterior approach. Various operative nuances were summarized and analyzed, and clinical efficacy, including postoperative complications and the extent of relief from facial paralysis, was evaluated. Fully endoscopic MVD was completed in all patients, with the offending vessels identified and adequately padded during surgery. The offending vessels were anterior inferior cerebellar artery in 12 cases (75%), vertebral artery in 3 cases (18.75%), and posterior inferior cerebellar artery in 1 case (6.25%). Intraoperative electrophysiological monitoring revealed that the lateral spread response of the facial nerve vanished in 15 cases and remained unchanged in 1 case. Postoperative facial spasms were promptly alleviated in 15 cases (93.75%) and delayed in 1 case (6.25%). Two cases of postoperative complications were recorded-one intracranial infection and one case of tinnitus-both were resolved or mitigated with treatment. All patients were subject to follow-up, with no instances of recurrence or mortality. Fully endoscopic MVD of the facial nerve is safe and effective. Proficiency in endoscopy and surgical skills are vital for performing this procedure.


Assuntos
Doenças do Nervo Facial , Espasmo Hemifacial , Cirurgia de Descompressão Microvascular , Humanos , Espasmo Hemifacial/cirurgia , Espasmo Hemifacial/etiologia , Cirurgia de Descompressão Microvascular/efeitos adversos , Estudos Retrospectivos , Doenças do Nervo Facial/cirurgia , Resultado do Tratamento , Endoscopia , Complicações Pós-Operatórias/etiologia
2.
Eur Arch Otorhinolaryngol ; 281(2): 655-661, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37486425

RESUMO

PURPOSE: To report three cases of facial nerve lesions that were clinically expected to be facial nerve tumors but showed fibrotic infiltration without any apparent signs of a specific tumor on histopathological findings. We also aimed to investigate the clinical characteristics of these cases. METHODS: Medical records of patients who underwent surgery for facial nerve lesions were reviewed. RESULTS: All three cases initially had House-Brackmann (HB) grade IV-V facial nerve palsy. On radiological imaging, schwannoma or glomus tumor originating from the facial nerve was suspected. All patients underwent complete surgical removal of the neoplasm followed by facial nerve reconstruction using the sural nerve. The lesions were histologically confirmed as infiltrative fibrous lesions without tumor cells. In two cases, facial nerve palsy improved to HB grade III by nine months post-surgery, and there were no signs of recurrence on follow-up MRI. The other case, after 1 year of follow-up, showed persistence of HB grade V facial nerve palsy without any evidence of recurrence. CONCLUSION: Fibrotic lesions of the facial nerve could mimic primary facial nerve tumors. Clinicians should consider this condition even when a facial nerve tumor is suspected.


Assuntos
Paralisia de Bell , Neoplasias dos Nervos Cranianos , Doenças do Nervo Facial , Paralisia Facial , Tumor Glômico , Neoplasias de Cabeça e Pescoço , Humanos , Nervo Facial/cirurgia , Doenças do Nervo Facial/diagnóstico , Doenças do Nervo Facial/cirurgia , Paralisia Facial/diagnóstico , Paralisia Facial/etiologia , Paralisia Facial/cirurgia , Neoplasias dos Nervos Cranianos/diagnóstico , Neoplasias dos Nervos Cranianos/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
3.
Am J Otolaryngol ; 45(1): 104078, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37806280

RESUMO

This article describes the first recorded case of intratemporal neurofibroma in an infant. A literature review of all other existing cases of intratemporal neurofibroma is performed, finding that the majority of cases involve multiple segments and can be found in the mastoid segment most often. Most common symptoms described included facial paralysis, otalgia, and conductive hearing loss, respectively.


Assuntos
Doenças do Nervo Facial , Paralisia Facial , Neurofibroma , Lactente , Humanos , Paralisia Facial/etiologia , Nervo Facial , Doenças do Nervo Facial/diagnóstico , Doenças do Nervo Facial/etiologia , Doenças do Nervo Facial/cirurgia , Neurofibroma/complicações , Neurofibroma/diagnóstico , Neurofibroma/cirurgia , Processo Mastoide , Osso Temporal
4.
Medicine (Baltimore) ; 102(51): e36751, 2023 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-38134097

RESUMO

Facial neuritis is a common clinical disease with high incidence, also known as Bell palsy or idiopathic facial nerve paralysis, which is an acute onset of peripheral facial neuropathy. In modern medicine, there have been obstacles to the effective treatment of facial neuritis. At present, the clinical use of Western medicine treatment is also a summary of clinical experience, the reason is that the cause of facial neuritis is unknown. Facial neuritis belongs to the category of "facial paralysis" in traditional Chinese medicine. For thousands of years, Chinese medicine has accumulated a lot of relevant treatment experience in the process of diagnosis and treatment. At the same time, traditional Chinese medicine, acupuncture and the combination of acupuncture and medicine play an important role in the treatment of facial neuritis. This article discusses the treatment of facial neuritis with acupuncture combined with Chinese medicine, based on the research progress of modern medicine. In this review, we provide an overview of the effectiveness of acupuncture and medication combinations and facial neuritis with current studies investigating acupuncture and medication combinations in the treatment of facial neuritis.


Assuntos
Terapia por Acupuntura , Paralisia de Bell , Doenças do Nervo Facial , Paralisia Facial , Humanos , Doenças do Nervo Facial/terapia , Paralisia de Bell/terapia , Paralisia Facial/terapia , Medicina Tradicional Chinesa
5.
J Int Adv Otol ; 19(4): 303-310, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37528595

RESUMO

We provide an extensive review of clinical features, diagnosis, and treatment of primitive facial nerve tumors in children, and report 2 recent personal observations. We conducted a comprehensive literature search through PubMed, Medline, and ScienceDirect and collected information on patients' age, symptoms, tumor types and sites, diagnostic procedures, surgical approaches, and outcomes. Overall, we reviewed 26 pediatric cases from 20 papers. About 69.2% of children presented with some degree of facial palsy. Other symptoms included hearing loss, dizziness, and tinnitus. 84.6% of tumors were schwannomas, followed by meningiomas, epithelioid hemangioendothelioma, and germ cell tumors. The geniculate ganglion was the most commonly affected segment of the facial nerve. A total of 92.3% of children received surgery as complete or partial tumor resection. Facial nerve function improved in 26.9% of children. No tumor recurrence was reported. Facial nerve tumors are extremely rare in children but should be considered in the differential diagnosis of facial palsy, even in newborns. Audiometric and radiologic examinations are necessary; radiologic imaging allows to determine tumor localization, and the correct surgical approach surgery is suggested in almost all cases.


Assuntos
Paralisia de Bell , Neoplasias dos Nervos Cranianos , Doenças do Nervo Facial , Paralisia Facial , Neoplasias de Cabeça e Pescoço , Neoplasias Meníngeas , Recém-Nascido , Humanos , Criança , Paralisia Facial/etiologia , Nervo Facial/cirurgia , Estudos Retrospectivos , Recidiva Local de Neoplasia , Doenças do Nervo Facial/diagnóstico , Doenças do Nervo Facial/cirurgia , Neoplasias dos Nervos Cranianos/diagnóstico , Neoplasias dos Nervos Cranianos/cirurgia
6.
J Neuroimmunol ; 382: 578156, 2023 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-37556888

RESUMO

We reported a 61-year-old man presented with 10-month progressing left sciatic neuropathy and 10-day right facial neuropathy. Serum amphiphysin-IgG was positive. 18F-FDG PET/CT of the whole body showed no signs of malignancy. Treatment with plasma exchange and oral prednisone relieved the symptoms. Nine months later, right hemiparesis and seizure of right limbs developed. 18F-FDG and 18F-PBR06 (18 kDa translocator protein, TSPO) radioligand PET/MRI of the whole body revealed intense uptake in the intracranial lesions. Intracranial lymphoma was diagnosed by stereotactic needle brain biopsy. Mononeuropathies could be paraneoplastic syndromes. TSPO shows high uptake in intracranial lymphoma on 18F-PBR06 PET images.


Assuntos
Neoplasias do Sistema Nervoso Central , Doenças do Nervo Facial , Linfoma , Neuropatia Ciática , Humanos , Masculino , Pessoa de Meia-Idade , Encéfalo/imunologia , Doenças do Nervo Facial/etiologia , Doenças do Nervo Facial/imunologia , Doenças do Nervo Facial/terapia , Fluordesoxiglucose F18 , Imunoglobulina G/imunologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Receptores de GABA/metabolismo , Neuropatia Ciática/etiologia , Neuropatia Ciática/imunologia , Neuropatia Ciática/terapia , Neoplasias do Sistema Nervoso Central/complicações , Neoplasias do Sistema Nervoso Central/diagnóstico por imagem , Neoplasias do Sistema Nervoso Central/imunologia , Doenças Autoimunes/etiologia , Doenças Autoimunes/imunologia , Linfoma/complicações , Linfoma/diagnóstico por imagem , Linfoma/imunologia , Polineuropatia Paraneoplásica/etiologia , Polineuropatia Paraneoplásica/imunologia , Prednisona/uso terapêutico , Glucocorticoides/uso terapêutico , Troca Plasmática , Proteínas do Tecido Nervoso/imunologia
7.
J Neurol ; 270(11): 5303-5312, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37523065

RESUMO

OBJECTIVE: To systematically review the published cases of bilateral facial palsy (BFP) to gather evidence on the clinical assessment and management of this pathology. METHODS: Following PRISMA statement recommendations, 338 abstracts were screened independently by two authors. Inclusion criteria were research articles of human patients affected by BFP, either central or peripheral; English, Italian, French or Spanish language; availability of the abstract, while exclusion criteria were topics unrelated to FP, and mention of unilateral or congenital FP. Only full-text articles reporting the diagnostic work-up, the management, and the prognosis of the BFP considered for further specific data analysis. RESULTS: A total of 143 articles were included, resulting a total of 326 patients with a mean age of 36 years. The most common type of the paralysis was peripheral (91.7%), and the autoimmune disease was the most frequent aetiology (31.3%). The mean time of onset after first symptoms was 12 days and most patients presented with a grade higher than III. Associated symptoms in idiopathic BFP were mostly non-specific. The most frequently positive laboratory exams were cerebrospinal fluid analysis, autoimmune screening and peripheral blood smear, and the most performed imaging was MRI. Most patients (74%) underwent exclusive medical treatment, while a minority were selected for a surgical or combined approach. Finally, in more than half of cases a complete bilateral recovery (60.3%) was achieved. CONCLUSIONS: BFP is a disabling condition. If a correct diagnosis is formulated, possibilities to recover are elevated and directly correlated to the administration of an adequate treatment.


Assuntos
Doenças do Nervo Facial , Paralisia Facial , Humanos , Adulto , Paralisia Facial/etiologia , Paralisia Facial/terapia , Paralisia Facial/diagnóstico , Causalidade , Imageamento por Ressonância Magnética
8.
Am J Otolaryngol ; 44(5): 103952, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37329696

RESUMO

OBJECTIVE: To report 20 years of natural history data for a facial paraganglioma and provide a comprehensive review of the existing literature. PATIENT: 81-year-old female with a remote history of cardiac arrest while under anesthesia who elected to observe her facial paraganglioma for 20 years. INTERVENTIONS: Observation, clinical documentation, radiographic surveillance. MAIN OUTCOME MEASURES: Tumor progression, patient symptomatology, and review of management options. RESULTS: The initial presentation of the facial paraganglioma was facial spasm. Over the course of observation, symptoms progressed to include complete facial nerve paralysis, pulsatile tinnitus, and otalgia on the affected side. Radiologic surveillance demonstrated incremental growth and erosion of surrounding structures, including the posterior external auditory canal, stylomastoid foramen, and lateral semicircular canal with near-dehiscence. Twenty-four cases of facial paraganglioma were identified in the extended literature search and are summarized herein. CONCLUSIONS: This unique case contributes to the scarce literature surrounding facial paragangliomas by reporting the extended natural history of this disease.


Assuntos
Neoplasias dos Nervos Cranianos , Doenças do Nervo Facial , Paralisia Facial , Paraganglioma , Humanos , Feminino , Idoso de 80 Anos ou mais , Neoplasias dos Nervos Cranianos/diagnóstico , Paraganglioma/diagnóstico por imagem , Paraganglioma/cirurgia , Doenças do Nervo Facial/etiologia , Doenças do Nervo Facial/complicações , Paralisia Facial/etiologia , Osso Temporal/patologia
10.
Auris Nasus Larynx ; 50(2): 305-308, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35241298

RESUMO

Hereditary gelsolin amyloidosis (HGA) is an autosomal dominant systemic amyloidosis, characterized by cranial and sensory peripheral neuropathy, corneal lattice dystrophy, and cutis laxa. We report a case of HGA presenting with bilateral facial palsy. A 70-year-old Japanese man presented with slowly progressive bilateral facial palsy and facial twitching, which had started in his 40s. His mother also had the same symptoms due to an unknown cause but rest of the family did not. He showed incomplete facial palsy with no frontal muscle movement and partial movement of the orbicularis oris and orbicularis oculi muscles. The patient showed no synkinesis. Electroneurography revealed symmetric low compound motor action potential amplitude of the orbicularis oris muscle, and a nerve excitability test showed a symmetric increase in the response threshold. Despite the partial voluntary movement of the orbicularis oculi muscle, bilateral blink reflexes were absent. He also showed facial spasms after contraction of the orbicularis oris muscle. Genetic testing revealed a heterozygous c.640G>A mutation (p. Asp214Asn); therefore, the patient was diagnosed with HGA. HGA related facial palsy showed moderate bilateral, upper blanch-dominant axonal degeneration of the facial nerve without reinnervation, and trigeminal nerve neuropathy.


Assuntos
Amiloidose , Paralisia de Bell , Distrofias Hereditárias da Córnea , Doenças do Nervo Facial , Paralisia Facial , Masculino , Humanos , Idoso , Paralisia Facial/genética , Gelsolina/genética , Gelsolina/metabolismo , Paralisia de Bell/complicações , Doenças do Nervo Facial/complicações , Amiloidose/complicações , Nervo Facial , Distrofias Hereditárias da Córnea/complicações , Distrofias Hereditárias da Córnea/genética , Músculos Faciais
11.
Artigo em Chinês | MEDLINE | ID: mdl-36543410

RESUMO

At present, the main treatment for vestibular schwannomas is surgery. Considering the risk of multiple complications from surgery and the subjective and objective conditions of patients, a non-surgical treatment modality, namely stereotactic radiotherapy, has gradually been included in the treatment of vestibular schwannomas. Studies have shown that Gamma Knife therapy has a more prominent therapeutic effect on smaller tumors and can alleviate facial nerve disorders caused by space occupying of tumor mass. Cyberknife not only has a better effect on tumor control, but also has an ideal retention rate for patients' auditory function. Proton beam therapy has also been gradually applied to the treatment of vestibular schwannomas, but the effect of treatment remains to be further studied. Drug therapy includes a variety of target inhibitors and anti-angiogenic drugs. At present, drug treatment focuses more on preclinical research. This article reviews the clinical research of various radiotherapy and the progress of drug treatment.


Assuntos
Doenças do Nervo Facial , Neuroma Acústico , Radiocirurgia , Humanos , Neuroma Acústico/patologia , Neuroma Acústico/radioterapia , Resultado do Tratamento , Audição/fisiologia , Radiocirurgia/efeitos adversos , Estudos Retrospectivos
12.
JAMA Otolaryngol Head Neck Surg ; 148(10): 983-984, 2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-35980653

RESUMO

A 21-year-old man presented with left-sided facial paralysis and sensorineural hearing loss; physical examination was otherwise normal. What is your diagnosis?


Assuntos
Neoplasias dos Nervos Cranianos , Doenças do Nervo Facial , Paralisia Facial , Perda Auditiva Neurossensorial , Neoplasias dos Nervos Cranianos/diagnóstico , Doenças do Nervo Facial/diagnóstico , Paralisia Facial/diagnóstico , Humanos
13.
Artigo em Chinês | MEDLINE | ID: mdl-35866274

RESUMO

Objective: To investigate the clinical characteristics, differential diagnosis, treatments and prognosis of facial nerve hemangioma and schwannoma at genicular ganglion, so as to provide reference for clinical diagnosis and treatments of facial nerve tumor at genicular ganglion. Methods: Clinical data of 13 patients with facial nerve tumors at genicular ganglion confirmed by postoperative pathology in the Ninth People's Hospital affiliated to Shanghai Jiaotong University School of Medicine from March 2018 to April 2020 were retrospectively analyzed, including seven cases of hemangioma and six cases of schwannoma. There were eight males and five females. Their ages ranged from 20 to 65, with an average age of 40. The course of disease ranged from 3 to 118 months, with an average of 52 months. All the patients underwent preoperative HRCT of the temporal bone and facial nerve dynamic contrast-enhanced(DCE) MRI examinations. All the patients had detailed surgical procedures and at least one-year postoperative follow-up. Results: On HRCT of the temporal bone, (4/7) hemangioma at geniculate ganglion showed characteristic honeycomb appearance, while 6/6 schwannoma and 3/7 hemangiomas showed expansive bone changes. On DCE-MRI, geniculate ganglion hemangioma (7/7) showed characteristic "point-to-surface" enhancement, and schwannoma (6/6) showed characteristic "face-to-surface" enhancement. For five hemangioma-patients with HB-Ⅱ-Ⅳ before surgery, the facial nerve anatomy was completely preserved through transcanal endoscopic approach(TEA), and the facial nerve function improved one year after surgery (two cases of HB-I, two cases of HB-Ⅱ, and one case of HB-Ⅲ). For two patients, with preoperative facial nerve function HB-Ⅴ-Ⅵ, since their tumors was inseparable from the nerves, they were performed with facial nerve anastomosis during the surgery, and the facial nerve function was improved to HB-Ⅳ level one year after surgery. For six patients with meningioma whose facial nerve function was greater than or equal to HB-Ⅲ, based on the preoperative hearing level, the involved segments, and duration of facial paralysis, three of them were conducted surgeries through middle cranial fossa approach, one by translabyrinthine approach, and one via mastoid approach. Two patients among them with complete facial paralysis over three years preoperatively were not performed facial nerve anastomosis after total resections of the tumors, and there was no improvement in facial nerve function one year after surgery. Three patients underwent facial nerve anastomosis after total tumor resections, and their facial nerve function was HB-Ⅲ in one patient, HB-Ⅳ in two patients one year after surgery. One patient (preoperative HB-Ⅲ) had a normal hearing level preoperatively, and the tumor involved the labyrinth segment. To protect the hearing, partial tumor was resected through the middle cranial fossa approach, and facial nerve function improved to HB-Ⅱ one year after surgery. Conclusions: Temporal bone HRCT combined with DCE-MRI are useful for the differential diagnosis of hemangioma and schwannoma at geniculate ganglion and provide references for preoperative clinical decision makings. It is extremely necessary to select the appropriate surgical approach based on the patient's hearing and involved segments. For geniculate ganglion hemangioma, early surgery can improve the possibilities of anatomical integrity of facial nerve, thereby improving facial nerve function postoperatively.TEA is a kind of surgical method worth consideration, with the characteristics of minimally invasive, favorable postoperative features, and so on. For schwannoma, one-stage functional reconstruction of the facial nerve is recommended during the resection of the tumors because of the inevitable damage to the anatomical integrity of the facial nerve.


Assuntos
Neoplasias dos Nervos Cranianos , Doenças do Nervo Facial , Paralisia Facial , Hemangioma , Neoplasias Meníngeas , Neurilemoma , Adulto , Pré-Escolar , China , Neoplasias dos Nervos Cranianos/cirurgia , Diagnóstico Diferencial , Nervo Facial/cirurgia , Doenças do Nervo Facial/diagnóstico , Paralisia Facial/diagnóstico , Feminino , Gânglio Geniculado/patologia , Gânglio Geniculado/cirurgia , Hemangioma/diagnóstico , Hemangioma/cirurgia , Humanos , Lactente , Masculino , Neoplasias Meníngeas/complicações , Neoplasias Meníngeas/diagnóstico , Neoplasias Meníngeas/patologia , Neurilemoma/cirurgia , Estudos Retrospectivos
14.
J Neurol ; 269(10): 5328-5336, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35583659

RESUMO

BACKGROUND: Facial nerve palsy is a cardinal manifestation of neurosarcoidosis, but dedicated studies of this disease feature have not been conducted. We sought to clarify the impact of facial palsy on the diagnosis of neurosarcoidosis, its subsequent clinicoradiographic evolution, and eventual treatment decisions. METHODS: A single-center retrospective analysis of patients with neurosarcoidosis and facial palsy was conducted over the preceding 10 years (01/01/2011-08/12/2021). RESULTS: 23/218 (10.6%) patients with neurosarcoidosis developed facial neuropathy. It was the inaugural manifestation of neurosarcoidosis in 17/23 (73.9%) and presented in isolation of other neurologic deficits or extra-facial MRI abnormalities in 12/23 (52.2%). At onset, facial palsy was unilateral in 20/23 (87.0%), and multiple cranial neuropathies were seen in 8/23 (34.8%). Non-facial inflammatory MRI abnormalities were observed in 6/15 (40.0%) patients at onset with leptomeningitis being most common (5/15, 33.3%). 13/23 (56.5%) experienced a second attack of neurosarcoidosis at a median of 8 months, including 3/23 (13.0%) with recurrent facial palsies. In the 12 patients with isolated facial paresis at onset, 4/12 (33.3%) remained free of new deficits or neuroimaging abnormalities by last follow-up. 17/23 (73.9%) eventually required initiation of steroid-sparing immunosuppressants, almost all for development of non-facial disease. The final median House-Brackmann score was 1. CONCLUSION: Facial neuropathy occurred less commonly than historically reported, and it often acts as a forerunner to systemic sarcoidosis and more widespread neurologic disease. Recurrent attacks of neurosarcoidosis occur early at high frequency following facial palsy. Recovery of facial nerve function is typically excellent.


Assuntos
Paralisia de Bell , Doenças do Nervo Facial , Paralisia Facial , Sarcoidose , Doenças do Sistema Nervoso Central , Nervo Facial/diagnóstico por imagem , Doenças do Nervo Facial/etiologia , Paralisia Facial/etiologia , Humanos , Estudos Retrospectivos , Sarcoidose/complicações , Sarcoidose/diagnóstico por imagem
15.
Cytopathology ; 33(5): 618-621, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35385173

RESUMO

Schwannoma is a benign nerve sheath tumour rarely found in the head and neck region and much less commonly found in the intraparotid facial nerve. It is a slow-growing encapsulated tumour arising from differentiated Schwann cells or axonal nerve sheath. It can occur anywhere along the course of the facial nerve. Patients most commonly present with an asymptomatic swelling, in the absence of any signs of facial nerve palsy. Accordingly, diagnosis is usually difficult before surgical removal and histopathological examination. Here, we report a rare case of facial nerve schwannoma (FNS), diagnosed on fine needle aspiration cytology, in a 35-year-old male who presented with a painless, gradually increasing swelling in the right infra-auricular region for the last 2 years. His general examination revealed no signs of facial muscle weakness. The cytodiagnosis of intraparotid FNS was further confirmed by immunohistochemistry on cell block.


Assuntos
Neoplasias dos Nervos Cranianos , Doenças do Nervo Facial , Paralisia Facial , Neurilemoma , Adulto , Biópsia por Agulha Fina , Neoplasias dos Nervos Cranianos/diagnóstico , Neoplasias dos Nervos Cranianos/patologia , Neoplasias dos Nervos Cranianos/cirurgia , Nervo Facial/patologia , Doenças do Nervo Facial/diagnóstico , Paralisia Facial/patologia , Humanos , Masculino , Neurilemoma/diagnóstico , Neurilemoma/patologia , Neurilemoma/cirurgia , Glândula Parótida/patologia
17.
Oper Neurosurg (Hagerstown) ; 22(1): e43, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34982914

RESUMO

Owing to their invasive character, extreme vascularity, and critical location, glomus jugulare tumors present a formidable challenge. Techniques have been developed for safe and successful removal of even giant glomus paragangliomas.1-3 Preoperative evaluation including genetic, hormonal, and multiplicity workup4 has enhanced the safety of surgical management, as did modern preoperative embolization by eliminating excessive blood loss.5 Despite these advancements, surgical outcomes of glomus jugulare remain haunted by cranial nerve dysfunction such as facial nerve palsies and hearing loss, with lower cranial nerves dysfunction being the most morbid. These can be avoided by technical maneuvers to preserve the cranial nerves. The external ear canal is not closed to maintain conductive hearing. The facial nerve is not transpositioned and kept inside a bony protective canal. Cranial nerves IX, X, and XI are the most vulnerable because they pass through the jugular foramen ventral to the venous bulb wall. They are preserved by intrabulbar dissection that maintains a protective segment of the venous wall over the nerves. By mastering the anatomy of the upper neck, meticulous dissection is performed to preserve the course of IX, X, XI, and XII.6,7 Ligation of the jugular vein is delayed until the tumor is totally isolated to avoid diffuse bleeding.7 We present the case of a 60-yr-old woman with a glomus jugulare tumor with intradural, extradural, and cervical extension. The technical nuances of cranial nerves preservation are demonstrated. The patient consented to the procedure and publication of her images. Images at 2:12, 2:50, and 3:09 from Al-Mefty and Teixeira,6 with permission from JNSPG.


Assuntos
Doenças do Nervo Facial , Tumor do Glomo Jugular , Glomo Jugular , Nervos Cranianos/cirurgia , Nervo Facial/cirurgia , Feminino , Glomo Jugular/patologia , Tumor do Glomo Jugular/diagnóstico por imagem , Tumor do Glomo Jugular/cirurgia , Humanos , Pessoa de Meia-Idade
18.
J Laryngol Otol ; 136(4): 349-353, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35094716

RESUMO

OBJECTIVE: To elucidate the aetiopathogenesis of facial neuritis in coronavirus disease 2019 associated mucormycosis. METHODS: A retrospective review was conducted of coronavirus disease 2019 associated mucormycosis patients who presented with peripheral facial nerve palsy from January 2021 to July 2021. The clinico-radiological details of four patients were assessed to examine the potential mechanism of facial nerve involvement. RESULTS: Serial radiological evaluation with contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging revealed infratemporal fossa involvement in all cases, with the inflammation extending along fascial planes to reach the stylomastoid foramen. Ascending neuritis with an enhancement of the facial nerve was demonstrated in all cases. CONCLUSION: The likely explanation for facial palsy in patients with coronavirus disease 2019 associated mucormycosis, backed by radiology, is the disease abutting the facial nerve at the stylomastoid foramen and causing ascending neuritis of the facial nerve.


Assuntos
COVID-19 , Doenças do Nervo Facial , Paralisia Facial , Mucormicose , Neurite (Inflamação) , Radiologia , COVID-19/complicações , Nervo Facial/diagnóstico por imagem , Nervo Facial/patologia , Paralisia Facial/etiologia , Humanos , Imageamento por Ressonância Magnética/efeitos adversos , Mucormicose/complicações , Mucormicose/diagnóstico por imagem , Neurite (Inflamação)/complicações , Neurite (Inflamação)/patologia
19.
Ann Clin Transl Neurol ; 9(1): 41-49, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-35064770

RESUMO

OBJECTIVES: Facial palsy is the most common manifestation of Lyme neuroborreliosis (LNB) in the United States. This study aimed to describe features of patients with early LNB presenting with facial palsy and to determine if corticosteroids in addition to antibiotic therapy was associated with unfavorable outcome. METHODS: Retrospective analysis of participants enrolled in clinical studies investigating Lyme disease (N = 486) identified 44 patients who had facial palsy from LNB. The House-Brackmann scale was used to quantify the facial nerve dysfunction. RESULTS: Most patients presented in the summer months. Erythema migrans, frequently associated with systemic symptoms, occurred in 29 patients. Thirteen patients presented with bilateral facial palsy, usually with sequential involvement. Fourteen patients had painful radiculopathy. Of the 38 patients treated with antibiotics before the resolution of the palsy who had complete follow-up, 24 received both antibiotics and corticosteroids. Of these 38 patients, 34 recovered completely, 3 had nearly complete recovery, and 1 had moderate dysfunction. There were no differences between the treatment groups in achieving complete resolution of the palsy at 12 months or in time to complete recovery. INTERPRETATION: A history of rash compatible with erythema migrans or febrile illness in the weeks preceding the palsy are helpful clues pointing toward LNB and should be actively sought when evaluating patients with acute-onset peripheral facial palsy, particularly bilateral facial palsy. Treatment with antibiotic therapy is highly effective and most patients will fully recover facial nerve function. Adjunctive corticosteroid therapy appears to not affect the speed of recovery or overall outcome in this retrospective observational study.


Assuntos
Corticosteroides/farmacologia , Antibacterianos/farmacologia , Doenças do Nervo Facial , Paralisia Facial , Neuroborreliose de Lyme , Adolescente , Adulto , Doenças do Nervo Facial/tratamento farmacológico , Doenças do Nervo Facial/epidemiologia , Doenças do Nervo Facial/etiologia , Doenças do Nervo Facial/fisiopatologia , Paralisia Facial/tratamento farmacológico , Paralisia Facial/epidemiologia , Paralisia Facial/etiologia , Paralisia Facial/fisiopatologia , Feminino , Humanos , Neuroborreliose de Lyme/complicações , Neuroborreliose de Lyme/epidemiologia , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Estudos Retrospectivos , Estados Unidos/epidemiologia , Adulto Jovem
20.
Artigo em Inglês | MEDLINE | ID: mdl-33826408

RESUMO

Background: Systematic reviews have identified the need for a patient-reported outcome measure for facial nerve paralysis (FNP). The aim of this study was to determine the psychometric properties of FACE-Q Craniofacial module scales when used in a combined sample of children and older adults with FNP. Methods: Data were collected between December 2016 and December 2019. We conducted qualitative interviews with children and adults with FNP. FACE-Q data were collected from patients aged 8 years and older with FNP. Rasch measurement theory analysis was used to examine the reliability and validity of the relevant scales in the FNP sample. Results: Twenty-five patients provided 2052 qualitative codes related to appearance, physical, psychological, and social function. Many patient concerns were common across age. The field-test sample included 235 patients aged 8-81 years. Of the 13 scales examined, all 122 items had ordered thresholds and good item fit to the Rasch model. For 12 scales, person separation index values were ≥0.79 and Cronbach's alpha values were ≥0.82. The 13th scale's reliability values were ≥0.71. Conclusion: The FACE-Q Craniofacial module scales described in this study can be used to collect and compare evidence-based outcome data from children and adults with FNP.


Assuntos
Doenças do Nervo Facial/diagnóstico , Paralisia Facial/diagnóstico , Medidas de Resultados Relatados pelo Paciente , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Doenças do Nervo Facial/fisiopatologia , Doenças do Nervo Facial/psicologia , Doenças do Nervo Facial/terapia , Paralisia Facial/fisiopatologia , Paralisia Facial/psicologia , Paralisia Facial/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Pesquisa Qualitativa , Reprodutibilidade dos Testes , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...