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Huang H, Lin Q, Rui X, Huang Y, Wu X, Yang W, Yu Z, He W. Research status of facial nerve repair. Regen Ther 2023; 24:507-514. [PMID: 37841661 PMCID: PMC10570629 DOI: 10.1016/j.reth.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/06/2023] [Accepted: 09/21/2023] [Indexed: 10/17/2023] Open
Abstract
The facial nerve, also known as the seventh cranial nerve, is critical in controlling the movement of the facial muscles. It is responsible for all facial expressions, such as smiling, frowning, and moving the eyebrows. However, damage to this nerve can occur for a variety of reasons, including maxillofacial surgery, trauma, tumors, and infections. Facial nerve injuries can cause severe functional impairment and can lead to different degrees of facial paralysis, significantly affecting the quality of life of patients. Over the past ten years, significant progress has been made in the field of facial nerve repair. Different approaches, including direct suture, autologous nerve grafts, and tissue engineering, have been utilized for the repair of facial nerve injury. This article mainly summarizes the clinical methods and basic research progress of facial nerve repair in the past ten years.
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Affiliation(s)
- Haoyuan Huang
- School of Stomatology, Jinan University, Guangzhou 510632, China
| | - Qiang Lin
- Hospital of stomatology, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- School of Stomatology, Jinan University, Guangzhou 510632, China
| | - Xi Rui
- Hospital of stomatology, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- School of Stomatology, Jinan University, Guangzhou 510632, China
| | - Yiman Huang
- Hospital of stomatology, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- School of Stomatology, Jinan University, Guangzhou 510632, China
| | - Xuanhao Wu
- School of Stomatology, Jinan University, Guangzhou 510632, China
| | - Wenhao Yang
- School of Stomatology, Jinan University, Guangzhou 510632, China
| | - Zhu Yu
- School of Stomatology, Jinan University, Guangzhou 510632, China
| | - Wenpeng He
- Hospital of stomatology, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- School of Stomatology, Jinan University, Guangzhou 510632, China
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Szot P, Płachta I, Nagórska E, Brożek-Mądry E. Analysis of mastoid portion of facial nerve course in temporal bone using computed tomography. OTOLARYNGOLOGIA POLSKA 2023; 77:39-47. [PMID: 37772376 DOI: 10.5604/01.3001.0016.3300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
<b>Introduction:</b> The facial nerve (FN) follows a complex route in the temporal bone. Successful temporal bone surgery requires knowledge of its course which can be achieved using imaging methods such as computed tomography. This investigation aims to analyze the FN course in its mastoid portion and second genu and the frequency of its atypical course.</br></br> <b>Material and methods:</b> This is a retrospective study that enrolled 104 CT scans of temporal bones of patients followed up in the outpatient clinic of the Otorhinolaryngology Department of Dentistry Faculty of the Medical University of Warsaw between 2020 and 2022. FN courses were classified as straight, bulging, or letter "S"-like. Other parameters estimated: </br> • position of the second genu according to the prominence of the lateral semicircular canal (classified as lateral, medial, or middle) and its distance from a line adjacent to the lateral semicircular canal was measured;</br> • the distance between the short process of the incus and the outermost point of the second genu;</br> • the course of the mastoid portion of FN and the location of SG in comparison to the tympanic portion of n. VII. The course was later classified as lateral, medial, or middle.</br></br> <b>Results:</b> Among the 104 assessed temporal bones, the course of the mastoid portion of FN was classified as bulging in 47 cases (45.2%). Straight and letter "S"-like courses were present in 41 (39.4%) and 16 (15.4%) cases, respectively. Deviation of the second genu according to the prominence of the lateral semicircular canal was medial in 86 cases (82.7%), and middle in 4 cases (3.8%). In the rest, second genu was paramedian to the prominence of the later circular canal. The mean distance between the short process of the incus and the outermost point of SG was 4.9 mm (0.73 mm). The mastoid portion was located laterally, medially, and in the middle of the tympanic portion plane in, respectively, 4.8%, 83.7%, and 11.5%. The second genu was located laterally, medially, and in the middle of the tympanic portion plane in 1.9%, 73.1%, and 25%, respectively. In conclusion, seven temporal bones (6.7%) of five patients presented with a lateral displacement of FN in relation to the established anatomical landmarks.</br></br> <b>Conclusions:</b> Although the atypical course of FN, including the lateral displacement of the mastoid portion, is rare, screening for it is crucial before surgical exploration.
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Affiliation(s)
- Paulina Szot
- Department of Otorhinolaryngology, Faculty of Dentistry, Medical University of Warsaw, Warsaw, Poland
| | - Iga Płachta
- Department of Otorhinolaryngology, Faculty of Dentistry, Medical University of Warsaw, Warsaw, Poland
| | - Emilia Nagórska
- Department of Otorhinolaryngology, Faculty of Dentistry, Medical University of Warsaw, Warsaw, Poland
| | - Eliza Brożek-Mądry
- Department of Otolaryngology, Central Clinical Hospital of the Ministry of Interior and Administration in Warsaw, Warsaw, Poland
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Kazemian E, Schaffer HM, Wozniak A, Leonetti JP. Economic Impact of Diagnostic Imaging in the Workup of Uncomplicated Bell's Palsy. Skull Base Surg 2022; 83:323-327. [DOI: 10.1055/s-0040-1722231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/12/2020] [Indexed: 10/22/2022]
Abstract
Abstract
Objective Our primary objective is to identify the costs associated with imaging in the diagnostic workup of uncomplicated Bell's palsy. Our secondary objective is to identify a dollar amount spent on extraneous diagnostic testing on a state and national level.
Design and Setting Retrospective chart analysis was performed at our tertiary care medical center between 2007 and 2018. International Statistical Classification of Diseases-10 code G51.0 was used to identify patients with Bell's palsy seen by the senior author. A total of 163 patients were divided into two groups: those having received imaging and those diagnosed without imaging. The imaging group was then further subdivided by imaging modality: computed tomography (CT) only, magnetic resonance imaging (MRI) only, or both. There was a total of 138 scans in 115 patients. To quantify the amount spent by insurance companies or patients on these scans, net expected pay (NEP) for each modality was used as a representation of cost. The NEP for a CT was $618. The NEP for an MRI was $1,119. The NEP for both scans was $1,737. We extrapolated our results to a state and national level.
Main Outcome Measurements Cost of workup; state and national economic burden.
Results Extrapolating our data, we forecast that in Illinois and in the United States, over $2 million and $53 million, respectively, are spent on unnecessary imaging.
Conclusion By highlighting an unnecessary financial burden, our study provides concrete evidence to support the American Academy of Otolaryngology's recommendation that clinicians should not perform routine imaging studies when diagnosing uncomplicated Bell's palsy.
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Affiliation(s)
- Elycia Kazemian
- Department of Otolaryngology, Loyola University Medical Center, Maywood, Illinois, United States
| | - Hollie Marie Schaffer
- Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, United States
| | - Amy Wozniak
- Division of Health Sciences, Loyola University Chicago, Center for Translational Research and Education, Maywood, Illinois, United States
| | - John P. Leonetti
- Department of Otolaryngology, Loyola University Medical Center, Maywood, Illinois, United States
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Acute Facial Nerve Palsy in Children: Gold Standard Management. CHILDREN 2022; 9:children9020273. [PMID: 35204994 PMCID: PMC8870855 DOI: 10.3390/children9020273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/07/2022] [Accepted: 02/14/2022] [Indexed: 11/16/2022]
Abstract
Facial nerve palsy (FNP) is a common illness in the paediatric emergency department. Missed or delayed diagnosis can have a serious impact on a patient’s quality of life. The aim of this article is to give a recent overview of this pathology in terms of the causes, diagnosis, red flag symptoms, complementary examinations, treatments and follow-up in the child population. In cases of acquired, acute onset and isolated FNP, Bell’s palsy can be assumed, and no further investigation is required. In any other scenario, complementary examinations are required. Treatment depends on the aetiology. Corticosteroids, in addition to antiviral medication, are recommended to treat Bell’s palsy whenever a viral infection is suspected. However, the lack of randomised control trials in the paediatric population does not allow us to comment on the effectiveness of these treatments. In all cases, treated or not, children have a very good recovery rate. This review emphasises the necessity of randomised control trials concerning this frequent neurological pathology in order to better treat these children.
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Ozgen Mocan B. Imaging Anatomy and Pathology of the Intracranial and Intratemporal Facial Nerve. Neuroimaging Clin N Am 2021; 31:553-570. [PMID: 34689933 DOI: 10.1016/j.nic.2021.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The facial nerve is one of the most complex cranial nerves, with motor, sensory, and parasympathetic fibers. A large spectrum of congenital, inflammatory, vascular, and neoplastic processes may affect one or more segments of the nerve. Customized use of computed tomography and magnetic resonance imaging combined with good understanding of the nerve anatomy and relevant clinical/surgical key points is crucial for appropriate assessment of facial neuropathy. This article reviews the anatomy of the intracranial and intratemporal facial nerve, and the imaging features of the most frequent disorders involving those segments of the nerve.
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Affiliation(s)
- Burce Ozgen Mocan
- Department of Radiology, University of Illinois at Chicago, 1740 West Taylor Street, MC 931, Chicago, IL 60612, USA.
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Lee MK, Choi Y, Jang J, Shin NY, Jung SL, Ahn KJ, Kim BS. Identification of the intraparotid facial nerve on MRI: a systematic review and meta-analysis. Eur Radiol 2020; 31:629-639. [PMID: 32857205 DOI: 10.1007/s00330-020-07222-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/03/2020] [Accepted: 08/21/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Accurate preoperative localization of the intraparotid facial nerve (IFN) on MRI could reduce intraoperative injury. This study aimed to assess the detection rate of the IFN and its branches on MRI. METHODS PubMed-MEDLINE and Embase databases were searched for articles published up to October 2019. The inclusion criteria were (a) adults, (b) MRI-based identification of IFN by radiologists, (c) original articles, and (d) detailed results to assess the proportion of visible IFN. Two radiologists reviewed the original articles. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to determine the quality of the selected studies. The DerSimonian-Laird random effects model was utilized to calculate the pooled estimates. Between-studies heterogeneity was evaluated using the chi-squared statistic test and Higgins' inconsistency index (I2). A subgroup meta-regression was performed to explore the factors causing study heterogeneity. RESULTS Nine original articles with 209 subjects were included. MRI reported a high pooled detection rate of 99.8% (95% CI, 98.4-100%) for the main trunk of the IFN. The pooled rates for the temporofacial and cervicofacial branches were 90.4% (95% CI, 84.1-96.7%) and 96.3% (95% CI, 96.1-99.5%), respectively. Heterogeneity was detected only in the temporofacial branch (I2 = 83%) as a result of both slice thickness and the use of steady-state sequences with diffusion-weighted imaging (DWI) implementation. CONCLUSIONS MRI showed an overall high detection rate of the IFN and its branches. Furthermore, an increased identification was observed in studies that used a slice thickness of < 1 mm and steady-state sequences with DWI implementation. KEY POINTS • MRI showed an overall high detection rate of the intraparotid facial nerve and its branches. • Higher detection rate was observed in studies that used a slice thickness of < 1 mm and steady-state sequences with diffusion-weighted imaging.
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Affiliation(s)
- Min-Kyung Lee
- Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 63-ro 10, Yeongdeungpo-gu, Seoul, 07345, South Korea
| | - Yangsean Choi
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea.
| | - Jinhee Jang
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
| | - Na-Young Shin
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
| | - So-Lyung Jung
- Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 63-ro 10, Yeongdeungpo-gu, Seoul, 07345, South Korea
| | - Kook-Jin Ahn
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
| | - Bum-Soo Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
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High Altitude Alternobaric Facial Palsy: Case Series and Systematic Review of the Literature. Otol Neurotol 2019; 40:1378-1385. [DOI: 10.1097/mao.0000000000002379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Eliezer M, Poillon G, Horion J, Lelion P, Gerardin E, Magne N, Gillibert A, Attyé A. MRI diagnosis of saccular hydrops: Comparison of heavily-T2 FIESTA-C and 3D-FLAIR sequences with delayed acquisition. J Neuroradiol 2019; 48:446-452. [DOI: 10.1016/j.neurad.2019.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/19/2019] [Accepted: 04/12/2019] [Indexed: 10/26/2022]
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Magnetic resonance imaging of developmental facial paresis: a spectrum of complex anomalies. Neuroradiology 2018; 60:1053-1061. [PMID: 30074067 DOI: 10.1007/s00234-018-2063-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/05/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Despite its clinical implications, the MRI features of developmental facial paresis (DFP) were described in a few case reports. This study aims to describe MRI features of DFP in relation to the embryological development with a proposed radiological new grading system. METHODS The clinical records and MRI of the brain and internal auditory canal of 11 children with DFP were retrospectively reviewed. The following sequences were analyzed: axial, oblique sagittal SPACE of the internal auditory canal and brainstem; axial T2, T1WI and coronal T2WI of the brain. The severity of the maldevelopment of the seventh nerve was graded from 0 to 4: 0 = no abnormalities, 1 = unilateral facial nerve hypoplasia, 2 = unilateral facial nerve aplasia, 3 = aplasia or hypoplasia involving facial nerves on both sides, and 4 = facial nerve aplasia or hypoplasia associated with other cranial nerve palsy. RESULTS Isolated facial nerve palsy was diagnosed in seven patients. It was of grade 1 in five and grade 3 in two. Hypoplasia of the nerve with interrupted course was encountered in two cases. Other associated cranial nerve abnormalities (grade 4) were seen in four patients; two of them were diagnosed previously as Moebius syndrome. In addition to inner ear anomalies, middle and external ear and parotid gland anomalies were described. CONCLUSION To our knowledge, this is the largest series of patients with DFP that represents a continuum of isolated and combined malformations. Understanding of embryological basis can give insights into the anomalous development of the facial nerve.
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Cobo J, Solé-Magdalena A, Menéndez I, de Vicente J, Vega J. Connections between the facial and trigeminal nerves: Anatomical basis for facial muscle proprioception. JPRAS Open 2017. [DOI: 10.1016/j.jpra.2017.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Skolnik AD, Loevner LA, Sampathu DM, Newman JG, Lee JY, Bagley LJ, Learned KO. Cranial Nerve Schwannomas: Diagnostic Imaging Approach. Radiographics 2016; 36:1463-77. [PMID: 27541436 DOI: 10.1148/rg.2016150199] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Schwannomas are benign nerve sheath tumors that may arise along the complex course of the cranial nerves (CNs), anywhere in the head and neck. Sound knowledge of the CN anatomy and imaging features of schwannomas is paramount for making the correct diagnosis. In this article, we review approaches to diagnosing CN schwannomas by describing their imaging characteristics and the associated clinical presentations. Relevant anatomic considerations are highlighted by using illustrative examples and key differential diagnoses categorized according to regions, which include the anterior skull base, orbit, cavernous sinus, basal cisterns, and neck. The clinical presentations associated with CN schwannomas vary and range from no symptoms to symptoms caused by mass effect or CN deficits. Individuals with the inherited disorder neurofibromatosis type 2 are predisposed to multiple schwannomas. When a lesion follows the course of a CN, the radiologist's roles are to confirm the imaging features of schwannoma and exclude appropriate differential considerations. The characteristic imaging features of CN schwannomas reflect their slow growth as benign neoplasms and include circumscribed margins, displacement of local structures, and smooth expansion of osseous foramina. These neoplasms exhibit various degrees of solid enhancement, often with internal cystic spaces on magnetic resonance (MR) and computed tomographic (CT) images and heterogeneous high signal intensity specifically on T2-weighted MR images. Clinical and/or imaging evidence of end-organ compromise of the involved CN may exist and aid in the identification of the nerve of origin. With a detailed understanding of the course of the CNs, the diagnostic features of CN schwannomas, and the correlation between these data and the associated clinical presentations of these tumors, the radiologist can have a key role in the diagnosis of CN schwannomas and the treatment planning for affected patients. (©)RSNA, 2016.
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Affiliation(s)
- Aaron D Skolnik
- From the Departments of Radiology (A.D.S., L.A.L., D.M.S., L.J.B., K.O.L.), Otorhinolaryngology (J.G.N.), and Neurosurgery (J.Y.L.), University of Pennsylvania Health System, Hospital of the University of Pennsylvania, 3400 Spruce St, 2 Dulles Room 219, Philadelphia, PA 19104
| | - Laurie A Loevner
- From the Departments of Radiology (A.D.S., L.A.L., D.M.S., L.J.B., K.O.L.), Otorhinolaryngology (J.G.N.), and Neurosurgery (J.Y.L.), University of Pennsylvania Health System, Hospital of the University of Pennsylvania, 3400 Spruce St, 2 Dulles Room 219, Philadelphia, PA 19104
| | - Deepak M Sampathu
- From the Departments of Radiology (A.D.S., L.A.L., D.M.S., L.J.B., K.O.L.), Otorhinolaryngology (J.G.N.), and Neurosurgery (J.Y.L.), University of Pennsylvania Health System, Hospital of the University of Pennsylvania, 3400 Spruce St, 2 Dulles Room 219, Philadelphia, PA 19104
| | - Jason G Newman
- From the Departments of Radiology (A.D.S., L.A.L., D.M.S., L.J.B., K.O.L.), Otorhinolaryngology (J.G.N.), and Neurosurgery (J.Y.L.), University of Pennsylvania Health System, Hospital of the University of Pennsylvania, 3400 Spruce St, 2 Dulles Room 219, Philadelphia, PA 19104
| | - John Y Lee
- From the Departments of Radiology (A.D.S., L.A.L., D.M.S., L.J.B., K.O.L.), Otorhinolaryngology (J.G.N.), and Neurosurgery (J.Y.L.), University of Pennsylvania Health System, Hospital of the University of Pennsylvania, 3400 Spruce St, 2 Dulles Room 219, Philadelphia, PA 19104
| | - Linda J Bagley
- From the Departments of Radiology (A.D.S., L.A.L., D.M.S., L.J.B., K.O.L.), Otorhinolaryngology (J.G.N.), and Neurosurgery (J.Y.L.), University of Pennsylvania Health System, Hospital of the University of Pennsylvania, 3400 Spruce St, 2 Dulles Room 219, Philadelphia, PA 19104
| | - Kim O Learned
- From the Departments of Radiology (A.D.S., L.A.L., D.M.S., L.J.B., K.O.L.), Otorhinolaryngology (J.G.N.), and Neurosurgery (J.Y.L.), University of Pennsylvania Health System, Hospital of the University of Pennsylvania, 3400 Spruce St, 2 Dulles Room 219, Philadelphia, PA 19104
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Poon R, Su N, Ching V, Darling M, Grushka M. Reduction in unstimulated salivary flow rate in burning mouth syndrome. Br Dent J 2014; 217:E14. [DOI: 10.1038/sj.bdj.2014.884] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2014] [Indexed: 01/03/2023]
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The fallopian canal: a comprehensive review and proposal of a new classification. Childs Nerv Syst 2014; 30:387-95. [PMID: 24322603 DOI: 10.1007/s00381-013-2332-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 11/18/2013] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The facial nerve follows a complex course through the skull base. Understanding its anatomy is crucial during standard skull base approaches and resection of certain skull base tumors closely related to the nerve, especially, tumors at the cerebellopontine angle. METHODS Herein, we review the fallopian canal and its implications in surgical approaches to the skull base. Furthermore, we suggest a new classification. CONCLUSIONS Based on the anatomy and literature, we propose that the meatal segment of the facial nerve be included as a component of the fallopian canal. A comprehensive knowledge of the course of the facial nerve is important to those who treat patients with pathology of or near this cranial nerve.
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Ergen B, Baykara M, Polat C. An investigation on magnetic imaging findings of the inner ear: A relationship between the internal auditory canal, its nerves and benign paroxysmal positional vertigo. Biomed Signal Process Control 2014. [DOI: 10.1016/j.bspc.2013.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Toulgoat F, Sarrazin JL, Benoudiba F, Pereon Y, Auffray-Calvier E, Daumas-Duport B, Lintia-Gaultier A, Desal HA. Facial nerve: from anatomy to pathology. Diagn Interv Imaging 2013; 94:1033-42. [PMID: 23891166 DOI: 10.1016/j.diii.2013.06.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The facial nerve (CN VII) emerges from the facial nerve nucleus in the pons. It is accompanied by CN VIII along its cisternal pathway, as well as at the internal auditory meatus. Its petrous pathway includes a labyrinthine segment, a horizontal tympanic segment and a vertical mastoid segment until the stylomastoid foramen. It then continues to the parotid gland. Pontine impairment is usually associated with other neurological symptoms. Lesions of the cerebellopontine angle (most often meningioma and schwannoma) initially result in impairment of CN VIII. The impairment of CN VII takes second place. Peripheral impairment (outside of a traumatic context) is most often due to Bell's palsy.
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Affiliation(s)
- F Toulgoat
- Neuroradiologie diagnostique et interventionnelle, Hôpital Laennec, CHU de Nantes, boulevard Jacques-Monod - Saint-Herblain, 44093 Nantes cedex 1, France.
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Imaging the facial nerve: a contemporary review. Radiol Res Pract 2013; 2013:248039. [PMID: 23766904 PMCID: PMC3676972 DOI: 10.1155/2013/248039] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 02/03/2013] [Accepted: 02/05/2013] [Indexed: 11/22/2022] Open
Abstract
Imaging plays a critical role in the evaluation of a number of facial nerve disorders. The facial nerve has a complex anatomical course; thus, a thorough understanding of the course of the facial nerve is essential to localize the sites of pathology. Facial nerve dysfunction can occur from a variety of causes, which can often be identified on imaging. Computed tomography and magnetic resonance imaging are helpful for identifying bony facial canal and soft tissue abnormalities, respectively. Ultrasound of the facial nerve has been used to predict functional outcomes in patients with Bell's palsy. More recently, diffusion tensor tractography has appeared as a new modality which allows three-dimensional display of facial nerve fibers.
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Mu X, Quan Y, Shao J, Li J, Wang H, Gong R. Enlarged geniculate ganglion fossa: CT sign of facial nerve canal fracture. Acad Radiol 2012; 19:971-6. [PMID: 22770465 DOI: 10.1016/j.acra.2012.03.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 03/29/2012] [Accepted: 03/29/2012] [Indexed: 10/28/2022]
Abstract
RATIONALE AND OBJECTIVES The aim of this study was to preliminarily investigate whether an enlarged geniculate ganglion fossa (GGF) on temporal bone computed tomography can diagnose GGF fracture in patients with traumatic facial paralysis by evaluating the diameter of the GGF. MATERIALS AND METHODS Thirty-six patients who underwent computed tomography before confirmation of GGF fracture on otologic surgery were recruited into a study group. Additionally, a cohort of 107 patients with no histories of head trauma, no structural abnormalities of inner ear, and no clinical symptoms of facial nerve disability who underwent computed tomography for other reasons were selected as a control group. The diameters of the GGFs of the study group were evaluated by two observers and compared retrospectively with those of the control group. Wilcoxon's test was used to compare discrepancies of both sides, and intraclass correlation coefficients were used to evaluate intraobserver and interobserver reliability. RESULTS The measurement of diameters showed good interobserver and intraobserver consistency. The discrepancy in the measurement of transdiameter between both sides of the GGF on reformatted transverse images of the study group was significantly different from that of the control group (Wilcoxon's test, P < .001). Discrepancy in the GGF on transverse images of the study group was larger than that of the control group. A significant difference existed in the discrepancy in vertical diameter between the study and control groups (Wilcoxon's test, P < .001) as well. CONCLUSIONS An enlarged GGF on temporal bone computed tomography offers an additional sign for the diagnosis of GGF fracture in patients with traumatic facial paralysis.
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Lerat J, Orsel S, Mounayer C, Riva R, Roudaut PY, Patron V, Bessede JP, Aubry K. Peripheral facial paralysis and bilateral carotid pseudoaneurysms of petrous localization: a case report. SKULL BASE REPORTS 2011; 1:133-8. [PMID: 23984216 PMCID: PMC3743601 DOI: 10.1055/s-0031-1284209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 05/06/2011] [Indexed: 11/17/2022]
Abstract
Carotid pseudoaneurysms of petrous localization are rare. They are mostly due to trauma, tumoral or infectious diseases, or a result of iatrogenic complications after skull base surgery. Symptoms such as facial paralysis are exceptional and have rarely been described in the literature until now. We report the case of a 64-year-old woman, who developed left peripheral facial paralysis induced by two carotid pseudoaneurysms in their intrapetrous section. The treatment is endovascular, despite the high morbidity rate. She was first put on antiplatelet medications, before the left carotid aneurysm was bypassed thanks to a self-expanding pipeline-type stent with flow diversion. The left peripheral facial paralysis was due to the compression exerted by the left carotid aneurysm, probably a congenital malformation. The progressive palsy recovery was fist due to the aneurysmal thrombosis, then to the secondary fibrosis.
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Affiliation(s)
- Justine Lerat
- Department of Otolaryngology, Head and Neck Surgery, Limoges, France
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Pavlou E, Gkampeta A, Arampatzi M. Facial nerve palsy in childhood. Brain Dev 2011; 33:644-50. [PMID: 21144684 DOI: 10.1016/j.braindev.2010.11.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Revised: 11/09/2010] [Accepted: 11/10/2010] [Indexed: 01/08/2023]
Abstract
Facial nerve palsy in children is usually idiopathic but can also result from many conditions such as neoplasias, systemic diseases, or congenital anomalies with poor prognosis. Children with idiopathic facial palsy (Bell's palsy) have a very good prognosis, while treatment with prednisone does not certainly improve the outcome. The causes of facial nerve palsy in childhood differ from those in adults. A detailed investigation and differential diagnosis are recommended for facial palsy in children.
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Affiliation(s)
- Evangelos Pavlou
- 2nd Department of Pediatrics, Aristotle University of Thessaloniki, AHEPA General Hospital, Thessaloniki, Greece.
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