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Park DJ, Hori YS, Nernekli K, Persad AR, Tayag A, Ustrzynski L, Emrich SC, Hancock SL, Chang SD. Stereotactic radiosurgery for facial nerve hemangioma: Case report and systematic review. J Clin Neurosci 2024; 126:21-25. [PMID: 38823231 DOI: 10.1016/j.jocn.2024.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/04/2024] [Accepted: 05/21/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Facial nerve hemangiomas (FNHs) are rare tumors that primarily occur near the geniculate ganglion in the temporal bone. Despite their rarity, they can cause significant facial nerve dysfunction. The optimal management approach for FNHs remains uncertain, with surgery being the mainstay but subject to debate regarding the extent of resection and preservation of the facial nerve. METHODS Systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We queried the PubMed/Medline (accessed on 5 March 2024) electronic database using combinations of the following search terms and words text: "geniculate ganglion hemangioma", "ganglional hemangioma", "hemangioma of the facial nerve", "facial hemangioma", and "intratemporal hemangioma". RESULTS We identified a total of 30 literatures (321 patients). The most common site involved for the facial nerve hemangioma was the geniculate ganglion area followed by internal auditory canal, tympanic segment, labyrinthine segment and mastoid involvement. All patients were treated with conservative management or surgery. We report a 48-year-old female patient with HB grade 2 facial palsy and hemifacial spasm underwent SRS using Cyberknife technology. The treatment targeted the FNH in the left internal acoustic canal near the geniculate ganglion. Six months post-treatment, clinical improvement was evident, and lesion control was confirmed in a follow-up brain MRI. CONCLUSION The rarity of FNHs contributes to the lack of consensus on optimal management. This illustrative case demonstrates the feasibility of SRS as a standalone treatment for FNHs.
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Affiliation(s)
- David J Park
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Yusuke S Hori
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Kerem Nernekli
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Amit R Persad
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Armine Tayag
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Louisa Ustrzynski
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Sara C Emrich
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Steven L Hancock
- Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Steven D Chang
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, United States.
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Wojciechowski T, Bisi N, Szopiński K, Marchioni D. Detailed Radiomorphometric Analysis of the Surgical Corridor for the Suprageniculate Approach. J Pers Med 2024; 14:516. [PMID: 38793098 PMCID: PMC11122192 DOI: 10.3390/jpm14050516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/05/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND The suprageniculate fossa (SGF) is located between the geniculate ganglion, the middle cranial fossa (MCF) and the anterior semicircular canal (ASCC). An endoscopic transcanal approach has been recently proposed to treat the different lesions in this area. The aim of the study is to describe the anatomical pathway of this approach by measuring the dimensions of its boundaries while checking their correlation with the pneumatization of the SGF area. METHODS This is a retrospective anatomical analysis of Cone Beam CT scans of 80 patients, for a total of 160 temporal bones analyzed. Two checkpoints were measured for the SGF route, as an internal and an external window. These are triangles between the MCF dura, the geniculate ganglion and the ASCC on parasagittal and axial planes. The pneumatization of the SGF was also assessed, classified and correlated with the measured dimensions. RESULTS The depth of the SGF was 7.5 ± 1.8 mm. The width of the external window was 7.5 ± 1.9, 5.6 ± 2.4 and 1.6 ± 1.6 mm for the posterior, middle and anterior points of measurement, respectively. The height of the internal window was 7.6 ± 1.2, 4.5 ± 1.5 and 1.7 ± 1.7 mm for the posterior, middle and anterior points of measurement, respectively. Type A pneumatization was found in 87 cases, type B in 34 and type C in 39. The degree of pneumatization directly correlated to the depth and height of the fossa. CONCLUSIONS The suprageniculate approach route is defined by the internal and external windows which should be evaluated during a pre-surgery imaging assessment. The detailed anatomy of the approach and the novel classification of the pneumatization of the SGF are here described which may be useful to plan a safer procedure with minimal complications.
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Affiliation(s)
- Tomasz Wojciechowski
- Department of Descriptive and Clinical Anatomy, The Medical University of Warsaw, 5 Chalubinskiego St., 02004 Warsaw, Poland;
- Department of Otorhinolaryngology, Head and Neck Surgery, The Medical University of Warsaw, 1a Banacha St., 02097 Warsaw, Poland
| | - Nicola Bisi
- Department of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedaliero-Universitaria di Modena, Via del Pozzo 71, 41125 Modena, Italy;
| | - Kazimierz Szopiński
- Department of Dental and Maxillofacial Radiology, The Medical University of Warsaw, 6 Bienieckiego St., 02097 Warsaw, Poland;
| | - Daniele Marchioni
- Department of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedaliero-Universitaria di Modena, Via del Pozzo 71, 41125 Modena, Italy;
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Molinari G, Serafini E, Barbazza A, Marchioni D, Presutti L, Nizzoli F, Reggiani E, Guidotti M, Borghi A, Fernandez IJ. Endoscopic approach to geniculate ganglion: a multicentric experience. Eur Arch Otorhinolaryngol 2024; 281:1761-1771. [PMID: 37917164 DOI: 10.1007/s00405-023-08294-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/16/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE A variety of lesions could arise from the GG area, or extend into this region from adjacent sites. The management of perigeniculate lesions includes observation, surgery, and radiation, according to the nature, the size of the lesion, and the accompanying symptoms. Preliminary experiences on the exclusive transcanal endoscopic approach to the GG area have shown safety and feasibility avoiding of any postauricular incision, or brain manipulation. The experience from two referral centers on patients treated for a GG lesion with a totally endoscopic approach is herein reported. METHODS Data about patients who underwent exclusive endoscopic approach to the GG area at the Otolaryngology Departments of the University Hospitals of Modena and Bologna between May 2017 and February 2022 were retrospectively collected. RESULTS The total number of patients included in our study was 11. 10 patients (91%) had progressive unilateral facial paralysis and 1 patient (11%) presented with chronic otorrhea. The mean largest diameter of the treated lesions was of 8 mm. The resection was extended to the fundus of the IAC in 2 patients (expanded approach). The remaining 9 patients (82%) underwent partial ossicular replacement prosthesis (PORP). No major complications occurred. Facial nerve outcomes were good in all patients and the mean ABG worsened from 12 dB pre-operatively to 22 dB post-operatively. CONCLUSIONS The exclusively endoscopic approach to GG lesions represents a viable alternative to traditional microscopic approaches and may be included in the armamentarium of ear surgeons.
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Affiliation(s)
- Giulia Molinari
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-Università di Bologna, Bologna, Italy
| | - Edoardo Serafini
- Department of Otolaryngology-Head and Neck Surgery, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy.
| | - Alice Barbazza
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-Università di Bologna, Bologna, Italy
| | - Daniele Marchioni
- Department of Otolaryngology-Head and Neck Surgery, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy
| | - Livio Presutti
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-Università di Bologna, Bologna, Italy
| | - Federica Nizzoli
- Department of Otolaryngology-Head and Neck Surgery, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy
| | - Elena Reggiani
- Department of Otolaryngology-Head and Neck Surgery, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy
| | - Monica Guidotti
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Aurora Borghi
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Ignacio Javier Fernandez
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-Università di Bologna, Bologna, Italy
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Dandinarasaiah M, Grinblat G, Keshavamurthy VB, Di Rubbo VM, Alessandra R, Lauda L, Sanna M. Characteristics and Management of Facial Nerve Schwannomas and Hemangiomas. Otol Neurotol 2024; 45:83-91. [PMID: 37853739 DOI: 10.1097/mao.0000000000004033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
OBJECTIVES To characterize facial nerve (FN) schwannomas (FNSs) and FN hemangiomas (FNHs) and their clinical features and management strategies, and to describe the results of cable nerve grafting after FN sectioning during tumor removal. METHODS This retrospective study included 84 FNS cases and 42 FNH cases managed between July 1989 and July 2020 at a quaternary referral center for skull base pathology. Clinical details, locations, management, and results of cable nerve grafting at 1 year and during an average period of 3.12 years were evaluated. Sural nerve interpositioning was performed for patients who experienced FN paralysis for less than 1 year and underwent nerve sectioning during tumor removal. RESULTS FNSs more often involved multiple segments compared with FNHs. The cerebellopontine angle and the mastoid segments were involved in 16 (19.1%) and 34 (40.5%) FNS cases, respectively; however, the cerebellopontine angle and the mastoid segments were involved in 0 and 7 (16.7%) FNH cases, respectively. Sectioned nerves of 99 patients (78.6%) were restored using interposition cable grafting. At the last follow-up evaluation, 56.3% of FNSs and 60.7% of FNHs attained House-Brackmann (HB) grade III. Lower preoperative HB grades were associated with poorer postoperative outcomes. For FNSs, the mean HB grades were 4.13 at 1 year postoperatively and 3.75 at the last follow-up evaluation ( p = 0.001); however, for FNHs, the mean HB grades were 4.04 postoperatively and 3.75 at the last follow-up evaluation. Therefore, extradural coaptation yielded better outcomes. CONCLUSION FNSs can occur along any part of the FN along its course, and FNHs are concentrated around the area of geniculate ganglion. The results of cable inter positioning grafts are better in patients with preoperative FN-HB-III or less when compared with higher grades. The outcome of the interpositioning continues to improve even after 1 year in extradural coaptation.
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Affiliation(s)
| | | | | | - Vittoria M Di Rubbo
- Department of Otology and Skull Base Surgery, Gruppo Otologico, Piacenza, Rome, Italy
| | - Russo Alessandra
- Department of Otology and Skull Base Surgery, Gruppo Otologico, Piacenza, Rome, Italy
| | - Lorenzo Lauda
- Department of Otology and Skull Base Surgery, Gruppo Otologico, Piacenza, Rome, Italy
| | - Mario Sanna
- Department of Otology and Skull Base Surgery, Gruppo Otologico, Piacenza, Rome, Italy
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Giotta Lucifero A, Luzzi S, Rabski J, Meredith D, Kadri PADS, Al-Mefty O. Surgical management of symptomatic hemangioma of the geniculate ganglion: fascicular-sparing resection or grafting? Neurosurg Rev 2023; 46:120. [PMID: 37184718 PMCID: PMC10185618 DOI: 10.1007/s10143-023-02029-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/18/2023] [Accepted: 05/06/2023] [Indexed: 05/16/2023]
Abstract
Geniculate ganglion hemangioma (GGH) is rarely presented in the neurosurgical literature. It extends extradurally on the middle fossa floor and displaces the intratemporal part of the facial nerve. Surgical treatment is advisable at early symptoms. Proposed techniques include fascicular-sparing resection or nerve interruption with grafting. No definitive conclusions exist about the superiority of a certain technique in preserving facial nerve integrity and function. Through the description of a surgically managed symptomatic GGH, we herein discuss literature data about the surgical results of fascicular-sparing resection versus grafting. A PRISMA-based literature search was performed on the PubMed database. Only articles in English and published since 1990 were selected and furtherly filtered based on the best relevance. Statistical comparisons were performed with ANOVA. One hundred sixteen GGHs were collected, 56 were treated by fascicular-sparing resection, and 60 were treated by grafting. The facial function was improved, or unchanged, in 53 patients of the fascicular-sparing group and 30 patients of the grafting one. Sixty-five patients achieved a good (House-Brackmann (HB) grade III) postoperative facial outcome, of which 47 and 18 belonged to the fascicular-sparing and grafting group, respectively. Greater efficacy of the fascicular-sparing technique in the achievement of a better facial outcome was found (p = 0.0014; p = 0.0022). A surgical resection at the earliest symptoms is critical to preserve the facial nerve function in GGHs. Fascicular-sparing resection should be pursued in symptomatic cases with residual facial function (I-III HB). Conversely, grafting has a rationale for higher HB grades (V-VI). Broader studies are required to confirm these findings and turn them into new therapeutic perspectives.
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Affiliation(s)
- Alice Giotta Lucifero
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Neurosurgery Unit, University of Pavia, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Sabino Luzzi
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Neurosurgery Unit, University of Pavia, Pavia, Italy.
- Department of Surgical Sciences, Neurosurgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Jessica Rabski
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - David Meredith
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Paulo Abdo do Seixo Kadri
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Medical School, Federal University of Mato Grosso Do Sul, Mato Grosso Do Sul, Campo Grande, Brazil
| | - Ossama Al-Mefty
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Outcomes and prognostic factors of facial nerve repair: a retrospective comparative study of 31 patients and literature review. Eur Arch Otorhinolaryngol 2021; 279:1091-1097. [PMID: 34402952 DOI: 10.1007/s00405-021-07043-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate functional results of facial nerve repair by direct nerve suture or grafting, compare results between a traumatic and a tumoral group and identify prognostic factors. METHODS A retrospective monocentric cohort study was studied in a university ENT department. Thirty-one patients who benefited from facial nerve suture or grafting, with at least 12 months postoperative follow-up were included. Patients were divided into two groups according to the lesion type: traumatic (accident of the public road or iatrogenic) and tumoral. Preoperative data studied were sex, side, etiology documented by CT and/or MRI, facial palsy duration and grade according to House Brackmann grading system. Intraoperative data included: surgeon, age of patient, surgical technique, graft type, use of biological glue, facial nerve derivation, lesioned site. Postoperative data included: histological diagnosis, radiotherapy history, time to onset of the first signs of reinnervation, follow-up duration, and final facial function. RESULTS Success rate, including grade III and IV, was 68% in the whole cohort, 79% in the traumatic group and 59% in the tumoral group. Patients presenting with facial palsy evolving less than 6 months had better recovery results than those evolving longer than 6 months (p = 0.02). No other prognostic factors were identified. CONCLUSIONS The best outcome that can be achieved by suture or grafting of the facial nerve in traumatic or tumoral lesions is a grade III. Preoperative facial palsy duration is a prognostic factor and must be considered when establishing an operative indication.
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Assessment of eye closure and blink with facial palsy: A systematic literature review. J Plast Reconstr Aesthet Surg 2021; 74:1436-1445. [PMID: 33952434 DOI: 10.1016/j.bjps.2021.03.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 10/22/2020] [Accepted: 03/11/2021] [Indexed: 02/05/2023]
Abstract
Facial palsy can cause the impairment of eye closure and affect blink, ocular health, communication, and esthetics. Dynamic surgical procedures can restore eye closure in patients with decreased facial nerve function. There are no standardized measures of voluntary and spontaneous eye closure that are used to evaluate the outcomes of blink restoration procedures. The purpose of this systematic literature review was to identify the measures used to assess normal and abnormal eye closure and blinking in patients with facial palsy. A literature search of the PubMed database using the keyword "facial nerve/surgery" was conducted. Only English language articles that pertain to the use of facial paralysis assessment systems published in the past 20 years, which involve eyelid closure were included. There were 57 articles that used a facial paralysis classification system with an eyelid closure component: House-Brackmann Facial Nerve Grading Scale (n = 43, 67%); Sunnybrook Facial Grading Scale (n = 9); palpebral fissure heights (n = 4), and the electronic clinician-graded facial function tool (n = 3) and three additional measures were reported once. Although the Terzis and Bruno Scoring System, blink ratio, and electronic, clinician-graded facial function scale(eFACE) Clinician-Graded Scoring System were valid measures of eyelid closure, there was no one comprehensive eye assessment that demonstrated all aspects of eye closure in facial palsy, which include closure amplitude, spontaneity, and quality of life. For blink assessment, eFACE is the most comprehensive tool currently available and recommended to be used with a patient-reported quality of life supplement that captures the specific domains related to facial nerve dysfunction.
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Lassaletta L, Ruiz-Bravo E, García-Raya P, Fernández-Zubillaga A, González-Otero T, Gavilán J. Fibrovascular Tumor-Like Lesions of the Facial Nerve. Audiol Neurootol 2020; 26:27-34. [PMID: 32599597 DOI: 10.1159/000508025] [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] [Received: 10/08/2019] [Accepted: 04/20/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Facial nerve tumors (FNTs) are relatively rare benign lesions that arise from any segment of the facial nerve (FN). About half of all patients present with FN dysfunction, mainly long-standing or progressive facial paralysis. Diagnosis of an FNT is usually based on radiological imaging and confirmed by histological study. Most reported cases of FNTs are schwannomas and hemangiomas. OBJECTIVES The aim of this study was to review 4 cases of lesions with clinical, radiological, and surgical findings that suggested an FNT, the pathology revealing a fibrovascular proliferation with no clear signs of a specific tumor. METHOD Medical records of patients who had surgery due to an FN lesion were reviewed. Cases with known tumoral lesions were excluded. Four patients with tumor-like lesions were identified. Their imaging studies were re-evaluated. The pathological study included hematoxylin-eosin, Masson's trichrome, and immunohistochemistry for S100 protein, neurofilaments, CD31, Wilms' tumor 1 (WT1), and D240. RESULTS The 4 cases revealed tumor-like fibrovascular lesions that could not be classified as typical pathological entities. All cases had a complete facial palsy preoperatively. Computed tomography and magnetic resonance imaging (MRI) suggested schwannoma or hemangioma. A complete excision was achieved, and a facial reconstruction was performed immediately after interruption. Postoperative FN function was improved in all cases. The histological study showed nervous tracts of normal morphology, with fibrous and vascular tissue interspersed in variable proportions. All cases showed areas of fibrosis with Masson's stain. In all cases, nervous tissue and Schwann cells tested positively for neurofilaments and S100, respectively. In vascular areas, endothelial cells stained positively for CD31, and negatively for D240 and WT1. CONCLUSIONS Fibrovascular lesions of the FN may mimic primary FNTs, especially schwannomas and hemangiomas. Surgical excision with grafting or nerve transfer is the procedure of choice if a complete facial paralysis is found. This unusual condition should be considered when counseling patients with FN lesions. The lack of hyperintensity on MRI T2-weighted images may suggest the presence of fibrous tissue.
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Affiliation(s)
- Luis Lassaletta
- Department of Otorhinolaryngology, La Paz University Hospital, Madrid, Spain, .,IdiPAZ Research Institute, Madrid, Spain, .,Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III (CIBERER-U761), Madrid, Spain,
| | - Elena Ruiz-Bravo
- Department of Pathology, La Paz University Hospital, Madrid, Spain
| | - Pilar García-Raya
- Department of Neuroradiology, La Paz University Hospital, Madrid, Spain
| | | | - Teresa González-Otero
- IdiPAZ Research Institute, Madrid, Spain.,Department of Maxillofacial Surgery, La Paz University Hospital, Madrid, Spain
| | - Javier Gavilán
- Department of Otorhinolaryngology, La Paz University Hospital, Madrid, Spain.,IdiPAZ Research Institute, Madrid, Spain
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Riutta SJ, Benson AG. Geniculate Ganglion Hemangioma Visualized Through Perforated Tympanic Membrane. EAR, NOSE & THROAT JOURNAL 2020; 100:759S-760S. [PMID: 32126814 DOI: 10.1177/0145561320910677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sarah J Riutta
- Aurora Research Institute, 5507Aurora Health Care, Milwaukee, WI, USA
| | - Aaron G Benson
- Department of Otolaryngology, 5507Aurora Health Care, Milwaukee, WI, USA
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10
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Rao D, Fiester P, Rahmathulla G, Makary R, Tavanaiepour D. A case of a facial nerve venous malformation presenting with crocodile tear syndrome. Surg Neurol Int 2020; 11:3. [PMID: 31966922 PMCID: PMC6969373 DOI: 10.25259/sni_570_2019] [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: 12/08/2019] [Accepted: 12/12/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Crocodile tears syndrome, also known as Bogorad syndrome, is characterized by lacrimation secondary to olfactory and gustatory stimuli and mastication. Crocodile tear syndrome is typically encountered as an uncommon complication of Bell’s palsy and usually occurs during the recovery phase of the disease course. Case Description: We present a case of a 39-year-old male who presented with facial paralysis with ipsilateral crocodile tear syndrome caused by a slow flow venous malformation of the petrous bone and facial nerve. Conclusion: We present a case of crocodile tear syndrome caused by a facial nerve venous malformation. To the best of our knowledge, this is the only case reported in literature.
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Affiliation(s)
- Dinesh Rao
- Departments of Neuroradiology, University of Florida College of Medicine, Jacksonville, Florida, United States
| | - Peter Fiester
- Departments of Neuroradiology, University of Florida College of Medicine, Jacksonville, Florida, United States
| | - Gazanfar Rahmathulla
- Departments of Neurosurgery, University of Florida College of Medicine, Jacksonville, Florida, United States
| | - Rafaat Makary
- Departments of Pathology, University of Florida College of Medicine, Jacksonville, Florida, United States
| | - Daryoush Tavanaiepour
- Departments of Neurosurgery, University of Florida College of Medicine, Jacksonville, Florida, United States
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Guerin JB, Takahashi EA, Lane JI, Hoxworth JM, Weindling SM, Blessing MM, Jentoft ME, Carlson ML, Neff BA, Wood CP. Facial nerve venous malformation: A radiologic and histopathologic review of 11 cases. Laryngoscope Investig Otolaryngol 2019; 4:347-352. [PMID: 31236470 PMCID: PMC6580060 DOI: 10.1002/lio2.267] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 04/16/2019] [Indexed: 01/15/2023] Open
Abstract
Objective The purpose of this article was to provide a combined pathologic and radiologic review of previous pathologically diagnosed facial nerve “hemangiomas” to confirm that these lesions are most characteristic of venous malformations rather than neoplasms. Study Design Retrospective radiologic, clinical, and histopathologic review of all patients with a previous pathologically diagnosed facial nerve hemangioma of the temporal bone who underwent computed tomography or magnetic resonance imaging (MRI) were included. A consensus radiologic review for characteristic features and pathologic analysis was performed. Materials and Methods A panel of 4 neuroradiologists retrospectively analyzed CT and MRI exams for 11 facial nerve hemangiomas and provided a consensus agreement on the characteristic imaging features. Concurrently, two neuropathologists reevaluated archived tissue specimens from these lesions and applied additional immunohistochemical and histochemical stains including D240, CD31, smooth muscle actin (SMA), Verhoeff Van Gieson (VVG) and glucose transporter 1 (GLUT1). Results Lesions were composed of dilated vascular spaces with a simple, CD31‐positive endothelial lining and a smooth muscle component. All lesions were negative for markers found in arterial and lymphatic malformations and infantile hemangiomas. They had characteristic radiologic features previously ascribed to facial nerve hemangiomas. Namely, these lesions are typically T1 isointense or hypointense and T2 hyperintense relative to cerebral cortex and heterogeneously enhance on MRI. Bony canal expansion and erosion, intralesional calcification, and intracranial extension are common. Conclusions On the basis of this radiologic and pathologic review, these lesions are best characterized as venous malformations. Level of Evidence 4
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Affiliation(s)
| | | | - John I Lane
- Department of Radiology Mayo Clinic Rochester Minnesota
| | | | | | - Melissa M Blessing
- Department of Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota
| | - Mark E Jentoft
- Department of Laboratory Medicine and Pathology Mayo Clinic Jacksonville Florida
| | - Matthew L Carlson
- Department of Otorhinolaryngology-Head and Neck Surgery Mayo Clinic Rochester Minnesota
| | - Brian A Neff
- Department of Otorhinolaryngology-Head and Neck Surgery Mayo Clinic Rochester Minnesota
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12
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Costa LEM, Castro RFD, Costa FMM, Santos MADO. Facial nerve hemangioma in the middle ear. EINSTEIN-SAO PAULO 2018; 16:eRC4509. [PMID: 30517366 PMCID: PMC6276807 DOI: 10.31744/einstein_journal/2018rc4509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/30/2018] [Indexed: 11/26/2022] Open
Abstract
Facial nerve hemangioma is a rare and benign vascular tumor, and accounts for 0.7% of intratemporal tumors. We report the second case described in the literature of a facial nerve hemangioma in its tympanic segment. A 14-year-old male patient presented with a history of progressive right ear hearing loss with preserved facial mimicry. Pure tone audiometry showed a right ear moderate conductive hearing loss. Magnetic resonance imaging demonstrated an expansive lesion involving the tympanic segment of the right facial nerve, suggestive of hemangioma. Watchful waiting was chosen as management. In the first case of middle ear facial hemangioma described in the literature, facial palsy was the symptom that led the patient to seek medical care. In the present case, it can be inferred that the first symptom was conductive hearing loss ipsilateral to the lesion. Facial palsy may not be present and the clinical presentation may resemble otosclerosis, ossicular chain disruption, and third window abnormalities, among other differential diagnoses of conductive hearing loss. The second case of tympanic portion facial nerve hemangioma is reported, describing the specificity of conductive hearing loss as its only clinical manifestation.
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