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Facial Nerve Paralysis in Patients With Chronic Ear Infections: Surgical Outcomes and Radiologic Analysis.

Choi JW, Park YH - Clin Exp Otorhinolaryngol (2015)

Bottom Line: The radiologic sensitivity for facial canal dehiscence was 91%.Facial paralyses associated with chronic ear infections were observed in more advanced lesions and the surgical outcomes for facial paralysis were relatively satisfactory.Facial canal dehiscences can be anticipated preoperatively with high resolution CTs.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea.

ABSTRACT

Objectives: The purpose of this study was to investigate the clinical features, radiologic findings, and treatment outcomes in patients of facial nerve paralysis with chronic ear infections. And we also aimed to evaluate for radiologic sensitivities on facial canal, labyrinth and cranial fossa dehiscences in middle ear cholesteatomas.

Methods: A total of 13 patients were enrolled in this study. Medical records were retrospectively reviewed for clinical features, radiologic findings, surgical findings, and recovery course. In addition, retrospective review of temporal bone computed tomography (CT) and operative records in 254 middle ear cholesteatoma patients were also performed.

Results: Of the 13 patients, eight had cholesteatomas in the middle ear, while two patients exhibited external auditory canal cholesteatomas. Chronic suppurative otitis media, petrous apex cholesteatoma and tuberculous otitis media were also observed in some patients. The prevalence of facial paralysis in middle ear cholesteatoma patients was 3.5%. The most common involved site of the facial nerve was the tympanic segment. Labyrinthine fistulas and destruction of cranial bases were more frequently observed in facial paralysis patients than nonfacial paralysis patients. The radiologic sensitivity for facial canal dehiscence was 91%. The surgical outcomes for facial paralysis were relatively satisfactory in all patients except in two patients who had petrous apex cholesteatoma and requiring conservative management.

Conclusion: Facial paralyses associated with chronic ear infections were observed in more advanced lesions and the surgical outcomes for facial paralysis were relatively satisfactory. Facial canal dehiscences can be anticipated preoperatively with high resolution CTs.

No MeSH data available.


Related in: MedlinePlus

Computed tomography of patient No. 2 showing all semicircular canals and vestibular destructions. Note the absence of the facial nerve in the tympanic and mastoid segment with a combined posterior cranial base defect (arrows).
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Figure 2: Computed tomography of patient No. 2 showing all semicircular canals and vestibular destructions. Note the absence of the facial nerve in the tympanic and mastoid segment with a combined posterior cranial base defect (arrows).

Mentions: On high resolution temporal bone CT, 11 of them showed bony wall defects in the tympanic segment of the facial nerve, while two patients with external auditory canal cholesteatomas revealed bony dehiscences in the mastoid segment of the facial nerve (Fig. 1). There were two patients that showed canal defects in both tympanic and mastoid segments. Two patients with complete facial paralysis showed that wide segments of the facial nerve were involved. Combined bony defects in the tegmen tympani were observed in eight patients, and three of them also revealed the defects in the posterior cranial fossa. Destruction of bony labyrinths was observed in six patients in the lateral semicircular canal, and there was one patient who had destruction of all semicircular canals and vestibules (Fig. 2). Four patients with bony labyrinth destruction showed total deafness during audiogram testing.


Facial Nerve Paralysis in Patients With Chronic Ear Infections: Surgical Outcomes and Radiologic Analysis.

Choi JW, Park YH - Clin Exp Otorhinolaryngol (2015)

Computed tomography of patient No. 2 showing all semicircular canals and vestibular destructions. Note the absence of the facial nerve in the tympanic and mastoid segment with a combined posterior cranial base defect (arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553351&req=5

Figure 2: Computed tomography of patient No. 2 showing all semicircular canals and vestibular destructions. Note the absence of the facial nerve in the tympanic and mastoid segment with a combined posterior cranial base defect (arrows).
Mentions: On high resolution temporal bone CT, 11 of them showed bony wall defects in the tympanic segment of the facial nerve, while two patients with external auditory canal cholesteatomas revealed bony dehiscences in the mastoid segment of the facial nerve (Fig. 1). There were two patients that showed canal defects in both tympanic and mastoid segments. Two patients with complete facial paralysis showed that wide segments of the facial nerve were involved. Combined bony defects in the tegmen tympani were observed in eight patients, and three of them also revealed the defects in the posterior cranial fossa. Destruction of bony labyrinths was observed in six patients in the lateral semicircular canal, and there was one patient who had destruction of all semicircular canals and vestibules (Fig. 2). Four patients with bony labyrinth destruction showed total deafness during audiogram testing.

Bottom Line: The radiologic sensitivity for facial canal dehiscence was 91%.Facial paralyses associated with chronic ear infections were observed in more advanced lesions and the surgical outcomes for facial paralysis were relatively satisfactory.Facial canal dehiscences can be anticipated preoperatively with high resolution CTs.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea.

ABSTRACT

Objectives: The purpose of this study was to investigate the clinical features, radiologic findings, and treatment outcomes in patients of facial nerve paralysis with chronic ear infections. And we also aimed to evaluate for radiologic sensitivities on facial canal, labyrinth and cranial fossa dehiscences in middle ear cholesteatomas.

Methods: A total of 13 patients were enrolled in this study. Medical records were retrospectively reviewed for clinical features, radiologic findings, surgical findings, and recovery course. In addition, retrospective review of temporal bone computed tomography (CT) and operative records in 254 middle ear cholesteatoma patients were also performed.

Results: Of the 13 patients, eight had cholesteatomas in the middle ear, while two patients exhibited external auditory canal cholesteatomas. Chronic suppurative otitis media, petrous apex cholesteatoma and tuberculous otitis media were also observed in some patients. The prevalence of facial paralysis in middle ear cholesteatoma patients was 3.5%. The most common involved site of the facial nerve was the tympanic segment. Labyrinthine fistulas and destruction of cranial bases were more frequently observed in facial paralysis patients than nonfacial paralysis patients. The radiologic sensitivity for facial canal dehiscence was 91%. The surgical outcomes for facial paralysis were relatively satisfactory in all patients except in two patients who had petrous apex cholesteatoma and requiring conservative management.

Conclusion: Facial paralyses associated with chronic ear infections were observed in more advanced lesions and the surgical outcomes for facial paralysis were relatively satisfactory. Facial canal dehiscences can be anticipated preoperatively with high resolution CTs.

No MeSH data available.


Related in: MedlinePlus