1/4. facial nerve monitoring in otologic surgery: clinical indications and intraoperative technique.While identification of the intratemporal portion of the facial nerve is mandatory in most otologic surgical procedures, inadvertent instrumentation, traction, or thermal injury may still result from inaccurate delineation, purposeful avoidance, or false protection of this critical structure. Improved functional preservation of the facial nerve has been achieved in acoustic neuroma surgery through the monitoring of evoked facial electromyographic activity. This technique may also be used during otologic procedures in which facial nerve manipulation is anticipated in the management of recurrent cholesteatoma, temporal bone trauma, congenital deformity, or purposeful access for cochlear implantation. Potential indications for using facial nerve monitoring in contemporary otologic surgery are detailed through illustrative case presentations, and necessary instrumentation and techniques are briefly reviewed. Intraoperative monitoring can assist the surgeon in isolating the facial nerve when chronic inflammation, traumatic injury, or anomalous development has resulted in distortion or absence of microanatomic landmarks.- - - - - - - - - - ranking = 1keywords = neuroma (Clic here for more details about this article) |
2/4. facial paralysis: traumatic neuromas vs. facial nerve neoplasms.Traumatic neuromas (TN) are benign proliferations of neural tissue that may occur without disruption of the facial nerve. The clinical presentation, as well as the radiographic appearance, may suggest neoplastic involvement of the facial nerve. Histologically, they may closely resemble neurilemomas (Schwannomas) or neurofibromas. Three cases of TN of the facial nerve associated with facial paralysis are presented here. Unlike previously reported cases, these tumors were not associated with chronic inflammatory middle ear disease. TN must be considered in the differential diagnosis and treatment of facial paralysis.- - - - - - - - - - ranking = 5keywords = neuroma (Clic here for more details about this article) |
3/4. Histopathology of the facial nerve after longitudinal temporal bone fracture.The temporal bone histopathology in a patient who suffered repeated head trauma and a longitudinal temporal bone fracture shows unusual features associated with the facial nerve. In the distal meatal segment, a type of traumatic neuroma was found with disorganized nerve bundles and distinct areas of Schwann's cell proliferation but lacking fibrosis. Periosteal new bone formation in the labyrinthine segment narrows the fallopian canal and protrudes into the nerve, which completely fills the canal. The tympanic and mastoid segments of the nerve show severe degeneration of nerve fibers and an increase in connective tissue between fascicles. An attempted facial nerve decompression did not reach the area of primary pathology in the labyrinthine and meatal segments of the nerve, which could have been exposed by the transtemporal supralabyrinthine approach.- - - - - - - - - - ranking = 1keywords = neuroma (Clic here for more details about this article) |
4/4. Treating the oral sequelae of an acoustic neuroma.This article describes the treatment of oral complications that arose after surgery for the removal of an acoustic brain tumor. The authors contend that a thorough oral examination can pinpoint the cranial nerves that have been affected by the tumor or the surgery, and that dental appliances can offer special protection after surgery.- - - - - - - - - - ranking = 4keywords = neuroma (Clic here for more details about this article) |