1/52. facial paralysis: a presenting feature of rhabdomyosarcoma.The purpose of this paper is to present a child with embryonal rhabdomyosarcoma involving the left middle ear, who initially presented with unilateral facial paralysis. A 5-year-old boy presented with a 4-week history of left-sided facial weakness, associated with persistent otitis media on that side. Examination revealed complete left lower motor neuron facial weakness and hearing loss. A myringotomy revealed a soft tissue mass behind the tympanic membrane. biopsy and oncologic assessment confirmed a stage II, group III left middle ear embryonal rhabdomyosarcoma. Despite debulking surgery, local irradiation and multiple chemotherapeutic courses the child deteriorated quickly. He developed carcinomatous meningitis and died 9 months after his initial presentation. In conclusion, middle ear tumors should be considered in the differential diagnosis of unresolving otitis media, particularly when associated with persistent ipsilateral facial paralysis. An ear mass, discharge, facial swelling, or systemic symptoms may be initially absent despite the presence of this aggressive malignancy. Careful examination of the middle ear is recommended in children with facial weakness. A myringotomy incision may be necessary including a complete assessment of the middle ear cavity, particularly when there is no fluid return.- - - - - - - - - - ranking = 1keywords = malignancy (Clic here for more details about this article) |
2/52. Muscle bow traction method for dynamic facial reanimation.A muscle bow traction method was developed for dynamic facial reanimation utilizing the masseter muscle and a fascial sling. The principle of this method is that the sling around the muscle pulls the oral commissure laterally and backward by the restoring force of the muscle from its relaxed position to its contracted position. The surgical procedure is simple. The sling is passed around the anterior half of the muscle so that the muscle can be bowed anteriorly at its center by the sling. One end of the sling is sutured to the center of the orbicularis oris and the dermis in front of the nasolabial fold, and the other end is sutured to the lower lip and oral commissure. This method was applied to 3 patients with facial palsy and to 1 patient with oral cancer. The restored motion of the oral commissure ranged from 5 to 8 mm when clenching the jaws. The concept of this method differs from those of other muscle transposition methods for facial reanimation in that the force acts at a right angle to the muscle contraction. The advantage of this method is that it is less invasive to the muscle and is a simpler procedure than other conventional muscle transposition methods.- - - - - - - - - - ranking = 0.20050301359203keywords = cancer (Clic here for more details about this article) |
3/52. Bilateral facial nerve palsy secondary to the administration of high-dose paclitaxel.Bilateral facial nerve palsy is an uncommon occurrence. We describe a case of bilateral facial nerve palsy secondary to a single cycle of high-dose paclitaxel therapy (825 mg/m2), in a woman with breast cancer. Prior to her high-dose therapy, she had a residual grade 2 peripheral neuropathy following treatment with ten cycles of standard-dose paclitaxel (total dose 3200 mg). The features of the peripheral neuropathy due to standard-dose paclitaxel, which can be both motor and sensory, are well described. Cumulative paclitaxel dose is considered a risk factor for development of the neuropathy. Although facial nerve palsy secondary to paclitaxel is not previously reported, other cranial nerve toxicity has been described. Consistent with reports of the reversibility of paclitaxel-induced peripheral neuropathy, the facial nerve palsies in our patient resolved over 23 months. Ongoing studies of high-dose paclitaxel warrant close attention to its cumulative neurotoxic effects, particularly in patients previously treated with neurotoxic chemotherapy.- - - - - - - - - - ranking = 0.20050301359203keywords = cancer (Clic here for more details about this article) |
4/52. Skull base osteomyelitis interpreted as malignancy.Lesions in the skull base may present difficulties in diagnosis primarily because the access needs to be invasive and one has to rely on imaging that may still be misleading. The case presented here illustrates this example in that the patient had abnormalities on computed tomography (CT) and magnetic resonance image (MRI) scans quite convincing of malignancy but which with time proved, essentially through clinical judgment, to be skull base osteomyelitis secondary to malignant external otitis (OME).- - - - - - - - - - ranking = 5keywords = malignancy (Clic here for more details about this article) |
5/52. lymphoma in the ear.BACKGROUND: Malignant tumors of the ear are rare. The most common malignant tumors are squamous cell carcinomas and adenocarcinomas. lymphoma in the ear is rare. methods: We report 2 cases of a primary presentation of a lymphoma of the ear. The literature since 1947 is reviewed. RESULTS: An 83-year-old woman with an anaplastic large cell lymphoma of the skin of the external auditory meatus and a 75-year-old man with a B-cell non-Hodgkin's lymphoma of the mastoid process are presented. The literature review shows that only 16 cases of lymphomas of the ear have been reported so far. CONCLUSIONS: In a case of therapy-resistant otitis and/or peripheral facial paralysis malignancy should be excluded by computer tomography of the mastoid. For histopathological diagnosis unfixed specimens are preferable. Uniform treatment of lymphomas of the ear has not been established.- - - - - - - - - - ranking = 1keywords = malignancy (Clic here for more details about this article) |
6/52. endolymphatic sac tumor: a case report.Papillary tumors of the temporal bone are aggressive neoplasms which may occur sporadically or as a part of von hippel-lindau disease. The term 'endolymphatic sac tumor' identifies the origin of these rare tumors. The clinical manifestations are sensorineural hearing loss, facial paralysis, cerebellar disorders and vertigo. The tumor is locally invasive, destructive and hypervascular exhibiting consistent imaging and histopathologic features. The treatment of choice is the total removal of the lesion although complete excision of the advanced lesion is nearly impossible due to the anatomic complexity of the endolymphatic sac and distinct patterns of extension. We present a 50-year-old male patient with endolymphatic sac tumor with left sided sensorineural hearing loss and review the literature.- - - - - - - - - - ranking = 5.7155214019282keywords = neoplasm (Clic here for more details about this article) |
7/52. facial paralysis with an inflammatory parotid mass.facial paralysis in association with a parotid mass is usually associated with a diagnosis of malignancy. Benign parotid neoplasms and inflammatory processes resulting in facial paralysis are extremely rare. This report describes such a case and highlights some of the difficulties surrounding the diagnosis and management of these cases.- - - - - - - - - - ranking = 6.7155214019282keywords = neoplasm, malignancy (Clic here for more details about this article) |
8/52. Bilateral peripheral facial palsy secondary to lymphoma in a patient with hiv/AIDS: a case report and literature review.Neurological complications represent one of the most important causes of morbidity and mortality in patients with hiv/AIDS. However, peripheral neuropathy comprises only 5% to 20% of the total neurological complications and facial nerve palsy, especially when it is bilateral, is a less common manifestation. Peripheral facial palsy has been considered as a possible neurological complication of the early stage of hiv infection but the number of reported cases in the literature is limited. Histological findings of nervous tissue in peripheral facial palsy at an early stage of hiv infection include a degenerative and not suppurative inflammatory process, but its etiology remains obscure. Peripheral facial palsy in the late stage of hiv infection is characterized by an advanced immunological deficit and generally it is secondary to an opportunistic infection of the CNS, such as neurotoxoplasmosis and lymphoma. However, this peripheral attack of the facial nerve is not very common at this late stage of hiv infection. Bilateral peripheral facial palsy as a complication of non-Hodgkin s lymphoma is considered an extremely rare entity. There are no published reports of bilateral peripheral facial palsy secondary to lymphomas or other neoplasms of the CNS in immunosuppressed patients. Non-Hodgkin s lymphoma (NHL) has been considered a late and relatively common manifestation of hiv infection, but an exact cause for the higher incidence of this malignant neoplasm in hiv/AIDS patients is still uncertain.- - - - - - - - - - ranking = 11.431042803856keywords = neoplasm (Clic here for more details about this article) |
9/52. facial paralysis caused by malignant skull base neoplasms.OBJECT: bell palsy remains the most common cause of facial paralysis. Unfortunately, this term is often erroneously applied to all cases of facial paralysis. methods: The authors performed a retrospective review of data obtained in 11 patients who were treated at a university-based referral practice between July 1988 and September 2001 and who presented with acute facial nerve paralysis mimicking bell palsy. All patients were subsequently found to harbor an occult skull base neoplasm. A delay in diagnosis was demonstrated in all cases. Seven patients died of their disease, and four patients are currently free of disease. CONCLUSIONS: Although bell palsy remains the most common cause of peripheral facial nerve paralysis, patients in whom neoplasms invade the facial nerve may present with acute paralysis mimicking bell palsy that fails to resolve. Delays in diagnosis and treatment in such cases may result in increased rates of mortality and morbidity.- - - - - - - - - - ranking = 34.293128411569keywords = neoplasm (Clic here for more details about this article) |
10/52. Recurrent facial palsy occurring with metastatic thymic carcinoid and nonarteritic ischemic optic neuropathy.A 74-year-old man was diagnosed with thymic carcinoid metastatic to the mediastinum. Two years later, he developed left and then right facial palsy. Four additional episodes of facial palsy developed within 2 years, followed by an occurrence of nonarteritic ischemic optic neuropathy. While recurrent facial palsy is uncommon, it may occur in the presence of various systemic conditions such as carcinoid, diabetes, infection, and neoplasm. The presence of recurrent facial palsy logically warrants an evaluation for systemic disease.- - - - - - - - - - ranking = 5.7155214019282keywords = neoplasm (Clic here for more details about this article) |
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