1/34. Congenital cholesteatoma and malformations of the facial nerve: rare manifestations of the BOR syndrome.We describe a 14-month-old girl with unilateral congenital cholesteatoma and anomalies of the facial nerve in addition to the more common branchial arch, otic, and renal malformations comprising the branchio-oto-renal (BOR) syndrome. Her mother also has the BOR syndrome and unilateral duplication of the facial nerve. This is the first study of a BOR patient with congenital cholesteatoma and the second family in which cholesteatoma and anomalies of the facial nerve are described in patients with the BO/BOR syndrome. We review the congenital cholesteatoma literature and discuss hypotheses for the pathogenesis of this entity in light of this new report.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/34. Schwannoma of the chorda tympani nerve.We report a case of schwannoma of the chorda tympani. This is a very rare benign tumour and only five other cases have been found in the literature. This is the first case to mimic a cholesteatoma presenting as a pearly tumour in the postero-superior segment of the drum with aural discharge and conductive deafness. Diagnosis is usually by biopsy and treatment is surgical with preservation of facial and auditory function. A summary of the other presentations of this tumour together with a review of the histopathology of the disease is presented.- - - - - - - - - - ranking = 0.57142857142857keywords = nerve (Clic here for more details about this article) |
3/34. otitis media and CNS complications.Intracranial complications from otitis media can be quite devastating to the patient if an early diagnosis is not made. patients may develop meningitis, venous sinus thrombosis or cranial nerve palsies, as well as intracranial abscess. The presenting features in such cases may be subtle and include headache, nausea, vomiting, personality changes and signs of increased intracranial pressure as well as focal neurological deficits. A case of intracranial brain abscess is presented in a patient with a history of chronic otitis media with cholesteatoma. Delay in the diagnosis of intracranial complications of otitis media can lead to improper treatment with increased morbidity and mortality. The etiology and treatment of complications affecting the CNS is discussed.- - - - - - - - - - ranking = 0.14285714285714keywords = nerve (Clic here for more details about this article) |
4/34. facial nerve paralysis secondary to chronic otitis media without cholesteatoma.Numerous papers have been written on facial nerve paralysis caused by chronic suppurative otitis media. However the authors found none documenting the results of therapy in a series of patients in whom facial nerve dysfunction was caused by chronic otitis media without cholesteatoma. Thus, there is little factual information available to help select a specific therapeutic plan for such cases. Over the past decade, the senior author has managed five cases (6 ears) of chronic suppurative otitis media without cholesteatoma in which facial paresis (4 ears) or paralysis (2 ears) developed 10 days or less before surgery. The chronic otitis media involved the mastoid and middle ear in five cases; and the mastoid, middle ear, and petrous apex in one case. Modified radical mastoidectomy was performed in four ears, tympanomastoidectomy with facial recess exposure in one ear, and complete mastoidectomy with middle cranial fossa petrous apicectomy in one ear. Five patients had complete recovery of facial nerve function (House grade I), and one patient had 90 percent recovery (House grade II). The results provide support for semi-emergent surgery in the management of chronic suppurative otitis media when facial nerve paralysis supervenes.- - - - - - - - - - ranking = 1.1428571428571keywords = nerve (Clic here for more details about this article) |
5/34. Foreign body granuloma of the external auditory canal.External auditory canal polyps are most commonly inflammatory in nature but may also manifest more severe disease. Prolonged conservative therapy may delay the correct diagnosis and appropriate intervention. A case is presented of a child with chronic otorrhea treated for 4 months with topical drops and antibiotics. On referral, a large external auditory canal polyp was confirmed to represent a foreign body granuloma covering a large electrical cap, with erosion approaching the facial nerve. External auditory canal polyps that fail to respond promptly to conservative medical therapy warrant a computed tomography scan and surgical exploration with biopsy.- - - - - - - - - - ranking = 0.14285714285714keywords = nerve (Clic here for more details about this article) |
6/34. Pediatric external canal cholesteatoma with extensive invasion into the mastoid cavity.cholesteatoma in the external auditory canal (EAC) is an uncommon situation, and is especially rare in pediatric patients. We report two pediatric cases of external canal cholesteatoma with extensive invasion into mastoid cavity. Both cases had otalgia and poor hearing as the initial symptoms, and received operation according to the extent of the lesions. Since external canal cholesteatoma with extensive invasion into the mastoid cavity has the propensity to involve the vertical segment of the facial nerve, extreme care should be taken when performing any procedure in this area. Through thorough pre-operative evaluation and adequate surgical procedures, good outcomes can be achieved and hearing as well as facial nerve function can be preserved.- - - - - - - - - - ranking = 0.28571428571429keywords = nerve (Clic here for more details about this article) |
7/34. Diagnosis and management of aggressive, acquired cholesteatoma with skull base and calvarial involvement: a report of 3 cases.A prospective case review of 3 patients treated at a tertiary referral center from 1997 to 2002 are presented. Three men, age 30 to 68 (mean, 45) years, were treated for acquired cholesteatoma with skull base invasion. Two patients had no prior otological surgery, and 1 was detected after 4 prior mastoid procedures. One presented with progressive unilateral facial palsy, 1 with otorrhea, and 1 with temporal mass above a modified radical mastoidectomy cavity. All 3 patients were treated with single-staged canal wall-down mastoidectomy. patients were followed up with otoscopy and neuroimaging from 40 to 61 months. Two patients had no recurrence of cholesteatoma, and 1 had squamous debris in the mastoid cavity removed in the outpatient clinic. One had complete ipsilateral facial nerve paralysis preoperatively and recovered to House-Brackmann grade III within 1 year of surgery. Patient 1 had labyrinthine involvement before surgery and had ipsilateral anacusis after resection and repair. No other complications occurred. Initial presentation, workup, surgical challenges, disease follow-up, facial nerve function, hearing results, and complications are reported.- - - - - - - - - - ranking = 0.28571428571429keywords = nerve (Clic here for more details about this article) |
8/34. facial nerve and medially invasive petrous bone cholesteatomas.Eight patients with extensive petrous bone cholesteatomas that invaded the labyrinth and fallopian canal are presented. The eight cases are added to a tabulation of prior literature reports to elucidate concepts of routes of extension of medially invasive temporal bone cholesteatoma. Medially invasive petrous bone cholesteatoma develops insidiously, often without symptoms other than facial palsy and/or unilateral deafness. Typically, a history of chronic ear disease can be obtained. While hearing is unlikely to be preserved in this group of patients, facial nerve function can usually be preserved, and a facial nerve graft was not necessary in our series. Acute facial nerve palsy or facial nerve paresis progressing to palsy in patients with a history of chronic ear disease should be studied radiographically for petrous bone cholesteatoma, even if there is no physical evidence of cholesteatoma.- - - - - - - - - - ranking = 1.1428571428571keywords = nerve (Clic here for more details about this article) |
9/34. Differential clinical and radiographic features of cholesterol granulomas and cholesteatomas of the petrous apex.cholesterol granulomas and cholesteatomas are expansile, destructive lesions of the petrous apex that occur more frequently than we previously realized. Having obscure causes, they grow silently, often reaching impressive proportions, until they encroach on adjacent cranial nerves or the otic capsule. The lesions have distinguishing histopathologies, early clinical manifestations, and neuroradiographic features that, when integrated, allow for a critical preoperative differentiation. cholesterol granulomas are treated effectively through internal marsupialization into the mastoid or middle ear cavity. Cholesteatomas, however, are managed usually by a much more aggressive and complicated exteriorization or exenteration. Selected case reports are used to emphasize salient clinical and radiographic features and perioperative management.- - - - - - - - - - ranking = 0.14285714285714keywords = nerve (Clic here for more details about this article) |
10/34. epidermal cyst attached to the chorda tympani nerve.The incidental post-mortem finding of a small epidermal cyst in the middle ear of a 78-year-old female is presented. The epidermal cyst was attached to the chorda tympani nerve adjacent to the body of the incus, but was not associated with bony erosion or any other suggestion of enlargement or invasive growth. The pathological relationship of this lesion to previously reported "congenital cholesteatomas" of the middle ear is discussed.- - - - - - - - - - ranking = 0.71428571428571keywords = nerve (Clic here for more details about this article) |
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