Die Chirurgie des Kleinhirnbr�ckenwinkels

Schaller, Bernhard

doi:10.1007/s00106-002-0797-3

Cited by 8 publications

(2 citation statements)

References 93 publications

(61 reference statements)

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“…The compression may cause acute inflammation and herniation of the nerve fibers from the internal porus. Thereafter, the tumor pushes the facial nerve toward the middle cerebellar peduncle and the lateral pontine surface and compresses it further (Jackler 1996;Schaller 2003a, b). This condition places the nerve in great jeopardy, since the protuberant portion can easily be shaved off inadvertently, when the surgeon removes the tumor (Samii and Matthies 1997).…”

Section: Introductionmentioning

confidence: 97%

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Nerve crush but not displacement-induced stretch of the intra-arachnoidal facial nerve promotes facial palsy after cerebellopontine angle surgery

et al. 2016

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Little is known about the reasons for occurrence of facial nerve palsy after removal of cerebellopontine angle tumors. Since the intra-arachnoidal portion of the facial nerve is considered to be so vulnerable that even the slightest tension or pinch may result in ruptured axons, we tested whether a graded stretch or controlled crush would affect the postoperative motor performance of the facial (vibrissal) muscle in rats. Thirty Wistar rats, divided into five groups (one with intact controls and four with facial nerve lesions), were used. Under inhalation anesthesia, the occipital squama was opened, the cerebellum gently retracted to the left, and the intra-arachnoidal segment of the right facial nerve exposed. A mechanical displacement of the brainstem with 1 or 3 mm toward the midline or an electromagnet-controlled crush of the facial nerve with a tweezers at a closure velocity of 50 and 100 mm/s was applied. On the next day, whisking motor performance was determined by video-based motion analysis. Even the larger (with 3 mm) mechanical displacement of the brainstem had no harmful effect: The amplitude of the vibrissal whisks was in the normal range of 50°-60°. On the other hand, even the light nerve crush (50 mm/s) injured the facial nerve and resulted in paralyzed vibrissal muscles (amplitude of 10°-15°). We conclude that, contrary to the generally acknowledged assumptions, it is the nerve crush but not the displacement-induced stretching of the intra-arachnoidal facial trunk that promotes facial palsy after cerebellopontine angle surgery in rats.

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Section: Introductionmentioning

confidence: 97%

“…It is usually so widely ribboned and splayed that even the slightest tweezers pinch may rupture facial motor axons (Jackler 1996;Morita et al 1988;Ogawa and Sando 1982;Rhoton and Tedeschi 1992;Schaller 2003a, b).…”

Section: Introductionmentioning

confidence: 97%