Effect of surgical intervention on middle-ear cholesteatoma with associated facial paralysis

Özkul, Yılmaz; Songu, Murat; Önal, Kazım; İmre, Abdülkadir; Arslanoğlu, Seçil; Horoz, E; Bayrak, Asuman Feda; Pınar, Ercan

doi:10.1017/s0022215116009804

Cited by 8 publications

(11 citation statements)

References 16 publications

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“…Hal ini disebabkan oleh devaskularisasi, fibrosis atau gangguan pada nervus fasialis. 12,14,15 Mekanisme terjadinya paresis nervus fasialis akibat OMSK belum dikatahui secara jelas. Namun proses inflamasi langsung yang melibatkan kanal falopi dan kompresi akibat edema dipercaya sebagai patofisiologi terjadinya paresis.…”

Section: Paresis Nervus Fasialisunclassified

“…16 Insisi nervus hanya diperlukan pada paresis fasialis yang komplit. 15 Dekompresi saraf fasialis diperlukan pada kasus paresis komplit dengan onset akut sedangkan paresis inkomplit dengan onset akut hanya memerlukan tindakan bedah untuk eradikasi penyebab penyakit. 17 .…”

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“…Hasil yang didapatkan bervariasi dan disimpulkan bahwa infeksi yang lama pada serat nervus menyebabkan kerusakan yang irreversible. 15 Penelitian lain melakukan operasi dekompresi pada hari ke 15 dan 73% pasien mengalami perbaikan komplit dalam waktu beberapa bulan setelah tindakan operasi. 2 Pasien dalam kasus ini menjalani operasi timpani mastoidektomi setelah tiga minggu terjadinya paresis nervus fasialis.…”

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Otitis Media Supuratif Kronis Tipe Kolesteatom dengan Komplikasi Meningitis dan Paresis Nervus Fasialis Perifer

Sari

Edward

Rosalinda

2018

JKA

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AbstrakPendahuluan: Otitis Media Supuratif Kronis (OMSK) tipe kolesteatom merupakan penyakit dengan morbiditas dan mortalitas yang tinggi akibat komplikasinya. Kolesteatom dapat menyebabkan erosi tulang dan kerusakan struktur-struktur di sekitarnya sehingga terjadi komplikasi. Kombinasi antibiotik dan tindakan bedah timpanomastoidektomi menjadi modalitas utama penatalaksanaan kasus OMSK dengan komplikasi. Laporan Kasus: Dilaporkan satu kasus seorang laki-laki 18 tahun dengan keluhan sakit kepala hebat disertai dengan penurunan kesadaran dan wajah mencong. Pada pasien terdapat riwayat telinga berair dan penurunan pendengaran. Pasien didiagnosis sebagai OMSK auris dektra dengan kolesteatom disertai komplikasi meningitis dan paresis nervus fasialis perifer. Pasien diterapi dengan antibioik dosis tinggi dan dilakukan tindakan timpanomastoidektomi dinding runtuh dengan dekompresi nervus fasialis. Kesimpulan: Penatalaksaan segera dan tepat pada OMSK dengan komplikasi dapat meningkatkan angka kesembuhan dan mencegah kematian. Abstract Introduction: Chronic suppurative otitis media (CSOM) with cholesteatoma type is a disease with high morbidity and mortality due to its complications. Cholesteatoma cause bone erosion and damage to the surrounding structures and resulting in complications. The combination of antibiotics and tympanomastoidectomy surgery becomes main modality for management of ofCSOM cases with complications. Case Report:A case of an 18-year-old man with severe headache accompanied by a decrease of conciousness and a skew face. The patient has history of discharge came out from the ear and decrease of hearing. Patient was diagnoseed as CSOM at right ear with cholesteatoma aaccompanied by meningitis and paralysis of facial nerve. Patient was treated with high-dose antibiotic and performed a canal wall down tympanomastoidectomy with decompression of facial nerve. Conclusions: Immediate and appropriate management of CSOM with complications can improve cure rates and prevent mortality.

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Section: Paresis Nervus Fasialisunclassified

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Otitis Media Supuratif Kronis Tipe Kolesteatom dengan Komplikasi Meningitis dan Paresis Nervus Fasialis Perifer

Sari

Edward

Rosalinda

2018

JKA

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“…Facial palsy (FP) is an uncommon but recognized complication of cholesteatoma; its incidence ranges from 1% to 3.4% of cholesteatoma presentations [ 1 , 2 , 3 ]. Facial palsy secondary to cholesteatoma has several causes; osteitis, bony erosion, direct compression resulting from edema, and inflammation of the nerve by bacteria or neurotoxic substances, which may be secreted from the cholesteatoma matrix can damage the facial nerve [ 4 , 5 ]. It has been shown that the facial nerve fills 35 to 65% of the fallopian canal; the remaining portion is filled with extra neural blood vessels and connective tissue, without leaving any empty space [ 5 , 6 ]; thus, edema secondary to infection can easily affect the neural transmission [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Facial palsy secondary to cholesteatoma has several causes; osteitis, bony erosion, direct compression resulting from edema, and inflammation of the nerve by bacteria or neurotoxic substances, which may be secreted from the cholesteatoma matrix can damage the facial nerve [ 4 , 5 ]. It has been shown that the facial nerve fills 35 to 65% of the fallopian canal; the remaining portion is filled with extra neural blood vessels and connective tissue, without leaving any empty space [ 5 , 6 ]; thus, edema secondary to infection can easily affect the neural transmission [ 5 , 6 ]. Direct pressure on the facial nerve due to cholesteatoma has also been reported [ 7 ]; however, FP was expected only after blockage of more than 50% of facial nerve fibers [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Facial Palsy Secondary to Cholesteatoma: A Case-Series of 14 Patients

Psillas

Constantinidis

2023

Audiology Research

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Background: To evaluate patients with middle ear cholesteatoma presenting with facial palsy (FP). Material-Methods: A total of 14 subjects (10 males and 4 females), with a mean age of 42.5 years, were included in our study. The majority of patients presented with incomplete FP (House–Brackmann HB II-IV, 11 cases) and the remaining 3 patients had complete facial paralysis (HB V-VI). A canal wall down mastoidectomy was performed in all the patients, followed by partial facial nerve decompression. Results: At the one-year follow-up, eleven (78.5%) patients demonstrated satisfactory recovery to HB I-II. Facial function recovered to HB grade I-II in 9 (100%) patients who were surgically treated within one month, and in 2 (40%) patients who underwent surgery after one month. The tympanic segment of facial nerve was the most common site of involvement (8 patients). The multiple regression analysis showed that a higher preoperative HB grade combined with a gradual than sudden onset of FP more likely resulted in worse postoperative HB grade. Conclusion: Early surgical removal of cholesteatoma associated with FP is more likely to result in good facial nerve recovery (78.5% of cases), when it is performed within one month from the onset of FP. According to the literature, the tympanic segment of the facial nerve was more frequently damaged (77.7%), followed by the mastoid segment (22.9%), labyrinthine segment (11.1%), and geniculate ganglion (11.1%). Labyrinthine fistula, mainly of the lateral semicircular canal, can be expected in cases of facial nerve dehiscence. The canal wall down mastoidectomy combined with partial decompression surgery was the most preferred surgical treatment for the FP secondary to cholesteatoma.

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Temporal Bone Cholesteatoma: The Full Picture

da Costa,

Rosito,

da Silva

et al. 2023

Textbook of Otitis Media

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Effect of surgical intervention on middle-ear cholesteatoma with associated facial paralysis

Abstract: Early surgical treatment is more likely to give good results, and poor outcomes are observed in patients with facial nerve perineurium damage.

Cited by 8 publications

References 16 publications

Otitis Media Supuratif Kronis Tipe Kolesteatom dengan Komplikasi Meningitis dan Paresis Nervus Fasialis Perifer

Otitis Media Supuratif Kronis Tipe Kolesteatom dengan Komplikasi Meningitis dan Paresis Nervus Fasialis Perifer

Facial Palsy Secondary to Cholesteatoma: A Case-Series of 14 Patients

Temporal Bone Cholesteatoma: The Full Picture

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