Is the width of the labyrinthine portion of the fallopian tube implicated in the pathophysiology of Bell's palsy?: A prospective clinical study using computed tomography

Kefalidis, Georgios; Riga, Maria; Argyropoulou, Paraskevi; Katotomichelakis, Michael; Gouveris, Haralampos; Prassopoulos, Panos; Danielides, Vassilios

doi:10.1002/lary.20896

Cited by 41 publications

(48 citation statements)

References 22 publications

(38 reference statements)

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“…However, the cross section of the bony canal might vary in shape, including round, ellipsoid, kidney-shaped, and a triangular contour [3]. These findings suggest that the cross-sectional area, not the diameter, of the facial nerve canal in the temporal bone may be an important factor for mechanical compression and circulatory disturbance of the swollen facial nerve in Bell's palsy.…”

Section: Discussionmentioning

confidence: 94%

“…Other features may include retroauricular pain which may extend into the neck and occiput, impaired tolerance of noise, and ipsilateral disturbance of taste [2]. Inflammation and edema of the facial nerve are considered fundamental parts of the pathogenesis in Bell's palsy [3]. Clinical studies have shown that corticosteroids significantly improve outcome compared with placebo, probably through their effects against inflammation and edema [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Kefalidis, et al [3] performed a high-resolution computerized tomography of the temporal bone with 1-mm thick contiguous axial sections in 25 patients with unilateral Bell's palsy. The width of the fallopian tube was measured at the meatal foramen and the middle part of its labyrinthine segment.…”

Section: Introductionmentioning

confidence: 99%

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Is There a Relationship Between Bell’s Palsy and Internal Auditory Canal?

Yılmaz

Yalcin

Çakan

et al. 2014

Indian J Otolaryngol Head Neck Surg

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In the present study, we evaluated the diameter of internal acoustic canal in patients with Bells palsy to investigate the role of anatomical differences of the temporal bone in etiology of Bell's palsy. Sixty-four patients who were diagnosed as Bells Palsy and temporal bone computed tomography imagings of them were included into the study group (Group 1). The control group (Group 2) was consisted of 35 healthy subjects without Bell's Palsy. All patients had temporal bone computed tomography imaging. The internal auditory canal inlet, mid-canal, outlet and canal lengths were measured at the most distinctive cross-section of the seventh and eighth cranial nerves bifurcation. In the study group, Bells palsy was on the right side in 26 patients (40.6 %) and on the left side in 38 patients (59.4 %). Initial House-Brackmann (HB) score was HB-2 in 29 patients (45.3 %), HB-3 in 18 patients (28.1 %), HB-4 in 13 patients (20.3 %) and HB-5 in 4 patients (6.2 %). At 6-month evaluation, HB-score of the patients were HB-1 in 37 patients (57.8 %), HB-2 in 25 patients (39.1 %) and HB-3 in 2 patients (3.1 %). Internal auditory canal (IAC) measurements of the groups showed that there were no significant differences between the measurements of right-mid canal, right canal length; and left canal outlet and left canal length of the study and control groups. Right inlet and outlet; and left inlet and mid-canal values of the study group (Bell's palsy) were significantly lower than those of the control group. In Bell's palsy group, left inlet, outlet and canal length values were significantly higher than those of the right ones. Correlation analysis showed that there were no significant correlation between paralysis side; initial HB stage; and IAC measurement results. In patients with higher initial HB score, their 6-month later HB-score was also higher. In patients with higher 6-month HB score; R canal inlet, R mid-canal, L-canal inlet, and L-mid canal values were lower. Lower IAC inlet and mid-canal values were detected in patients with Bell's palsy. Therefore narrow IAC inlet and mid-canal values may be one of the risk factors for Bell's palsy.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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Is There a Relationship Between Bell’s Palsy and Internal Auditory Canal?

Yılmaz

Yalcin

Çakan

et al. 2014

Indian J Otolaryngol Head Neck Surg

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“…Despite the extensive research, the etiology of Bell's palsy remains unclear [14]. However, positive evidence on the pathophysiology of this disease seems restricted to the edema of the facial nerve, which has been reported by contrast-enhanced MRI of the facial nerve 9-23 days after onset [10,[15][16][17][18].…”

Section: Introductionmentioning

confidence: 98%

“…Former intraoperative observations gave the impression that the most likely site for conduction block and neural compression of the facial nerve is at the narrowest point of the facial canal, i.e. the entrance to the meatal foramen [14]. A bulbous swelling of the facial nerve proximal to this point [i.e.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the early phase of Bell’s palsy using 3 T MRI

Burmeister

Baltzer

Volk

et al. 2011

Eur Arch Otorhinolaryngol

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This prospective study on Bell's palsy investigated the value of 3 T MRI as a diagnostic tool to evaluate pathophysiological changes (i.e. edema) of facial nerve segments and the possibility to differentiate patients with high risk for incomplete recovery from patients who recover completely within 3 days after symptoms onset. For this institutional review board approved investigation, thirty patients (14 male, 16 female, mean age 44 years) with Bell's palsy underwent pre and postcontrast 3 T MRI of the cerebellopontine angle. T1-weighted imaging was performed (TR 20.0 ms, TE 2.46 ms, isotropic voxel size: 0.6 mm). Region-of-interest measurements were performed on the healthy and paralyzed side. To obtain normalized values, signal intensity increase percentage (SIIP) values were divided by contralateral results of the healthy side. Signal intensity measurements of examined nerve segments were compared using Wilcoxon and Mann-Whitney U tests and correlated to clinical findings categorized by the House-Brackmann score. The lesion side showed significantly higher signal intensities in the premeatal segment before and after contrast agent administration (P < 0.001). SIIP was highest in the premeatal segment compared to the geniculate ganglion (P < 0.001). Correlation analyses revealed no association between signal intensity measurements, clinical findings or early recovery rates after 3 months (P > 0.05). According to our results, early palsy-associated pathophysiological changes in the facial nerve premeatal segment might also be related to accumulation of proteins and not exclusively to edema. However, contrast agent enhancement quantification was not suitable as a diagnostic tool to distinguish different prognostic groups.

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Gabriel Falloppius (1523–1562) and the facial canal

Macchi

Porzionato

Morra³

et al. 2013

Clinical Anatomy

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Gabriel Falloppius is known for his contributions to anatomy. Indeed, many anatomic structures bear his name, such as the Fallopian tubes, and his descriptions often contradicted those of other notable anatomists, such as Galen and Andreas Vesalius. In his textbook "Observationes Anatomicae," he described for the first time the structures of the ear, eye, and female reproductive organs, and elucidated the development of the teeth. Furthermore, Falloppius described the facial canal. The objectives of this paper are to provide an overview of Falloppius's life and to discuss the clinical relevance of the facial canal as understood from his description of this anatomic structure.

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Is the width of the labyrinthine portion of the fallopian tube implicated in the pathophysiology of Bell's palsy?: A prospective clinical study using computed tomography

Cited by 41 publications

References 22 publications

Is There a Relationship Between Bell’s Palsy and Internal Auditory Canal?

Is There a Relationship Between Bell’s Palsy and Internal Auditory Canal?

Evaluation of the early phase of Bell’s palsy using 3 T MRI

Gabriel Falloppius (1523–1562) and the facial canal

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