Total Intratemporal Exposure of the Facial Nerve: Pathologic Findings in Bell's Palsy

Fisch, Ugo; Esslen, E

doi:10.1001/archotol.1972.00770080529008

Cited by 237 publications

(139 citation statements)

References 8 publications

Supporting

Mentioning

120

Contrasting

Unclassified

Order By: Relevance

“…MRI enhancement of the facial nerve in Bell's palsy after administration of gadopentetate dimeglumine has been explained by hypervascularity of the perineural structures and formation of an increased vascular pool of contrast material, and/or disruption of the blood-nerve barrier by acute inflammation [12]. The strangulation of the nerve is more likely to take place at its labyrinthine portion and probably at the meatal foramen (the canalicular entrance to the labyrinthine segment of the facial nerve canal), which is the narrowest site of the bony canal where the loosely arranged intrameatal fibers of the facial nerve are constricted by a fibrous ligament [13,14].…”

Section: Discussionmentioning

confidence: 99%

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

Yılmaz

Yalcin

Çakan

et al. 2014

Indian J Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

Yılmaz

Yalcin

Çakan

et al. 2014

Indian J Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

show abstract

“…Regarding deep connections between the facial and vestibulocochlear nerves, Paturet [18] found connections between the genu of the facial nerve and Scarpa's ganglion. Cruveilhier [5] also described nerve connections between the facial and vestibulocochlear nerves and this was confirmed by later reports [8][9][10]. Hovelacque [11] cited Arnold two connections at the level of the porus acousticus, 1 lateral (from the facial nerve to the vestibular ganglion, with containing sympathetic fibers, 1 medial that might belong to the nervus.…”

Section: Discussionmentioning

confidence: 78%

“…Clinically, this vestibular to facial nerve communication is a possible reason why some patients develop nystagmus following facial nerve block as a treatment of hemifacial spasm [30]. Furthermore, such connections have been implicated in the vestibular disturbance seen in patients with facial paralysis [8], Some have considered that persistence of vertigo in patients who have undergone cochlear nerve neurectomy might be due to connections between the cochlear and vestibular nerves [19]. Asram et al [3] found that muscles around the mouth contracted with stimulation of the nervus intermedius, implying that this nerve might carry some motor fibers from the facial nerve.…”

Section: Discussionmentioning

confidence: 99%

Neural connections between the nervus intermedius and the facial and vestibulocochlear nerves in the cerebellopontine angle: an anatomic study

et al. 2015

View full text Add to dashboard Cite

Purpose: Unexpected clinical outcomes following transection of single nerves of the internal acoustic meatus have been reported. Therefore, this study aimed to investigate interneural connections between the nervus intermedius and the adjacent nerves in the cerebellopontine angle.Methods: On 100 cadaveric sides, dissections were made of the facial/vestibulocochlear complex in the cerebellopontine angle with special attention to the nervus intermedius and potential connections between this nerve and the adjacent facial or vestibulocochlear nerves. Results:A nervus intermedius was identified on all but 10 sides. Histologically confirmed neural connections were found between the nervus intermedius and either the facial or vestibulocochlear nerves on 34% of sides. The mean diameter of these small interconnecting nerves was 0.1 mm. The fiber orientation of these nerves was usually oblique (anteromedial or posterolateral) in nature, but 13 connections traveled anteroposteriorly. Connecting fibers were single on 81% of sides, doubled on 16% and tripled on 3%, Six sides had connections both with the facial nerve anteriorly and the vestibular nerves posteriorly. On 6.5% of sides, a connection was between the nervus intermedius and cochlear nerve. For vestibular nerve connections with the nervus intermedius, 76% were with the superior vestibular nerve and 24% with the inferior vestibular nerve. Conclusions:Knowledge of the possible neural interconnections found between the nervus intermedius and surrounding nerves may prove useful to surgeons who operate in these regions so that inadvertent traction or transection is avoided. Additionally, unanticipated clinical presentations and exams following surgery may be due to such neural interconnections. 4

show abstract

“…10,11 An intraoperative study showed swelling of facial nerve proximal to meatal foramen in patients with Bell's palsy. 8 Entrapment of swollen facial nerve was found at meatal foramen and labyrinth segment. Magnetic resonance imaging studies similarly showed signs of inflammation of facial nerve within the facial canal.…”

Section: Introductionmentioning

confidence: 99%

“…7 Along the facial canal, the labyrinth segment is the narrowest part. 1 Herpes simplex infection was believed to result in inflammation and swelling of the facial nerve, as evidenced by operative, 1,8 magnetic resonance imaging 1,9 and histopathology studies. 10,11 An intraoperative study showed swelling of facial nerve proximal to meatal foramen in patients with Bell's palsy.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Bell's Palsy Using Monochromatic Infrared Energy: A Report of 2 Cases

Chu

2014

Journal of Chiropractic Medicine

View full text Add to dashboard Cite

Objective: The purpose of the study is to describe the use of monochromatic infrared energy (MIRE) therapy in the management of 2 patients with Bell's palsy. Clinical features: Two patients presented to a chiropractic clinic with Bell's palsy that was diagnosed by a medical physician. Both patients were treated using MIRE. The acute patient was a 32-year-old male. He presented with left facial palsy 1 day before the consultation. He was unable to puff the left cheek and close the left eyelid. He had difficulty raising the left eyebrow. The chronic case was a 46-year-old lady. Prior to the first consultation, she was treated with corticosteroid and electro-acupuncture for one and a half years, with incomplete recovery. When first seen, the left corner of mouth drooped and she had difficulty raising her left eyebrow. Intervention and outcome: Monochromatic infrared energy therapy, emitting 890 nm infrared light, was placed on the post-auricular area, pre-auricular area, the temple and mandibular area of the affected side. Each treatment lasted 30 minutes. Photographs were taken every week to document changes. The acute case received 19 treatments in 6 weeks. He reported an improvement of 95%. The chronic case received a total of 45 treatments in 9 months. She rated an improvement of 50%. At the conclusion of treatment, she was able to close her left eyelid and puff her left cheek but still could not raise her left eyebrow. Conclusion: These 2 patients seemed to respond to a different degree to the MIRE therapy. As 71% of patients with Bell's palsy recover uneventfully without any treatment, the present study describes the course of care but cannot confirm the effectiveness of MIRE therapy in the management of Bell's palsy.

show abstract

Total Intratemporal Exposure of the Facial Nerve: Pathologic Findings in Bell's Palsy

Cited by 237 publications

References 8 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?

Neural connections between the nervus intermedius and the facial and vestibulocochlear nerves in the cerebellopontine angle: an anatomic study

Treatment of Bell's Palsy Using Monochromatic Infrared Energy: A Report of 2 Cases

Contact Info

Product

Resources

About