Venous Engorgement as a Cause of Facial Canal Enlargement

Abstract

There are various causes of facial canal enlargement. From congenital anomalies to neoplasms, many pathologic conditions should be considered. However, normal variants of vascular anatomy can also result in facial canal enlargement on temporal bone imaging. In order to avoid unnecessary procedures and complications, such as bleeding and facial nerve injury, this possibility should also be taken into account. A case of a 50-year-old male who was diagnosed with facial canal enlargement because of venous engorgement in the facial canal is herein described.

Embryonic Primary Head Sinus may Persist in the Petrosal Bone

“…In those studies, the relevance of the venous anomaly to the embryonic primary head sinus remains unclear. We found three reports describing a dilated vein in the facial canal; 5,21,22) these cases were similar to the present Case 3. Nagar et al 22) reported on a case with a dilated vein situated in the facial canal from the genu to the stylomastoid foramen and asserted that the vein was the remnant of the lateral capital vein.…”

Prominent Enlargement of the Facial Nerve Canal in a Case of a Persistent Stapedial Artery

“…A venous cause for facial canal enlargement has been nicely described on both histopathology and CT by Moonis et al [2]. In another case report by Kim et al, in which similar findings on MR to our case were described, venous engorgement around the facial nerve was observed intraoperatively [3]. In these cases, there was no PSA.…”

“…This is confirmed by the prominent contrast enhancement around a normal facial nerve on MR imaging (Figure 1B). On the basis of literature data, we can confidently suppose that a vein rather than an artery causes the canal enlargement [2,3].…”