A rare cause of bilateral facial nerve paralysis due to acute otitis media in a 52-year-old man

2022

Int J Adv Med

Congenital cholesteatoma (CC) is a whitish mass lesion found in the middle ear cleft behind the intact tympanic membrane in early life. It is a relatively uncommon disease and shows its growth and extension over a period of time. CC is evidenced with no prior history of tympanic membrane perforation, otorrhea, previous otologic procedures, normal pars tensa, and pars flaccida. The etiopathogenesis of CC is still controversial; however, the epithelial cell rest theory is the most commonly accepted one. The most common sites of CC are the anterior-superior and posterior-superior quadrants of the tympanic cavity. The most common clinical presentation of CC is conductive hearing loss. Early detection and intervention are needed to avoid the complications of CC. The treatment of choice in CC is still surgical. The frequency of recurrence seems to be lower in patients with CC than in acquired cholesteatoma. Rapid progression of the CC may occur in older children and the recurrence has been associated with advanced progression of the cholesteatoma. There are very few reports for CC available in the medical literature This objective of this review article is to discuss the prevalence, etiopathology, clinical manifestations, diagnosis, and treatment.

Section: Clinical Presentationsmentioning

confidence: 99%

Congenital cholesteatoma: a review

2022

Int J Adv Med

“…GSPN is the first branch of the facial nerve which arises from the geniculate ganglion. 4 It carries both parasympathetic and sensitive fibers and it merges in the middle cranial fossa occupying the facial hiatus. It innervates the lacrimal glands, mucosal linings of the nasal cavity and palate.…”

Section: Surgical Anatomymentioning

confidence: 99%

“…It innervates the lacrimal glands, mucosal linings of the nasal cavity and palate. 4 The nerve fibers which form the greater petrosal nerve arise from the lower part of the pons. This nerve is called as a mixed nerve because of its both sensory and parasympathetic nerve fibers.…”

Section: Surgical Anatomymentioning

confidence: 99%

Greater superficial petrosal nerve and its surgical importance: a review

2021

Int J Res Med Sci

The greater superficial petrosal nerve (GSPN) is an important but often underappreciated branch of the facial nerve. The GSPN is a mixed nerve which contains both sensory and parasympathetic fibers. It serves as the motor root of the pterygopalatine (sphenopalatine) ganglion. GSPN has a long course which passes across the middle skull base between the petrous bone and dura mater and running through the foramen lacerum. It then incorporates to the deep petrosal nerve and crosses along the pterygoid canal to the pterygopalatine ganglion. The postganglionic nerve fibers innervates the lacrimal glands, nasal mucosa and palatal mucosal glands via branches of the zygomatic nerve/zygomaticotemporal branch, sphenopalatine, greater palatine, lesser palatine nerves and pharyngeal nerve. Surgical anatomy of the GSPN nerve is often unfamiliar to many clinicians. As this nerve is usually unrecognized without use of high resolution microscope or endoscope, its anatomical knowledge is essential for surgeons basically otologists and other head and neck surgeon to minimize the risk of injury during surgical intervention. This review article surely increases the precise knowledge of the GSPN including its embryology, surgical anatomy, blood supply, relations with other structures and imaging.

Delayed Facial Nerve Paralysis Following Tympanomastoid Surgery

Annals of Indian Academy of Otorhinolaryngology Head and Neck Surgery

2021

Facial nerve paralysis is the most severe form of cranial neuropathy that causes facial deformity. Late-onset or delayed facial nerve palsy is uncommon following tympanomastoid surgery, although it can occur up to 2 weeks following the procedure. Although pinpointing the specific reason for delayed facial nerve paralysis following tympanomastoid surgery is complex, several variables such as facial nerve injury and/or viral reactivation can play a role. Late facial nerve paralysis after tympanomastoid surgery is caused by exposure of the facial nerve and fallopian canal dehiscence. Late facial nerve paralysis may be produced by viral reactivation and damage to the chorda tympani nerve. This study aims to look at the prevalence, etiology, clinical signs, diagnosis, and current treatment options for delayed facial nerve paralysis following tympanomastoid surgery. The exact cause of delayed facial nerve paralysis after tympanomastoid surgery has significant consequences for therapy and prognosis. The use of steroid and antiviral drugs is helpful for the treatment of the delayed facial nerve paralysis due to viral reactivation. The overall prognosis of the delayed facial nerve paralysis following tympanomastoid operation is good. This article discusses the prevalence, etiopathogenesis, clinical features, diagnosis, and present treatment of late/delayed facial nerve palsy following the tympanomastoid operation.