Facial Nerve Palsy: Anatomy, Etiology, Evaluation, and Management

Mavrikakis, Ioannis

doi:10.1080/01676830802352543

Cited by 58 publications

(68 citation statements)

References 41 publications

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“…Unlike central FNP, in peripheral idiopathic FNPs imaging is not crucial for work-up or treatment in patients with typical clinical findings, as most patients recover within 3–6 months of onset [10]. Imaging is, therefore, only recommended to rule out neoplasms and other causes in patients with no response to initial treatment after 3 months or with progressive facial nerve paralysis [3, 4].…”

Section: Discussionmentioning

confidence: 99%

Microcystic adnexal carcinoma (MAC)-like squamous cell carcinoma as a differential diagnosis to Bell's palsy: Review of guidelines for refractory facial nerve palsy

Müller

Iro

Lell

et al. 2017

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundBell´s palsy is the most common cause of facial paralysis worldwide and the most common disorder of the cranial nerves. It is a diagnosis of exclusion, accounting for 60–75% of all acquired peripheral facial nerve palsies. Our case shows the first case of a microcystic adnexal carcinoma-like squamous cell carcinoma as a cause of facial nerve palsy.Case presentationThe patient, a 70-year-old Caucasian male, experienced subsequent functional impairment of the trigeminal and the glossopharyngeal nerve about 1½ years after refractory facial nerve palsy.An extensive clinical work-up and tissue biopsy of the surrounding parotid gland tissue was not able to determine the cause of the paralysis. Primary infiltration of the facial nerve with subsequent spreading to the trigeminal and glossopharyngeal nerve via neuroanastomoses was suspected. After discussing options with the patient, the main stem of the facial nerve was resected to ascertain the diagnosis of MAC-like squamous cell carcinoma, and radiochemotherapy was subsequently started.ConclusionThis case report shows that even rare neoplastic etiologies should be considered as a cause of refractory facial nerve palsy and that it is necessary to perform an extended diagnostic work-up to ascertain the diagnosis. This includes high-resolution MRI imaging and, as perilesional parotid biopsies might be inadequate for rare cases like ours, consideration of a direct nerve biopsy to establish the right diagnosis.

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Section: Discussionmentioning

confidence: 99%

Microcystic adnexal carcinoma (MAC)-like squamous cell carcinoma as a differential diagnosis to Bell's palsy: Review of guidelines for refractory facial nerve palsy

Müller

Iro

Lell

et al. 2017

Journal of Otolaryngology - Head & Neck Surgery

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“…14 The results of MGD assessment in this study were similar to those from a previous study 1 ; however, the previous study showed no significant difference in Schirmer values between sides. 1 Reflexive hyperlacrimation due to exposure keratitis 6 and decreased lacrimal pump function 15 occasionally occur in patients with CN VII palsy. Although the severity of CN VII palsy was not examined, this may differ between the present and previous studies, 1 causing the discrepant finding in Schirmer test I.…”

Section: Discussionmentioning

confidence: 99%

Meibomian Gland Dysfunction in Cranial Nerve VII Palsy

Takahashi

Kakizaki

2015

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…Between the labyrinthine and tympanic segments lies the geniculate ganglion where the petrosal branches are given off. Lesions prior to the geniculate ganglion result in more severe ocular complications due to the lack of lacrimal secretions (Mavrikakis 2008 ) . In the tympanic segment, the nerve passes behind the cochleariform process against the medial wall of the cavum tympani, above and posterior to the oval window.…”

Section: Anatomymentioning

confidence: 99%