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Anatomical Science International Sep 2014Patients with Ramsay Hunt syndrome have various clinical symptoms including vesicular rash of the external acoustic meatus and auricle. In addition to facial nerve...
Patients with Ramsay Hunt syndrome have various clinical symptoms including vesicular rash of the external acoustic meatus and auricle. In addition to facial nerve paresis, neurological disturbances of various cranial nerves such as the acoustic nerve, glossopharyngeal nerve and vagus nerve are reported in patients of Ramsay Hunt syndrome. To understand the reasons for the clinical symptoms, we observed the nerve branches of the auricle and external acoustic meatus. We used 18 halves of 11 Japanese cadavers. All cadavers were fixed in 8% formalin and preserved in 30% ethanol. Dissection was performed under a stereomicroscope and the communication among the nerve branches was analyzed. Posterosuperior wall of the acoustic meatus was innervated by nerve branches that emerged from the tympanomastoid fissure in 17 specimens (17/18). These branches always crossed the facial canal and had more than one communicating branch with the facial nerve inside the canal (17/17) or in the petrous bone (1/17). These branches originated from the superior ganglion of the vagus. In the origin from the vagus nerve, some of these branches communicated with the glossopharyngeal nerve (3/17). In addition to these branches, the facial nerve, after originating from the stylomastoid foramen, bifurcated into two nerve branches in some specimens (7/17). Nerve branches around the external acoustic meatus and the auricle have various communications before reaching the central nervous system. The variety of communications could explain the varied symptoms of Ramsay Hunt syndrome.
Topics: Aged; Cadaver; Cochlear Nerve; Ear Canal; Facial Nerve; Female; Glossopharyngeal Nerve; Humans; Male; Vagus Nerve
PubMed: 24604237
DOI: 10.1007/s12565-014-0231-4 -
Rinsho Shinkeigaku = Clinical Neurology Feb 2018A 58-year-old female was admitted to our hospital because of recurrent multiple cranial neuropathy (right facial palsy followed by involvement of the left trigeminal,...
A 58-year-old female was admitted to our hospital because of recurrent multiple cranial neuropathy (right facial palsy followed by involvement of the left trigeminal, facial, acoustic, pharyngeal, and vagal nerves and the right abducens nerve). Brain MRI showed gadolinium enhancement of the right abducens, bilateral facial/acoustic, and left pharyngeal/vagal nerves, and F-Fluorodeoxyglucose (FDG)-positron emission tomography revealed abnormal FDG uptake in the right facial, acoustic, pharyngeal, and vagal nerves and the left cervical lymph nodes. Blood and biochemical analyses did not show any abnormalities, including in the patient's lactate dehydrogenase and soluble interleukin-2 receptor (sIL2R) levels. A cerebrospinal fluid (CSF) examination showed gradual increases in the patient's cell counts and protein, β2-microglobulin, and sIL2R levels, but no malignant cells were detected. A thorough investigation involving repeated CSF examinations, whole-body computed tomography, bone marrow aspiration, random skin biopsies, and cervical lymph node aspiration biopsy examinations did not result in any definitive conclusions. Steroid therapy was ineffective, and the patient developed deafness in her left ear. Therefore, we performed a biopsy examination of the left acoustic nerve, which resulted in the patient being diagnosed with diffuse large B-cell lymphoma. High-dose MTX following the intrathecal administration of MTX, cytarabine, and prednisolone partially improved her symptoms, but she died after several episodes of clinical recurrence. Acoustic nerve biopsy may help diagnose neurolymphomatosis in carefully selected cases.
Topics: Animals; Biopsy; Cochlear Nerve; Female; Humans; Lymphoma, Large B-Cell, Diffuse; Magnetic Resonance Imaging; Middle Aged; Neuroimaging; Peripheral Nervous System Neoplasms; Tomography, X-Ray Computed
PubMed: 29386492
DOI: 10.5692/clinicalneurol.cn-001080 -
Acta Oto-laryngologica 1990With conventional light and transmission electronmicroscopy we studied 10 cases of acoustic nerve tumour, 3 of which proved to be instances of von Recklinghausen...
With conventional light and transmission electronmicroscopy we studied 10 cases of acoustic nerve tumour, 3 of which proved to be instances of von Recklinghausen neurofibroma and 7 of schwannoma. Schwannomas were not found to infiltrate the cochlear nerve. Hearing loss, if present in cases of schwannoma, could be related to non-specific lesions of the uninfiltrated cochlear nerve in the vicinity of the vestibular nerve tumour. Only neurofibromas were found to infiltrate the cochlear nerve. Distinction between tumour infiltration and non-specific lesion could be made by electron microscopy.
Topics: Adolescent; Adult; Aged; Cochlear Nerve; Female; Humans; Male; Middle Aged; Neuroma, Acoustic
PubMed: 2239214
DOI: 10.3109/00016489009122544 -
European Archives of... 2000In an attempt to better understand the mechanism of eighth nerve dysfunction in acoustic neuromas (vestibular schwannomas), we have morphologically examined microvessels...
In an attempt to better understand the mechanism of eighth nerve dysfunction in acoustic neuromas (vestibular schwannomas), we have morphologically examined microvessels and nerve fibers in the intracanalicular portion of eighth nerve specimens attached to these tumors. At the light microscopic level, microvessels were well preserved in all the specimens, even in the extremely flattened or markedly small nerve fascicles. However, the density of microvessels was quite variable in the different specimens, presumably as the result of different levels of compression by the tumors and the subsequent formation of a collateral microcirculation in each nerve. Focal areas of mild endoneurial fibrosis were found in 9 out of 22 specimens examined, but severe and widespread degeneration or demyelination was not found in any of the specimens. Ultrastructural studies frequently revealed mild to moderate abnormalities in myelin sheaths, and occasionally showed endothelial hyperplasia and hypertrophy in all the specimens. These findings are consistent with the slight to moderate reduction of endoneurial blood flow in the eighth nerves. The resultant ischemic condition in the eighth nerve may account for the eighth nerve conduction block in acoustic neuromas.
Topics: Adult; Aged; Cochlear Nerve; Female; Humans; Male; Microcirculation; Microscopy, Electron; Middle Aged; Nerve Fibers; Neural Conduction; Neuroma, Acoustic; Severity of Illness Index; Ultrasonography
PubMed: 11073189
DOI: 10.1007/s004050000258 -
Journal of Neurosurgery Apr 1965
Topics: Cochlear Nerve; Facial Nerve; Humans; Microsurgery; Neoplasms; Neuroma; Neuroma, Acoustic; Neurosurgery; Neurosurgical Procedures; Vestibulocochlear Nerve
PubMed: 14318119
DOI: 10.3171/jns.1965.22.4.0399 -
Archives of Otolaryngology (Chicago,... Dec 1964
Topics: Cochlear Nerve; Cornea; Diagnosis, Differential; Facial Nerve; Neoplasms; Neurilemmoma; Neuroma, Acoustic; Neurosurgery; Pain; Touch; Trigeminal Nerve; Vestibulocochlear Nerve
PubMed: 14205467
DOI: No ID Found -
The Ceylon Medical Journal Mar 1964
Topics: Adolescent; Cochlear Nerve; Humans; Neoplasms; Neurilemmoma; Neuroma, Acoustic; Pathology; Radiography; Surgical Procedures, Operative
PubMed: 14213146
DOI: No ID Found -
British Medical Bulletin Oct 1987
Review
Topics: Acoustic Stimulation; Animals; Cochlear Nerve; Humans; Rhombencephalon
PubMed: 3329928
DOI: 10.1093/oxfordjournals.bmb.a072221 -
Acta Otorrinolaringologica Espanola May 2008To evaluate the fraction of patients recovering to normal function after complete facial nerve paralysis secondary to acoustic neuroma surgery, and also to address the...
OBJECTIVE
To evaluate the fraction of patients recovering to normal function after complete facial nerve paralysis secondary to acoustic neuroma surgery, and also to address the ophthalmologic complications associated with it and the therapeutic options.
MATERIAL AND METHOD
We performed a retrospective review of 30 cases operated on in our department for acoustic neuroma and who, despite anatomical preservation of the facial nerve, developed a complete post-operative facial nerve paralysis (grade VI of House-Brackmann [HB]). We analyzed the evolution of the facial paralysis in relation to the tumour size, patient age, surgical approach and localization of the tumour. In addition, we studied the ophthalmologic complications and their treatment.
RESULTS
Only 5 of the 30 cases studied (16.6 %) recovered to normal facial nerve function (HB grade I). We observed a tendency for a poor recovery of the cases with tumour size bigger than 2 cm, males, those older than 65 years and lesions resected by the translabyrinthine approach. Only 1 patient presented serious ophthalmologic complications.
CONCLUSIONS
Our study reveals that only a small percentage of patients achieve total recovery of facial function. We have to be on the alert to ocular complications in this kind of patient.
Topics: Adult; Aged; Cochlear Nerve; Corneal Ulcer; Disease Progression; Facial Paralysis; Female; Humans; Male; Middle Aged; Neuroma, Acoustic; Peripheral Nervous System Neoplasms; Postoperative Complications; Retrospective Studies
PubMed: 18501157
DOI: No ID Found -
Expert Review of Neurotherapeutics Aug 2009MRI studies are of paramount importance for diagnosis and follow-up measurements during conservative and postinterventional management of vestibular schwannomas (VS).... (Review)
Review
MRI studies are of paramount importance for diagnosis and follow-up measurements during conservative and postinterventional management of vestibular schwannomas (VS). MRI findings that convey important information for hearing-preservation VS surgery are: length of tumor-cochlear nerve contact, involvement of the internal auditory canal, incomplete filling of internal auditory canal, tumor size less than 15 mm and the intralabyrinthine signal intensity on 3DFT-CISS gradient-echo images. Functional neuro-otologic studies of facial nerve function, hearing and vestibular/balance function provide a valuable means of assessment of the actual impairment of the functional status of the VS patient. Intraoperative monitoring of facial nerve function and hearing has been refined, resulting in improved final postoperative facial nerve and hearing outcomes in VS patients treated with microsurgery. Long-term results reported by teams practicing stereotactic radiosurgery or fractionated stereotactic radiotherapy have been very encouraging. On the other hand, conservative management appears to be a viable option for a select group of VS patients. The refinement of surgical technique has rendered surgery safer and less invasive, resulting in better functional outcomes. Steroid use is currently used postinterventionally to improve final hearing outcome, although with questionable effectiveness. Physical rehabilitation programs are applied to accelerate vestibular functional recovery postoperatively and there is weak evidence that early physical rehabilitation may improve the final facial nerve outcome. Quality-of-life measures have emerged as important determinants of final therapeutic decision-making. More studies with high levels of evidence are needed to support clinical decisions.
Topics: Cochlear Nerve; Diagnostic Imaging; Hearing; Humans; Neuroma, Acoustic; Neurosurgery
PubMed: 19673609
DOI: 10.1586/ern.09.66