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Facial Canal Dehiscence and Prolapse of the Facial Nerve – Case Reports


Authors: Viktor Chrobok 1 ;  B. Ježek 2;  E. Šimáková 3;  Michal Černý 1
Authors place of work: Klinika otorinolaryngologie LF UK a FN Hradec Králové 1;  Katedra veřejného zdravotnictví, Fakulta vojenského zdravotnictví Hradec Králové, Univerzita obrany, Brno 2;  Fingerlandův ústav patologie, LF UK a FN Hradec Králové 3
Published in the journal: Cesk Slov Neurol N 2011; 74/107(4): 478-481
Category: Case Report

Summary

Two cases are presented. The first of them involved a histological study of facial canal dehiscence with a retraction pocket of the tympanic membrane of the right ear. Prolapse of the facial nerve from its facial canal was revealed; the facial nerve was in contact with the stapes and retraction pocket. Computer-assisted three-dimensional reconstruction was performed with histological sections of the temporal bone. The second case involved malformation of the stapes suprastructure and fixation of footplate, with subsequent prolapse of the facial nerve, which covered the footplate. Our approach to the surgery consisted of gently retrac­ting the prolapsed facial nerve, then making a monitoring hole in the visible portion of the footplate, following down the fracture and removing the stapes superstructure. A piston prosthesis was inserted. After surgery, the patient suffered from slight facial paresis at H-B II level. The functions of facial nerve and hearing were normal after six months. The surgeon should bear in mind that procedures performed in the middle ear have a high potential to traumatize or damage the facial nerve at the site of dehiscence. We conclude that stapes surgery in patients with significant facial nerve prolapse can be performed safely, with good hearing results, in the hands of an experienced surgeon.

Key words:
facial nerve – canal dehiscence – prolapse of facial nerve – computer-assisted three-dimensional reconstruction – facial pares


Zdroje

1. Di Martino E, Sellhaus B, Haensel J, Schlegel JG, Westhofen M, Prescher A. Fallopian canal dehiscences: a survey of clinical and anatomical findings. Eur Arch Otorhinolaryngol 2005; 262(2): 120–126.

2. Ježek B, Chrobok V, Antoš K, Vaněk J. Prostorová rekonstrukce histologických řezů spánkové kosti. Vojenské zdravotnické listy 2009; 78(4): 154–157.

3. Lin JC, Ho KY, Kuo WR, Wang LF, Chai CY, Tsai SM. Incidence of dehiscence of the facial nerve at surgery for model ear cholesteatoma. Otolaryngol Head Neck Surg 2004; 131(4): 452–456.

4. Bayazit YA, Ozer E, Kanlikama M. Gross dehiscence of the bone covering the facial nerve in the light of otological surgery. J Laryngol Otol 2002; 116(10): 800–803.

5. Li D, Cao Y. Facial canal dehiscence: a report of 1,465 stapes operations. Ann Otol Rhinol Laryngol 1996; 105(6): 467–471.

6. Tange RA, Bruijn AJG. Dehiscences of the horizontal segment of the facial canal in otosclerosis. ORL 1997; 59(2): 277–279.

7. Welling DB, Glasscock ME, Gantz BJ. Avulsion of the anomalous facial nerve at stapedectomy. Laryngoscope 1992; 102(7): 729–733.

8. Neff BA, Lippy WH, Schuring AG, Rizer FM. Stapedectomy in patiens with a prolapsed facial nerve. Otolaryngol Head Neck Surg 2004; 130(5): 597–603.

9. Noss RS, Lalwani AK, Yingling CD. Facial nerve monitoring in middle ear and mastoid surgery. Laryngoscope 2001; 111(5): 831–836.

Štítky
Paediatric neurology Neurosurgery Neurology

Článok vyšiel v časopise

Czech and Slovak Neurology and Neurosurgery


2011 Číslo 4
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