The American journal of otology
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The study aimed to present clinical, radiographic, and operative findings in cases of recurrent facial neuromas and discuss changes in demographics of primary facial neuromas since 1986. ⋯ Improved imaging techniques have documented an increased incidence of primary facial neuromas medial to the geniculate ganglion. Clinical suspicion, histologic confirmation of tumor-free margins, interspecialty cooperation in tumor resection, and routine follow-up imaging with magnetic resonance imaging are suggested to minimize recurrent facial neuromas.
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To review the incidence of complications resulting from temporal bone fractures and analyze the outcomes from surgical and nonsurgical management. ⋯ Facial function following temporal bone fractures should be evaluated in the emergency room. If facial motion is noted at any time after the injury, surgical intervention is rarely indicated. Prophylactic antibiotics should be considered in temporal bone fractures when CSF fistulae are present. Surgical closure of a CSF fistula is indicated if it persists for > 7-10 days.
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Review Comparative Study
A comparison of facial nerve monitoring systems in cerebellopontine angle surgery.
The use of peripheral nerve monitoring during skull base surgery is becoming a more common procedure. One widely used method (Jako) detects surface muscle contraction, which can be transduced into an audible signal. A 200 microsecond square wave current can be delivered periodically, in order to identify the nerve and verify its integrity. ⋯ Each of the three study groups are matched for a time at which postoperative evaluation was made. Analysis of results reveals that in addition to the expected increase in facial nerve preservation rates when monitoring is in use, the near real-time feedback provided by audible evoked EMG results in a significant reduction in permanent postoperative facial nerve dysfunction. Using evoked monitoring, a greater proportion of the cases had a final outcome of class I or II results, compared to those cases performed using Jako motion detection monitoring.