Magnetic Resonance Imaging Findings in Delayed Facial Palsy After Stapes Surgery.
Summary of "Magnetic Resonance Imaging Findings in Delayed Facial Palsy After Stapes Surgery."
OBJECTIVES:
:
PATIENTS:
: Four hundred fifty stapedectomies performed between 2001 and 2007 by a single surgeon were retrospectively reviewed. Two patients in this series developed a delayed facial palsy postoperatively.
INTERVENTIONS:
: Magnetic resonance imaging (MRI) was performed on patients with delayed facial palsy after stapedectomy and was repeated as their clinical symptoms resolved. The patients were treated medically with oral corticosteroids and antiviral medications. MAIN OUTCOME
MEASURES:
: The clinical course and radiographic characteristics on MRI of patients with delayed facial palsy are presented.
RESULTS:
: Two of 450 patients who underwent stapedectomies (0.4%) during a 7-year period developed the rare complication of delayed facial palsy (postoperative Days 12 and 41, respectively). Both patients experienced periauricular pain and dysgeusia, followed by rapidly progressive complete facial nerve paralysis. The operated ear showed no sign of infection. MRI with gadolinium of the internal auditory canal demonstrated enhancement of the labyrinthine portion of the facial nerve as seen in Bell's palsy. Both patients were treated with oral corticosteroids and antiviral medications. Subsequent imaging revealed decreased enhancement with resolution of facial paralysis.
CONCLUSION:
: In the rare complication of delayed facial palsy after stapedectomy, MRI findings support the hypothesis that reactivation of a latent virus is the underlying cause. Therefore, delayed facial paralysis after stapedectomy should be treated similarly to Bell's palsy with steroid and antiviral medical therapy.
Affiliation
*Division of Head and Neck Surgery, University of California-Los Angeles School of Medicine, Los Angeles, California; and daggerDepartment of Radiology, Ohio State University, Columbus, Ohio, U.S.A.
Journal Details
This article was published in the following journal.
Name: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Aca
ISSN: 1537-4505
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20657331
- DOI: http://dx.doi.org/10.1097/MAO.0b013e3181eb3259
Medical and Biotech [MESH] Definitions
Molecular Imaging
The use of molecularly targeted imaging probes to localize and/or monitor biochemical and cellular processes via various imaging modalities that include RADIONUCLIDE IMAGING; ULTRASONOGRAPHY; MAGNETIC RESONANCE IMAGING; fluorescence imaging; and MICROSCOPY.
Electron Spin Resonance Spectroscopy
A technique applicable to the wide variety of substances which exhibit paramagnetism because of the magnetic moments of unpaired electrons. The spectra are useful for detection and identification, for determination of electron structure, for study of interactions between molecules, and for measurement of nuclear spins and moments. (From McGraw-Hill Encyclopedia of Science and Technology, 7th edition) Electron nuclear double resonance (ENDOR) spectroscopy is a variant of the technique which can give enhanced resolution. Electron spin resonance analysis can now be used in vivo, including imaging applications such as MAGNETIC RESONANCE IMAGING.
Mobius Syndrome
A syndrome of congenital facial paralysis, frequently associated with abducens palsy and other congenital abnormalities including lingual palsy, clubfeet, brachial disorders, cognitive deficits, and pectoral muscle defects. Pathologic findings are variable and include brain stem nuclear aplasia, facial nerve aplasia, and facial muscle aplasia, consistent with a multifactorial etiology. (Adams et al., Principles of Neurology, 6th ed, p1020)
Magnetic Resonance Spectroscopy
Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (MAGNETIC RESONANCE IMAGING).
Echo-planar Imaging
A type of MAGNETIC RESONANCE IMAGING that uses only one nuclear spin excitation per image and therefore can obtain images in a fraction of a second rather than the minutes required in traditional MRI techniques. It is used in a variety of medical and scientific applications.
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