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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Numerous papers have been written on facial nerve paralysis caused by chronic suppurative otitis media. However the authors found none documenting the results of therapy in a series of patients in whom facial nerve dysfunction was caused by chronic otitis media without cholesteatoma. Thus, there is little factual information available to help select a specific therapeutic plan for such cases. Over the past decade, the senior author has managed five cases (6 ears) of chronic suppurative otitis media without cholesteatoma in which facial paresis (4 ears) or paralysis (2 ears) developed 10 days or less before surgery. The chronic otitis media involved the mastoid and middle ear in five cases; and the mastoid, middle ear, and petrous apex in one case. Modified radical mastoidectomy was performed in four ears, tympanomastoidectomy with facial recess exposure in one ear, and complete mastoidectomy with middle cranial fossa petrous apicectomy in one ear. Five patients had complete recovery of facial nerve function (House grade I), and one patient had 90 percent recovery (House grade II). The results provide support for semi-emergent surgery in the management of chronic suppurative otitis media when facial nerve paralysis supervenes.
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PMID:Facial nerve paralysis secondary to chronic otitis media without cholesteatoma. 141 4

Since the advent of antibiotics, otogenic complications have decreased considerably. However, incomplete antibiotic therapy has altered the clinical course of middle ear disease so as to be more insidious. This paper reports a case of Bezold's abscess associated with cholesteatoma. A 48-year-old man visited our hospital presenting with a 4-day history of right otorrhea and a tender swelling in the right neck. Physical examination showed a febrile patient (38.8 degrees C) with right facial paresis and trismus. A hyperemic, hard and tender swelling was observed in his right neck from the lateral cervical to the mental region. The tympanic membrane was invisible because of granulation and swelling of the posterior wall of the external auditory canal. Intravenous clindamycin and ceftazidime therapy was started immediately. A CT-scan revealed a diffuse shadow with bony destruction in the right mastoid cortex. Extensive abscess formation was also found in the right sternocleidomastoid muscle, in the anterior neck and in the posterior neck. He was diagnosed as having Bezold's abscess associated with cholesteatoma. Radical mastoidectomy and drainage of the neck abscess was performed on the third day under general anesthesia. The mastoid cavity was found to be filled with pus and cholesteatoma debris. A small area of defective bone was found at the mastoid tip, through which there were communications between the mastoid cavity and the abscesses in the neck. Bony destruction was also found in the horizontal and vertical portion of the facial canal. Bacteroides and three kinds of gram-negative rods were cultured from the mastoid cavity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of Bezold's abscess associated with cholesteatoma]. 149 Dec 72

Eight patients with extensive petrous bone cholesteatomas that invaded the labyrinth and fallopian canal are presented. The eight cases are added to a tabulation of prior literature reports to elucidate concepts of routes of extension of medially invasive temporal bone cholesteatoma. Medially invasive petrous bone cholesteatoma develops insidiously, often without symptoms other than facial palsy and/or unilateral deafness. Typically, a history of chronic ear disease can be obtained. While hearing is unlikely to be preserved in this group of patients, facial nerve function can usually be preserved, and a facial nerve graft was not necessary in our series. Acute facial nerve palsy or facial nerve paresis progressing to palsy in patients with a history of chronic ear disease should be studied radiographically for petrous bone cholesteatoma, even if there is no physical evidence of cholesteatoma.
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PMID:Facial nerve and medially invasive petrous bone cholesteatomas. 174 34

The congenital cholesteatoma of the petrous bone is a rarity. The topographic situation corresponds to a congenital dermoid. The evolution is typic. On the beginning the ear drum is intact, very early one will find a loss of the labyrinth function, often accompanied by a facial paresis. The suppuration of the middle ear comes in a later state. The drainage operation is insufficient. The subtotal petrosectomy with permanent anterior dislocation of the facial nerve gives the chance for a definitive healing.
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PMID:[On the problem of the congenital (?) cholesteatoma of the petrous bone (author's transl)]. 708 56

Cholesteatomas are found almost exclusively in the middle ear and mastoid. Occasionally this disease is seen in the external auditory canal. Cholesteatoma of the external auditory canal is a rare condition. Severe pain and profuse discharge associated with a normal eardrum and normal hearing are essential clinical features. In addition, we found facial paresis and conductive hearing loss in our case. Smaller cholesteatomas can be managed by frequent debridement in the office; larger lesions require surgical intervention. Surgery is successful in resolving otorrhea and relieving pain. In addition, our own experience has shown that surgery is successful in relieving facial paresis.
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PMID:Giant cholesteatoma of the external auditory canal. 919 5

The most common complications of cochlear implantation are flap necrosis, compressed or improperly placed electrodes, and facial nerve injury, paresis, or stimulation. We report on three recent complications experienced at our institution: 1) a flap ischemia and partial-thickness necrosis without infection or device exposure, 2) facial nerve stimulation, which was managed with a new programming technique, and 3) a postimplant cholesteatoma in a patient with chronic eustachian tube dysfunction that required reoperation and explanation. We discuss the pathophysiology, likely etiology, and recommendations for management of these complications.
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PMID:Surgical complications of cochlear implantation: a report of three cases and their clinical features. 1062 55

Computer-aided navigation in otolaryngology has been used mainly for nasal operation and rarely for ear surgery. The reason for its limited use in ear surgery appears to be that microscopic observation may be sufficient in most cases of ear surgery. We report a case of congenital cholesteatoma at the petrous apex operated on using navigation. A 65-year-old man with facial palsy, deafness, and canal paresis in caloric test on the left ear was found in preoperative computed tomograph (CT) showed a large mass at the apex with an expansively eroded skull base and inner ear. Navigation used for the operation was magnetic (Insta Trak). A probe 3.2 mm in diameter was moved in the operative field and 3 axial CTs were simultaneously monitored on a workstation to show the tip location. With this image-guided system, cholesteatoma was thoroughly and safely removed. We concluded that navigation should be used for safe surgery, especially in ear surgery at the petrous apex, because anatomical identification is very easy and damage to vital areas around the inner ear, nerve, brain, and internal carotid artery could be avoided.
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PMID:[Navigation-aided surgery for congenital cholesteatoma at the petrous apex]. 1260 83

Unilateral paresis of 9th-11th cranial nerves together is defined as jugular foramen (Vernet's) syndrome. A cholesteatoma case that penetrated into intracranial area after eroding temporal bone and led to jugular foramen syndrome is presented here, since such a case has not been reported in the literature hitherto. A 46-year-old male patient was evaluated for hoarseness. It was learnt from his anamnesis that he had been operated for otitis media nearly 20 years ago. Uvula deviated towards right. Loss of gag reflex was remarkable on the left. Paresis was found on the left vocal cord. There was weakness in rotation of the head to the right. Computerized tomography (CT) scan revealed that the temporal bone lost its integrity and that there was an extra-axial hypodense mass neighboring pontocerebellum. Post-contrast magnetic resonance imaging showed that the mass, which showed thin, regular circular contrasting and which was hypointense in T1-weighted MR and hyperintense in T2-weighted MR, extended to the left jugular foramen. The mass was totally removed with left sub-occipital approach in the treatment. After the treatment, hoarseness, weakness in the rotation movement of the head and loss of gag reflex recovered totally, while deviation in the uvula was permanent. Cholesteatomas can extend to posterior fossa and cause jugular foramen syndrome. Early surgery is important to completely reverse the lost nerve functions in treatment.
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PMID:Jugular foramen syndrome caused by choleastatoma. 1588 97

The author presents the analysis of 56 CT images of the temporal bone in 5 to 72 year old patients operated on the middle ear; characterizes CT possibilities in the study of the operated ear; shows that the operation outcomes may be different (complete epidermization of the postoperative cavity, the presence of the granulation tissue, cholesteatoma recurrence); presents CT changes in the temporal bone in various perioperative and postoperative complications: otoliquorrhea, paresis of the facial nerve, labyrinthitis, progressive hypoacusis and deafness.
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PMID:[Possibilities of temporal bone CT in examination of patients after sanitation operation on the middle ear]. 1603 46

A 40-year-old man underwent surgery for a right middle ear cholesteatoma. One month later, he presented with a subacute ocular pain that was followed one day later by the appearance of vertical diplopia attributable to a right superior rectus paresis, lid ptosis and hypoaesthesia in the territory of the I and the II right trigeminal branches. A fat-suppressed (selective partial inversion recovery, SPIR) gadolinium-enhanced MRI favours the detection of inflammatory pathological tissue inside the right cavernous sinus, and in this patient it suggested a diagnosis of Tolosa-Hunt syndrome. The pain disappeared quickly after steroid treatment was started whereas the ocular nerve involvement improved only slightly during the first week of treatment. After two months, the patient only complained of diplopia on up-gaze, but the therapy was discontinued two months later on the basis of both clinical signs and MRI findings. SPIR MRI may be useful not only to support a diagnosis of Tolosa-Hunt syndrome, but also to follow-up the disease course and to manage steroid treatment.
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PMID:SPIR MRI usefulness for steroid treatment management in Tolosa-Hunt syndrome. 1681 14


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