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

Intractable, unexplained deep-ear pain presents a rare, albeit significant problem in otolaryngological and neurosurgical practice. The authors review their experience with 18 cases of primary otalgia during the past 15 years. A total of 31 surgical procedures were performed. Seventeen patients had sequential rhizotomies and one patient had microvascular decompression alone. Based on the clinical diagnosis, the nerves sectioned were singly or in combination: the nervus intermedius (14 patients), geniculate ganglion (10 patients), ninth nerve (14 patients), 10th nerve (11 patients), tympanic nerve (four patients), and chorda tympani nerve (one patient). Microvascular decompression of the involved nerves was undertaken in nine patients, in whom vascular loops were discovered. Adhesions (six patients), thickened arachnoid (three patients), and benign osteoma (one patient) were other intraoperative abnormalities noted. The overall success of these procedures in providing pain relief was 72.2%, and the mean follow-up period was 3.3 years (range 1 month to 14.5 years). There was no surgical mortality. Expected side effects were: decreased lacrimation, salivation, and taste related to nervus intermedius nerve section, and transient hoarseness and diminished gag related to ninth and 10th nerve section. Four patients developed sequelae consisting of sensorineural hearing loss, vertigo, and transient facial nerve paresis. One patient had a cerebrospinal fluid leak and another developed aseptic meningitis as postoperative complications. Except when primary glossopharyngeal neuralgia is the working diagnosis, a combined posterior cranial fossa-middle cranial fossa approach is recommended for adequate exploration and/or section of the fifth, ninth, and 10th cranial nerves as well as the geniculate ganglion and nervus intermedius.
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PMID:Geniculate neuralgia: the surgical management of primary otalgia. 152 Mar 57

Benign and malignant tumors of bone often have common musculoskeletal manifestations mimicking rheumatic disorders. The detection and resolution of mimicking symptoms require knowledge, skills, and a problem-solving attitude for musculoskeletal disorders. Before engaging in an extensive investigation, a careful history and full physical examination must be done. This review addresses the recent literature from June 2001 to May 2002 on musculoskeletal manifestations of benign and malignant tumors of bone using "red flag" rubrics: nonspecific pain pattern, atypical soft-tissue or bony swellings, pathologic fracture, spinal paresis, osteolytic x-ray findings, and unexpected results of laboratory tests. Early diagnosis (appropriate use of imaging techniques) and multidisciplinary management have improved considerably the survival of patients with primary malignant bone disease (eg, osteosarcoma). For some benign bone tumors (eg, osteoid osteoma), interstitial laser photocoagulation is now the treatment of choice with a success rate comparable with that of other treatments.
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PMID:Musculoskeletal manifestations of benign and malignant tumors of bone. 1249 13

Osteomas occur throughout the temporal bone and, depending on their location, may cause tinnitus, hearing loss, vertigo, and facial nerve paresis. We present a rare case of a 25-year-old woman with a mastoid osteoma enlarging over a 6-month period. Other than a cosmetic deformity of her upper neck, the patient was asymptomatic. After surgical removal of the bony neoplasm, the patient was noted to have a high-frequency sensorineural hearing loss. This case study presents clinical, radiologic, intraoperative, pathologic, and audiometric findings of a mastoid osteoma and a review of the literature.
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PMID:Giant mastoid osteoma with postoperative high-frequency sensorineural hearing loss. 1835 40