Neurological complications are important causes of morbidity and mortality in patients with human immunodeficiency virus (HIV) infection. They can occur at any stage of the disease and can affect any level of the central or peripheral nervous systems. In the literature, several cases of HIV-associated facial paralysis have been reported; however, bilateral facial palsy is rarely reported. In this paper, we present the first case in Korea, of a bilateral facial palsy occurring as the first clinical manifestation of HIV infection.
Male ; Humans ; HIV Infections/*complications/*diagnosis ; Facial Paralysis/*diagnosis/etiology ; Adult

Facial Paralysis ; diagnosis ; etiology ; Humans ; Infant ; Leukemia, Myeloid, Acute ; complications ; diagnosis

OBJECTIVETo discuss prognostic factors in microsurgery of intratemporal facial nerve schwannoma.

METHODSClinical and follow-up materials from 13 cases of facial nerve schwannoma were analyzed retrospectively. Spearman rank-order correlation and nonparametric Mann-Whitney U test from SPSS 10.0 for Windows was used for the analysis.

RESULTSEach of 13 cases was operated on using modern microsurgery. Eleven cases among them received facial nerve reconstruction. One of the 13 cases lost follow-up. Others had no residue or recurrence. The House-Brackmann grades of the cases received facial nerve reconstruction were II through V. Spearman rank-order correlation showed the postoperative facial nerve function was correlated with the preoperative duration of facial nerve paralysis (r = 0.925, P = 0.000) and the preoperative facial nerve function(r = 0.712, P = 0.021). Mann-Whitney U test showed that the tumor position had no effect on the postoperative facial nerve function (P = 0.889).

CONCLUSIONSAmong most of the patients who received microsurgery of facial nerve schwannoma, facial nerve functions could be restored to great extent. The longer the preoperative duration of facial nerve paralysis or the worse the preoperative facial nerve function, the worse the postoperative facial nerve function in cases who received facial nerve resection and reconstruction. Facial nerve reconstruction was helpful for the patient with facial nerve schwannoma whose facial muscles were denervated but have fibrillation potentials, as well as for the patient whose facial nerve schwannoma intruded internal acoustic canal.

Adult ; Aged ; Facial Neoplasms ; diagnosis ; Facial Nerve ; pathology ; Facial Paralysis ; diagnosis ; etiology ; Female ; Humans ; Male ; Microsurgery ; Middle Aged ; Neurilemmoma ; diagnosis ; Prognosis ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo analyze the clinical features of facial nerve neuroma about its diagnosis and management.

METHODSTen patients with facial nerve neuroma were analyzed retrospectively from February 1993 to August 2005. The period of follow-up varied from 1.5 years to 10 years (mean 5 years). Facial nerve function was evaluated with House-Brackmann grading system.

RESULTSThe patients complained of facial paralysis in 7 cases, otitis media in 1 case, a mass in parotid gland in 1 case and a mass on the side of the orbital on face in 1 case. Seven patients were undergone either CT scan or MRI or both. Image studies revealed mass located along the facial nerve course from the nerve endings to the intracranial parts. All the patients accepted the surgery. Intraoperative findings showed that the tumor location matched the image findings. Postoperative pathological diagnosis demonstrated 8 Schwannoma, 2 neurofibroma. There was partial tumor resection in 1 patient accepted and his nerve function was unchanged. Four patients were undergone facial nerve graft but 1 case failed while facial nerve function was improved in 3 other patients. Two patients underwent tumor resection while the continuity of facial nerve was preserved as result their facial nerve function improved respectively. No facial nerve reconstruction was done on other 2 patients.

CONCLUSIONSMultiple origins of facial nerve neuroma were noted and the most common system was facial nerve palsy. The decision on how to treat these patients should be individualized and based on initial facial function, growth rate, surgical experience and informed patient consent. The more effective methods need being seeked for the management of facial nerve neuroma.

Adolescent ; Adult ; Cranial Nerve Neoplasms ; diagnosis ; surgery ; Facial Nerve ; physiopathology ; Facial Paralysis ; diagnosis ; etiology ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Multiple Primary ; diagnosis ; surgery ; Retrospective Studies ; Young Adult

Biopsy, Fine-Needle ; Diagnosis, Differential ; Facial Paralysis ; diagnosis ; etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Parotid Gland ; pathology ; Sclerosis ; Sialadenitis ; diagnosis

Facial nerve palsy due to temporal bone metastasis of hepatocellular carcinoma (HCC) has rarely been reported. We experienced a rare case of temporal bone metastasis of HCC that initially presented as facial nerve palsy and was diagnosed by surgical biopsy. This patient also discovered for the first time that he had chronic hepatitis B and C infections due to this facial nerve palsy. Radiation therapy greatly relieved the facial pain and facial nerve palsy. This report suggests that hepatologists should consider metastatic HCC as a rare but possible cause of new-onset cranial neuropathy in patients with chronic viral hepatitis.
Carcinoma, Hepatocellular/complications/*pathology ; Facial Nerve Diseases/diagnosis/etiology ; Facial Pain/etiology ; Facial Paralysis/diagnosis/etiology ; Hepatitis B, Chronic/diagnosis ; Hepatitis C, Chronic/diagnosis ; Humans ; Immunohistochemistry ; Liver Neoplasms/complications/*pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Positron-Emission Tomography ; Skull Neoplasms/*diagnosis/pathology/secondary ; Tomography, X-Ray Computed

Kawasaki disease is a multisystem disorder with varying clinical expression. This is a report on one case of Kawasaki disease which during its clinical course developed facial nerve palsy and spontaneous recovery without specific treatment. It is hoped that this report will serve to remind physicians of the association of facial nerve paralysis with Kawasaki disease.
Aspirin/administration & dosage ; Case Report ; Facial Paralysis/*etiology ; Female ; Gamma-Globulins/administration & dosage ; Human ; Infant ; Mucocutaneous Lymph Node Syndrome/*complications/diagnosis/drug therapy

OBJECTIVETo observe the ways of diagnosis and treatment of bilateral facial nerve palsy.

METHODSSeven cases of bilateral facial nerve paralysis in 1996 - 2003 were retrospectively reviewed, and then the ways of diagnosis and therapies of these cases were analyzed. There were 6 patients with doubtless diagnosis. They were diagnosed as acute leukaemia, Vogt-Koyanagi-Harada disease (VKH), Machado-Jesoph disease, bilateral mandible fractures, Guillain-Barré syndrome, and Bell's palsy. The last one was diagnosed as Herpes zoster virus infection or Lyme disease. In all these cases, there were 4 of 5 positive cerebrospinal fluids test, 1 of 6 positive lyme antibody test, 2 of 5 positive images test, 7 of 7 EMG and Br test showed that the paralysis was peripheral palsy. All the 7 cases were treated with steroid and vitamin.

RESULTSHouse-Brackmann I was defined as complete recovery, after up to 2 months follow up, there were four cases got completely recovery while 2 cases incomplete recovery, and 1 case was not reacted to the therapy.

CONCLUSIONSBilateral facial nerve paralysis was rare, and it was difficult to diagnosis and differentiation, while diagnostic mistakes would be serious. More attention should be paid to it in clinic.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Facial Paralysis ; diagnosis ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVE: To explore the clinical features, pathologic characteristics and treatments of the facial paralysis caused by temporal bone tumors. METHOD: Retrospective analyzed the 23 clinical data of peripheral facial paralysis caused by temporal bone tumors, including 11 cases of facial nerve tumor: facial nerve neurilemmoma in 8 cases, facial nerve neurofibroma in 3 cases; 12 cases of temporal bone malignant tumor: temporal bone squamous cell carcinoma in 9 cases, chondrosarcoma in 1 case, rhabdomyosarcoma in 2 cases. All the patients accepted the CT scan examination and MRI examination. Twenty-three cases were surgically treated: facial nerve tumor resection were performed in 11 cases, among those, through mastoid approach in 7 cases, combined mastoid with middle cranial fossa approach in 3 cases, combined mastoid with parotid approach in 2 cases. Eight cases underwent facial nerve graft following the surgical removal of tumors. Twelve cases were temporal bone malignant tumor resection: among those, extended mastoidotympanectomy in 5 cases, subtotal temporal bone resection in 6 cases, total temporal bone resection in 1 case, all were treated by radiotherapies after surgeries. RESULT: Whether the tumors go along the facial nerve in imaging is the major identification method to identify the facial nerve tumors or no-facial nerve tumors. During the 3-8 years follow-up, 10 patients who were totally removed the facial nerve tumor were no recurrence, 1 patient had tumors present. The recurrence rate of temporal bone malignancy was 41. 7% (5/12), 5 cases of Stell stage T2 and 5 cases of stage T3. The 5-year survival rate was 66.7% (8/12). CONCLUSION Most of facial nerve tumors that cause the facial palsy are benign, and no-facial nerve tumors are most common among the malignant tumors. CT and MRI films are valuable for the diagnosis. Operation is the major treatment, the manner of the operation bases on the type and the extent of the tumors. Facial nerve grafting can improve the facial neurological function after the tumor excision. Malignancy should be treated by combination of operation and radiotherapy, etc.
Adolescent ; Adult ; Aged ; Bone Neoplasms ; complications ; pathology ; Child ; Facial Paralysis ; diagnosis ; etiology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Temporal Bone ; Young Adult

Objective: To explore the diagnosis, surgical management and outcome of jugular foramen chondrosarcoma (CSA). Methods: Fifteen patients with jugular foramen CSA hospitalized in the Department of Otorhinolaryngology Head and Neck Surgery of Chinese PLA General Hospital from December 2002 to February 2020 were retrospectively collected,of whom 2 were male and 13 were female, aging from 22 to 61 years old. The clinical symptoms and signs, imaging features, differential diagnosis, surgical approaches, function of facial nerve and cranial nerves IX to XII, and surgical outcomes were analyzed. Results: Patients with jugular foramen CSA mainly presented with facial paralysis, hearing loss, hoarseness, cough, tinnitus and local mass. Computed tomography (CT) and magnetic resonance (MR) could provide important information for diagnosis. CT showed irregular destruction on bone margin of the jugular foramen. MR demonstrated iso or hypointense on T1WI, hyperintense on T2WI and heterogeneous contrast-enhancement. Surgical approaches were chosen upon the sizes and scopes of the tumors. Inferior temporal fossa A approach was adopted in 12 cases, inferior temporal fossa B approach in 2 cases and mastoid combined parotid approach in 1 case. Five patients with facial nerve involved received great auricular nerve graft. The House Brackmann (H-B) grading scale was used to evaluate the facial nerve function. Preoperative facial nerve function ranked grade Ⅴ in 4 cases and grade Ⅵ in 1 case. Postoperative facial nerve function improved to grade Ⅲ in 2 cases and grade Ⅵ in 3 cases. Five patients presented with cranial nerves Ⅸ and Ⅹ palsies. Hoarseness and cough of 2 cases improved after operation, while the other 3 cases did not. All the patients were diagnosed CSA by histopathology and immunohistochemistry, with immunohistochemical staining showing vimentin and S-100 positive, but cytokeratin negative in tumor cells. All patients survived during 28 to 234 months' follow-up. Two patients suffered from tumor recurrence 7 years after surgery and received revision surgery. No complications such as cerebrospinal fluid leakage and intracranial infection occurred after operation. Conclusions: Jugular foramen CSA lacks characteristic symptoms or signs. Imaging is helpful to differential diagnosis. Surgery is the primary treatment of jugular foramen CSA. Patients with facial paralysis should receive surgery in time as to restore the facial nerve. Long-term follow-up is necessary after surgery in case of recurrence.
Humans ; Male ; Female ; Young Adult ; Adult ; Middle Aged ; Facial Paralysis/etiology* ; Diagnosis, Differential ; Jugular Foramina ; Retrospective Studies ; Cough ; Hoarseness ; Neoplasm Recurrence, Local ; Chondrosarcoma/surgery*