Objective:To exploring the value of MR neuroimaging for quantitative assessment of the facial nerve and peripheral lymph nodes in patients with acute peripheral facial paralysis. Methods:Based on a prospective experimental design, 32 patients with idiopathic peripheral facial palsy were enrolled in the experiment. Based on MR neuroimaging technology, MR high-resolution thin-layer images of bilateral facial nerves were acquired. The diameters of different segments of the bilateral facial nerve were measured, including the labyrinthine segment, the geniculate ganglion, the horizontal segment, the vertical segment, the stem-mammary foramen segment, the trunk of the parotid segment, the temporal trunk, and the cervical trunk, as well as the quantitative indicators of peri-auricular and parotid lymph nodes（number, length and diameter of the largest lymph nodes）. Differences in quantitative indices of nerve diameter and peripheral lymph nodes between the paraplegic and healthy sides were compared using the paired t-test and Wilcoxon signed rank test. Results:The diameter of geniculate ganglion, mastoid foramen stem, parotid main trunk, temporal facial trunk, and cervical facial trunk were notably increased on the facial paralysis side compared to the contralateral side（P<0.05）. However, no significant differences were observed in the diameter of labyrinthine segment, horizontal segment, or vertical segment compared to the contralateral side. There were significantly more periauricular lymph nodes on the facial paralysis side than the contralateral side（P=0.001）. Conclusion:MR neuroimaging enables the quantitative assessment of structural changes in the facial nerve of patients with acute peripheral facial paralysis, demonstrating nerve enlargement in the geniculate ganglion, stylomastoid foramen segment, main trunk of the parotid segment, temporal facial trunk, and cervical facial trunk. Additionally, an increased number of periauricular lymph nodes is observed on the affected side. These findings may aid clinicians in assessing the efficacy of treatments and predict the prognosis of these patients.
Humans ; Facial Nerve/diagnostic imaging* ; Magnetic Resonance Imaging/methods* ; Prospective Studies ; Female ; Male ; Neuroimaging/methods* ; Lymph Nodes/diagnostic imaging* ; Facial Paralysis/diagnostic imaging* ; Adult ; Middle Aged

Objective:To explore the value of high resolution computed tomography（HRCT） combined with Magnetic Resonance Imaging（MRI） in the diagnosis of inner ear malformation. Methods:HRCT and MRI data of 82 patients with inner ear malformations were analyzed retrospectively. HRCT MPR and CPR reconstruction of the inner ear structure, facial nerve canal and oblique sagittal MRI reconstruction of the internal auditory canal were performed. The inner ear malformations were classified, the conditions of facial nerve canal and cochlear nerve were evaluated. The association between inner ear malformation and cochlear nerve dysplasia were analyzed by Chi-square test with continuity correction. Results:Among the 82 patients with inner ear malformations,there were 49 cases of bilateral symmetry, 11 cases of bilateral asymmetry and 22 cases of unilateral inner ear malformations. Respectively, the most prevalent types were IP-Ⅱ（42.96%）, dilatation of atrium aqueduct（18.31%） and malformations of atrium and semicircular canal 19.72%. Out of 50 cases of cochlear malformations,only 3 were isolated cochlear malformations, and the rest were accompanied by other malformations of varying degrees. In the 67 ears examined by MRI, 26（38.81%） had cochlear nerve deficiency（CND）, and the incidence of CND varied with different types of inner ear malformations. Out of 142 ears, 28（19.72%） had abnormalities of the facial nerve canal. Conclusion:HRCT combined with MRI can accurately distinguish the types of inner ear malformation and effectively evaluate the facial nerve canal and cochlear nerve, and further provides the important finger and Guide value for the clinician to formulate the reasonable treatment and the operation plan.
Humans ; Ear, Inner/diagnostic imaging* ; Magnetic Resonance Imaging/methods* ; Retrospective Studies ; Female ; Male ; Tomography, X-Ray Computed/methods* ; Child ; Adolescent ; Adult ; Child, Preschool ; Cochlear Nerve/diagnostic imaging* ; Facial Nerve/abnormalities* ; Cochlea/abnormalities* ; Infant ; Young Adult

Objective:To observe the position and morphology of tubular cell in lateral facial recess by CT scanning and surgical finding, and its clinical significance. Methods:Thirty patients（32 ears） with cholesteatoma and/or adhesive otitis media requiring radical mastoidectomy and tympanoplasty were included in this study. To observe the morphology of the tubular cell in the lateral facial recess cavity through temporal bone HRCT and surgery, and to analyze its relationship with the facial nerve. Results:Tubular cell were found in 59.4%（19/32） ears by temporal bone HRCT and through surgeon. The length ranged from 1.5-6.5 mm, with median length of 2.5 mm. All of them opened in the facial recess, ran on the posterior wall of the facial recess, and even reached the bottom of the inferior tympanic cavity or the level of the inferior wall of the external auditory canal（sagittal view and surgical findings）. Probing from the inside out, the tubular cell located between the second genu of the facial nerve and the chorda tympani, which was a part of the lateral wall of the facial nerve（facial crest）. When the tubular cell is occupied by granulation tissue, it is easy to be regarded as the facial nerve. Fully drilling out the tubular cell is helpful to cut down the facial nerve crest. In the study, the follow-up and/or postoperative no facial paralysis happens during the operation and in the follow up. Conclusion:Preoperative temporal bone HRCT can clearly show the tubular cell in the lateral facial recess cavity. Comprehensive and accurate identification of these structures is helpful to fully cut down the facial nerve crest and remove the hidden lesions in the posterior tympanic cavity.
Humans ; Facial Nerve/diagnostic imaging* ; Tomography, X-Ray Computed ; Male ; Adult ; Temporal Bone/diagnostic imaging* ; Otitis Media/surgery* ; Female ; Middle Aged ; Cholesteatoma, Middle Ear/diagnostic imaging* ; Mastoidectomy/methods* ; Tympanoplasty/methods* ; Young Adult ; Adolescent ; Clinical Relevance

A 61-year-old female presented with 4 years history of left-sided hemifacial spasm. Head MRI and angiography indicated left vertebral artery dissecting aneurysm which compressed ipsilateral cranial nerves Ⅶ and Ⅷ. Microvascular decompression was performed. The dissecting aneurysm was pushed apart and the distal part of the parent artery was adhered to the dura on the petrosum. The compressed nerves were totally decompressed. The symptom of facial spasm was completely resolved immediately after surgery and did not recur during 6 months of follow up.
Cerebral Angiography ; Facial Nerve ; pathology ; Female ; Hemifacial Spasm ; surgery ; Humans ; Magnetic Resonance Imaging ; Microvascular Decompression Surgery ; Middle Aged ; Nerve Compression Syndromes ; diagnosis ; etiology ; surgery ; Vertebral Artery Dissection ; diagnostic imaging ; surgery ; Vestibulocochlear Nerve ; pathology

Classical trigeminal neuralgia is characterized by recurrent attacks of lancinating pain in the trigeminal nerve distribution, and no cause of the symptoms can be identified, other than vascular compression. This type of injury may rarely be caused by identifiable conditions, including tumor in the cerebellopontine angle. If the patient is suspected for secondary trigeminal neuralgia, further evaluation is required to diagnose and treat correctly. We report a case of a 49-year-old woman with a 1-month history of facial pain, who was initially misdiagnosed as odontalgia, and even treated with the extraction of her molar teeth. This case with the review of secondary trigeminal neuralgia may highlight the difficulties of diagnosis, and the importance of early diagnostic imaging, when trigeminal neuralgia occurs with a brain tumor.
Brain Neoplasms ; Cerebellopontine Angle ; Diagnostic Imaging ; Facial Pain ; Female ; Humans ; Meningioma ; Molar ; Neuroma, Acoustic ; Tooth ; Toothache ; Trigeminal Nerve ; Trigeminal Neuralgia

OBJECTIVE: To explore a method of demonstrating the facial nerve anatomical landmarks under transmastoid and epitympanum approach with multi-slice CT using double oblique multi-planar reconstruction (MPR). METHOD: Two temporal bone of a corpse were dissected, under transmastoid and epitympanum approach, to observe the anatomical landmarks of facial nerve. Based on that, the anatomical landmarks of facial nerve under transmastoid and epitympanum approach in 30 (60 ears) normal temporal bones of adult corpses were reconstructed using double oblique MPR in multi-slice CT. The achievement ratio was calculated and the differences among transverse plane, coronal plane, sagittal plane and double oblique were compared. RESULT: The different part of facial nerve, such as mastoid segment, tympanum segment, pyramid segment, geniculate ganglion and the outer labyrinthine segment could be exposed clearly with the main anatomical landmarks, such as horizontal semicircular canal, epitympanic recess and cochleariform process through transmastoid and epitympanum approach. The image of anatomical landmarks could be showed in the same sections by double oblique multi-planar reconstruction. The double oblique multi-planar reconstruction to show the landmarks of facial nerve displaying on the same imaging is better than transverse plane, coronal plane and sagittal plane. The achievement ratio of every section is 100%. CONCLUSION Double oblique MPR is a new method to demonstrate anatomical landmarks through transmastoid and epitympanum approach in one slice. Combined with the operative approach and purpose, the reconstructive images with double oblique MPR can provide valuable information for operation.
Adult ; Ear, Middle ; diagnostic imaging ; surgery ; Facial Nerve ; diagnostic imaging ; surgery ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Mastoid ; diagnostic imaging ; surgery ; Tomography, Spiral Computed

OBJECTIVE: To study the vertical and pyramidal segment of facial nerve canal based on three-dimensional reconstruction of temporal bone CT, and provide a quantitative data for the middle ear and mastoid surgery. METHOD: Reconstruction of adult axial CT images shows the vertical and pyramidal segment of facial nerve canal. Using the Able Software 3D-DOCTOR 3.5 to show and measure the angle of the vertical and pyramidal segment of the facial nerve canal and to analyze the features and regularity based on the measured data. RESULT: According to the angle of the vertical and pyramidal segment of facial nerve canal based on the three-dimensional reconstruction model. A certain regularity has been found in the direction and the angle of different segments of the vertical and pyramidal segment of facial nerve canal. CONCLUSION The temporal bone CT three-dimensional reconstruction can accurately show the characteristic and angle of the vertical and pyramidal segment of facial nerve canal. The characteristics and quantitative angle of the vertical and pyramidal segment of facial nerve canal from the anatomical viewpoint for clinical utility could keep the vertical and pyramidal segment of facial nerve from injury in temporal bone surgery.
Adult ; Ear, Middle ; diagnostic imaging ; Facial Nerve ; diagnostic imaging ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Mastoid ; diagnostic imaging ; Middle Aged ; Temporal Bone ; diagnostic imaging ; Tomography, Spiral Computed ; Young Adult

Anti-Inflammatory Agents ; therapeutic use ; Aspirin ; therapeutic use ; Child ; Facial Nerve Diseases ; diagnosis ; etiology ; Facial Paralysis ; diagnosis ; etiology ; Humans ; Immunoglobulins, Intravenous ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnostic imaging ; Platelet Aggregation Inhibitors ; therapeutic use ; Prednisolone ; therapeutic use ; Ultrasonography ; Warfarin ; therapeutic use

OBJECTIVE: To investigate the diagnostic value of high resolution CT for temporal bone traumatic facial nerve paralysis and the guidance significance for surgery. METHOD: Twenty-nine patients of traumatic facial nerve paralysis were investigated. The predictive diagnosis was made according to the clinical data and the image features of HRCT, then a comparative analysis of the preoperative image features and the surgical findings were carried out. RESULT: The trend of temporal bone fracture displayed on the CT scan was basically consisted with the surgical findings. The direct CT signs of facial nerve injury include the bone fracture line went through the tube, bone tube rupture or continuity interruption, while the indirect CT signs include local incrassation of the facial nerve, lower bone density of the tube, geniculate fossa expansion, oppressed facial nerve, et al. The predictive diagnostic accordance rates of all the image features were above 90% as to the surgical findings. CONCLUSION High resolution CT could localize the trend of temporal bone fracture,and is helpful to estimate the extent of facial nerve injury and other complications. High resolution CT could provide reliable basis for clinical diagnosis and treatment.
Adolescent ; Adult ; Facial Nerve ; diagnostic imaging ; Facial Nerve Injuries ; diagnostic imaging ; Facial Paralysis ; diagnostic imaging ; Female ; Fractures, Bone ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Temporal Bone ; diagnostic imaging ; injuries ; Tomography, X-Ray Computed ; methods ; Young Adult

OBJECTIVETo analyze the misdiagnosis of facial nerve tumor and better understand facial nerve tumor.

METHODSTwenty-eight patients with facial nerve tumor were undergone surgical treatment during January 1993 to September 2006. Eleven patients had been misdiagnosed. All patients were undergone pure tone audiometry, CT scan or MRI. Facial nerve function was evaluated with House-Brackmann grading system.

RESULTSEleven cases were misdiagnosed. Two cases were misdiagnosed as parotid tumor preoperatively. They were identified as facial never tumor because the masses originated from facial nerve during the surgery and confirmed by pathological examination. Four cases with unilateral facial nerve paralysis lasting from one year to eight years had been misdiagnosed as Bell palsy. Two cases with recurrent facial nerve palsy were misdiagnosed as Bell palsy. Finally MRI and CT demonstrated a mass at the genicular segment of facial nerve. One case with hearing loss and mass in external acoustic meatus was misdiagnoses as external acoustic meatus neoplasm. It was verified as facial schwannomas by biopsy and CT scan. One case with ear discharge, tympanic membrane perforation, soft tissue mass at epitympanum was misdiagnosed as chronic suppurative otitis media, lump was found close to the horizontal segment of facial nerve intraoperatively, and then it was confirmed as facial schwannomas by pathology. One case with soft tissue mass at mastoid and facial paralysis lasting about one and a half years was misdiagnosed as congenital cholesteatoma preoperatively. After admission, MRI study revealed the mass was involved in the facial nerve and parotid gland, and facial nerve tumor was suspected. All the 11 cases were undergone surgery, and the diagnosis was confirmed pathologically.

CONCLUSIONSFacial nerve tumor was rare and unfamiliar with most of Otologists. The present study showed that the three symptoms or signs should be alert: patient presents with facial paralysis does not partially recovered within six months or patient presents with recurrent facial paralysis, CT scan and MRI should be ordered for these patients to rule out space-occupation along facial nerve. Soft tissue mass associates with the horizontal or vertical segment of facial nerve should be distinguished with Cholesteatoma and otitis media while patient complains of facial paralysis. Parotid neoplasm close to facial nerve should be considered it originates from facial nerve.

Adolescent ; Adult ; Child ; Cranial Nerve Neoplasms ; diagnosis ; Diagnostic Errors ; Facial Nerve Diseases ; diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurilemmoma ; diagnosis ; Tomography, X-Ray Computed ; Young Adult