OBJECTIVE: To present and discuss the clinical presentation and treatment in patients with long-duration unilateral facial paralysis and normal magnetic resonance imaging (MRI) findings. DESIGN: Case series. SETTING: Ear, nose, and throat department of the University of Cologne, Cologne, Germany. PATIENTS: A total of 486 patients with unilateral facial paralysis who were treated from 1986 to 1998. Besides the usual diagnostic workup, a complete electrophysiological evaluation, including investigations such as needle electromyography and neuromyography (also known as electroneurography), of the facial nerve was performed at repeated intervals. In 19 patients, a malignant tumor was delineated with ultrasonography or MRI. In 8 of these patients, the initially performed MRI did not detect any parotid gland lesion causing the paralysis, whereas long duration of the paralysis and electroneurography indicated malignancy. RESULTS: Exploration surgery was performed as total parotidectomy in these 8 patients and malignant parotid gland tumors were proved in all 8 patients. CONCLUSIONS: Individuals with facial nerve paralysis without any signs of regeneration 6 months after the onset of paralysis and/or persistent electrophysiological evidence of ongoing neuronal degeneration should undergo surgical exploration of the parotid gland and facial nerve, even if MRI studies show no tumoral lesion.
OBJECTIVE: To present and discuss the clinical presentation and treatment in patients with long-duration unilateral facial paralysis and normal magnetic resonance imaging (MRI) findings. DESIGN: Case series. SETTING: Ear, nose, and throat department of the University of Cologne, Cologne, Germany. PATIENTS: A total of 486 patients with unilateral facial paralysis who were treated from 1986 to 1998. Besides the usual diagnostic workup, a complete electrophysiological evaluation, including investigations such as needle electromyography and neuromyography (also known as electroneurography), of the facial nerve was performed at repeated intervals. In 19 patients, a malignant tumor was delineated with ultrasonography or MRI. In 8 of these patients, the initially performed MRI did not detect any parotid gland lesion causing the paralysis, whereas long duration of the paralysis and electroneurography indicated malignancy. RESULTS: Exploration surgery was performed as total parotidectomy in these 8 patients and malignant parotid gland tumors were proved in all 8 patients. CONCLUSIONS: Individuals with facial nerve paralysis without any signs of regeneration 6 months after the onset of paralysis and/or persistent electrophysiological evidence of ongoing neuronal degeneration should undergo surgical exploration of the parotid gland and facial nerve, even if MRI studies show no tumoral lesion.
Authors: V Vander Poorten; A Triantafyllou; L D R Thompson; J Bishop; E Hauben; J Hunt; A Skalova; G Stenman; R P Takes; D R Gnepp; H Hellquist; B Wenig; D Bell; A Rinaldo; A Ferlito Journal: Eur Arch Otorhinolaryngol Date: 2015-12-19 Impact factor: 2.503
Authors: Madison J Hill; Karl M Hoegler; Albert E Zhou; Chloe R Snow; Amor Khachemoune Journal: Arch Dermatol Res Date: 2022-04-25 Impact factor: 3.017
Authors: Eun-Jae Chung; Damir Matic; Kevin Fung; S Danielle MacNeil; Anthony C Nichols; Ruba Kiwan; KengYeow Tay; John Yoo Journal: J Otolaryngol Head Neck Surg Date: 2022-10-18
Authors: Nicole J M Freling; Johannes H M Merks; Peerooz Saeed; Alfons J M Balm; Johannes Bras; Bradley R Pieters; Judit A Adam; Rick R van Rijn Journal: Pediatr Radiol Date: 2010-08-20