MyMedR

Congenital bilateral facial nerve hypoplasia with sensorineural hearing loss: a case report

Hamizan AW, Yean KT, Abdullah A

Int J Pediatr Otorhinolaryngol, 2012 Mar;76(3):455-9.

PMID: 22281372 DOI: 10.1016/j.ijporl.2012.01.002

A 3-year-old child presented with congenital bilateral facial nerve palsy with bilateral profound sensorineural hearing loss. High Resolution Computed Tomogram (HRCT) of the temporal bones found bilateral atresia of cochlear nerve canals, incomplete partition of the cochleae and narrow facial nerve canals. Magnetic resonance imaging (MRI) revealed bilateral hypoplasia of facial nerves and aplasia of both vestibulocochlear nerves. There have been no other reported cases with this presentation. The possible aetiology and treatment options for the patient are discussed. We highlighted the review of aplasia/hypoplasia of the facial nerve and hypoplasia of cochlear nerve canal.

Matched MeSH terms: Facial Paralysis/complications*; Facial Paralysis/congenital*; Facial Paralysis/diagnosis

Duplicate internal auditory canals with facial and vestibulocochlear nerve dysfunction

Kew TY, Abdullah A

J Laryngol Otol, 2012 Jan;126(1):66-71.

PMID: 21867589 DOI: 10.1017/S0022215111002258

We report an extremely rare case of duplication of the internal auditory canal associated with dysfunction of both the facial and vestibulocochlear nerves. We also review the literature regarding the integrity of the facial and vestibulocochlear nerves in such cases.

Matched MeSH terms: Facial Paralysis/physiopathology

Fulltext A Rare Case of an Undiagnosed Middle Ear Tumor Due to Late Referral

Ng JJ, Ong HY, Nasseri Z, Azmi MI, Abdullah A

Cureus, 2021 Jan 08;13(1):e12584.

PMID: 33457146 DOI: 10.7759/cureus.12584

Facial nerve tumors constitute about 5% of all facial nerve paralysis. As it is relatively uncommon, it could be misdiagnosed. We encountered an 18-year-old girl who had right facial weakness since the age of four, referred to otorhinolaryngology clinic for further evaluation only when her hearing deteriorated and the facial weakness worsened. Further investigation revealed facial nerve schwannoma. Facial nerve paralysis in the pediatric age group is uncommon and should be examined in detail to rule out other possible etiologies besides Bell's palsy.

Matched MeSH terms: Facial Paralysis

Fulltext Facial nerve paralysis: a rare complication of parotid abscess

Sabir Husin Athar PP, Yahya Z, Mat Baki M, Abdullah A

Malays J Med Sci, 2009 Apr;16(2):38-9.

PMID: 22589657

Benign parotid neoplasm and inflammatory processes of the parotid resulting in facial paralysis are extremely rare. We report a 72-year-old Malay female with poorly-controlled diabetes mellitus who presented with a painful right parotid swelling associated with right facial nerve palsy. The paralysis (Grade VI, House and Brackmann classification) remained after six months.

Matched MeSH terms: Facial Paralysis

Fulltext Rare case of temporal bone carcinoma with intracranial extension

Kasim KS, Abdullah AB

Indian J Otolaryngol Head Neck Surg, 2012 Dec;64(4):397-8.

PMID: 24294589 DOI: 10.1007/s12070-011-0250-6

Temporal bone cancer, a relatively rare disease, accounting for less than 0.2% of all tumors of the head and neck and is associated with a poor outcome; often presents in a subtle manner, which may delay diagnosis. It should be suspected in any case of persistent otitis media or otitis externa that fails to improve with adequate treatment. Despite advances in operative technique and postoperative care, long-term survival remains poor). It includes cancers arising from pinna that spreads to the temporal bone, primary tumors of the external auditory canal (EAC), middle ear, mastoid, petrous apex, and metastatic lesions to the temporal bone. Here is a report on a case of temporal bone carcinoma presenting with right otalgia, otorrhea and facial paralysis. The patient was initially diagnosed as mastoiditis and later the clinical impression was revised to temporal bone carcinoma (undifferentiated type), based on the pathologic findings.

Matched MeSH terms: Facial Paralysis

Fulltext Retrospective review of facial nerve schwannomas: the universiti kebangsaan malaysia medical centre experience

Mazita, A., Zahirrudin, Z., Saim, L., Asma, A.

Medicine & Health, 2010;5(2):86-92.

MyJurnal

Facial nerve schwannoma is a rare slow growing benign tumour which arises from the Schwann cell of the neurilemma. A retrospective review of 6 patients who had been diagnosed with facial nerve schwannoma between 1998 and 2008 was conducted. There was equal distribution of male and female patients. The mean age was 42 years (range 19 to 66 years). The tumour originated in the internal auditory canal (2 patients), intra-temporal (3 patients) and intraparotid (1 patient) segments of the facial nerve. All tumours were successfully removed and facial nerve continuity was pre-served in 2 cases. The presenting symptoms of facial nerve schwannoma are non specific and dependent on the site of tumour origin. It is a great mimicker of other lesions that can present at the same location. The surgeon should have a high index of suspicion when patients present with progressive facial nerve palsy. Patients should always be counselled regarding risk of facial paralysis because the diagnosis of facial nerve schwannoma is often confirmed intra-operatively.

Matched MeSH terms: Facial Paralysis

Fulltext Parotid abscess: an unusual cause of facial nerve palsy

Noorizan Y, Chew YK, Khir A, Brito-Mutunayagam S

Med J Malaysia, 2009 Jun;64(2):172-3.

PMID: 20058583 MyJurnal

Facial nerve palsy with a parotid mass is usually associated with malignant neoplasm of parotid gland. Its occurrence as a complication of parotid abscess is extremely rare. A literature review revealed only 16 cases of facial nerve palsy associated with suppurative parotitis or parotid abscess were reported. We present a case of deep parotid abscess which is complicated by facial nerve dysfunction. Underlying neoplasia was excluded.

Matched MeSH terms: Facial Paralysis/etiology*

Fulltext Facial nerve palsy in otitis externa: A red flag?

Badaruddin A, Choo MM

Malays Fam Physician, 2021 Mar 25;16(1):117-120.

PMID: 33948150 DOI: 10.51866/cr1108

Otitis externa is an infection of the external auditory canal. It rarely results in facial palsy except in severe cases such as necrotizing otitis externa, which is a life-threatening invasive infection of the external auditory canal. Early recognition with prompt and appropriate treatment of necrotizing otitis externa is crucial to prevent more sinister complications. Here we report a case of an elderly gentleman who presented with otitis externa and developed facial palsy a month later. We identified possible problems that may have led to the complication so that such an occurrence can be prevented in the future.

Matched MeSH terms: Facial Paralysis

Fulltext A Case Series of Malignant Otitis Externa Mimicking Malignancy

Selvamalar V, Othman NAN, Daud MK

Acta Medica (Hradec Kralove), 2021;64(1):36-41.

PMID: 33855957 DOI: 10.14712/18059694.2021.6

Malignant otitis externa is an inflammation of the external auditory canal with preceding osteomyelitis of the temporal bone and the adjacent structures that could be potentially lethal. Malignant otitis externa may present with cranial nerve involvements and massive spread of disease mimicking nasopharyngeal carcinoma or any other malignancies on imaging. Two elderly patients who presented with severe otalgia and significant facial nerve palsy and lower cranial nerve palsies showing extensive spread of disease are reported in this case series. They both had resolution of disease after a prolonged course of antibiotics and cortical mastoidectomy for disease clearance in one of them.

Matched MeSH terms: Facial Paralysis/diagnosis; Facial Paralysis/therapy

Fulltext Recurrent Bell's palsy in a young woman

Ngow HA, Wan Khairina WM, Hamidon BB

Singapore Med J, 2008 Oct;49(10):e278-80.

PMID: 18946598

Bell's palsy is a benign lower motor neuron facial nerve disorder. It is almost always unilateral. We report a 20-year-old nulliparous woman with five episodes of recurrent Bell's palsy. A review of recent medical literature revealed a paucity of case reports involving an individual with five episodes of recurrent Bell's palsy, with none found in Asian neurology medical literature. Despite the multiple episodes of Bell's palsy recurrences, the patient did not suffer much neurological sequelae from the disease.

Matched MeSH terms: Facial Paralysis/complications

Fulltext Managing a Complicated Acute Otomastoiditis at Day Four of Life

Lim R, Zulkifli S, Hailani I, Hashim ND

Cureus, 2021 Jan 25;13(1):e12905.

PMID: 33654590 DOI: 10.7759/cureus.12905

Acute mastoiditis in a newborn complicated by the presence of facial nerve palsy is an alarming finding requiring rapid assessment and further investigation. Such an early presentation should point the clinician towards an underlying systemic pathology or congenital anatomical abnormality. Facial nerve involvement indicates severe infection and possible dehiscence of the facial canal. Although more frequent in children, it is rare in neonates. We would like to share our experience in managing the youngest known presentation of otomastoiditis at four days of life. The patient presented with otorrhea and facial paralysis and progressed to meningitis. He was finally diagnosed with chronic granulomatous disease.

Matched MeSH terms: Facial Paralysis

Relapse of B-cell acute lymphoblastic leukaemia presenting as right aural polyp with facial and mandibular nerves palsy

Shiun Chuen C, Md Daud MK, Che Jalil NA, Hazmi H

Med J Malaysia, 2017 10;72(5):318-320.

PMID: 29197892 MyJurnal

A patient presenting with an ear polyp is a common finding in otorhinolaryngology practice. The common causes include chronic otitis media and cholesteatoma. We report an adult female patient with a history of acute leukaemia presenting with chronic otitis media symptoms and right ear polyp. She was subsequently diagnosed as relapse of B-cell acute lymphoblastic leukaemia based on histopathological examination. The presentation may be similar to an inflammatory pathology of the middle ear, making it misleading.

Matched MeSH terms: Facial Paralysis/physiopathology*

Surgical outcomes of transmastoid facial nerve decompression: Preliminary data from a Malaysian tertiary hospital from 2013-2018

Siang PG, Ying XT, Dayang Suhana AM, Ing PT

Med J Malaysia, 2020 05;75(3):281-285.

PMID: 32467545

INTRODUCTIONS: Facial nerve palsy (FNP) occurs in 7-10% of temporal bone fractures. The aim of this study was to review the surgical outcome of nine patients with severe to complete traumatic facial nerve (FN) injury.

METHODS: The patients were evaluated clinically and FNP was graded using the House Brackmann (HB) scale. High resolution computerized tomography (HRCT) of the temporal bone was used to evaluate temporal bone fractures. Transmastoid facial nerve decompression was performed and the facial nerve function was re-evaluated in subsequent follow ups.

RESULTS: There were five cases with immediate onset and four with delayed onset of FNP. Only three cases had pure temporal bone fractures, the others were associated with other life threatening injuries. The sensitivity and specificity of HRCT temporal bone to detect the obvious facial canal fracture line were 50% and 40% respectively. 75% of patients with immediate onset of HB grade VI FN palsy who were operated within a month recovered completely. Surgeries for the delayed onset FNP were performed at a mean of 70 days (range 51-94). All recovered to HB grade II-III from severe FNP.

CONCLUSIONS: Our study demonstrated that transmastoid FN decompression surgery was beneficial to traumatic nerve injury. Early intervention resulted in better outcomes. However, FN function could still be salvaged even in delayed FN decompression.

Matched MeSH terms: Facial Paralysis/surgery*

Methylcobalamin treatment of Bell's palsy

Jalaludin MA

Methods Find Exp Clin Pharmacol, 1995 Oct;17(8):539-44.

PMID: 8749227

Sixty patients with Bell's palsy were included in an open randomized trial. Patients were assigned into three treatment groups: steroid (group 1), methylcobalamin (group 2) and methylcobalamin + steroid (group 3). Comparison between the three groups was based on the number of days needed to attain full recovery, facial nerve scores, and improvement of concomitant symptoms. The time required for complete recovery of facial nerve function was significantly shorter ( p < 0.001) in the methylcobalamin (mean of 1.95 +/- 0.51 weeks) and methylcobalamin plus steroid groups (mean of 2.05 +/- 1.23 weeks) than in the steroid group (mean of 9.60 +/- 7.79 weeks). The facial nerve score after 1-3 weeks of treatment was significantly more severe (p < 0.001) in the steroid group compared to the methylcobalamin and methylcobalamin plus steroid groups. The improvement of concomitant symptoms was better in the methylcobalamin treated groups than the group treated with steroid alone.

Matched MeSH terms: Facial Paralysis/drug therapy*

Fulltext Facial nerve palsy by nasal tumour--a case report

Khanijow VK

Med J Malaysia, 1991 Sep;46(3):259-61.

PMID: 1667539

A case of an adenoid cystic carcinoma of the minor salivary glands of then nasal cavity is reported. The tumour had spread locally and by perineural spread to the internal auditory mentus, causing facial nerve palsy.

Matched MeSH terms: Facial Paralysis/etiology*

Fulltext Keratosis obturans complicated with facial nerve palsy: a diagnostic dilemma

Saniasiaya J, Nik Othman NA, Mohamad Pakarul Razy NH

Braz J Otorhinolaryngol, 2016 05 24;86(1):130-132.

PMID: 27269254 DOI: 10.1016/j.bjorl.2016.04.012

Matched MeSH terms: Facial Paralysis/etiology

Fulltext Facial nerve palsy in a child: Bell's palsy? Think again!

Sam JE, Priya S, Nasser AW

Malays Fam Physician, 2017;12(3):30-32.

PMID: 29527278

Introduction: Half of facial paralysis in children is idiopathic at origin. However, dismissing facial paralysis as being idiopathic without a thorough history and meticulous examination could be disastrous as illustrated by this case.

Case report: We report a case of sphenoid wing meningioma in a 4-year-old girl. She first presented with only facial asymmetry that was noticed by her mother. Examination suggested a left upper motor neuron facial nerve palsy. A sphenoid wing meningioma was found on magnetic resonance imaging (MRI) of her brain. She underwent craniotomy and total tumour excision. Histopathological examination of the tumour showed a grade 1 transitional type meningioma. Meningiomas in children are rare compared to the adult population. Presentations in children may be delayed due to their inability to recognise or communicate abnormalities. Distinguishing between upper and lower motor neuron facial palsy is crucial in decision making for facial paralysis in children.

Matched MeSH terms: Facial Paralysis

Fulltext Intra-aural tick resulting in facial nerve paresis

Rajinder S, Nik Adilah NO

Malays Fam Physician, 2017;12(3):25-27.

PMID: 29527276 MyJurnal

The presence of a tick in the ear is an uncommon problem encountered by the department of otorhinolaryngology. A tick infestation in the ear can be a traumatising experience for the patient. Here, we report a case of a woman who presented with left facial weakness due to the presence of a tick in the external auditory canal.

Matched MeSH terms: Facial Paralysis

Fulltext Isolated facial palsy due to intra-aural tick (ixodoidea) infestation

Zamzil Amin, A., Baharudin, A., Shahid, H., Din Suhaimi, S., Nor Affendie, M.J.

Archives of Orofacial Sciences, 2007;2(1):51-53.

MyJurnal

A tick in the ear is a very painful condition and removal is difficult because it grips firmly to the external auditory canal or tympanic membrane. Facial paralysis is a rarely reported localised neurological complication of an intra-aural tick infestation. The pathophysiology of localised paralysis is discussed, together with the safe way of handling patients with an intra-aural tick infestation.

Matched MeSH terms: Facial Paralysis

Fulltext Ancient Schwannoma Of The Facial Nerve: An Unusual Histological Variant Of A Rare Disease

Baharudin, A., Din Suhaimi, S., Omar, E.

International Medical Journal Malaysia, 2006;5(2):1-4.

MyJurnal

Schwannomas are benign slow growing lesions arising from the Schwann cells that ensheath the axons of the peripheral, cranial and autonomic nervous systems. Intracranial schwannomas develop from the facial nerve much more rarely than from the vestibular or trigeminal nerves. Ancient schwannoma is an unusual histological variant of this rare disease. A 48 years old man who had recurrent facial nerve paralysis and right external auditory mass is presented in this case report.

Matched MeSH terms: Facial Paralysis

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