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PubMed1978

Attempts to isolate virus from human trigeminal and facial ganglions.

Herpes virus hominis type 1 was isolated from the trigeminal ganglion (ganglion semilunare, gasservian) in three out of 20 randomly selected autopsies. Two of the three patients had been treated with immunosuppressive or cytostatic agents. Clinical signs of herpes infection were not observed during the previous 6 months. No virus was isolated from the facial ganglion (geniculate ganglion) in the same 20 cases. The findings are discussed in relation to the viral etiology of acute peripheral facial palsy.

Adult↗
PubMed1991

Distribution of the cells of primary afferent fibers to the cat auricle in relation to the innervated region.

The origin and peripheral distribution of the primary afferent fibers to the cat auricle were studied by the horseradish peroxidase (HRP) method. Following HRP injection into the whole region of the auricle, HRP-labeled cells were found ipsilaterally in the trigeminal ganglion, geniculate ganglion, superior ganglion of the vagus nerve and in the C1 to C4 spinal ganglia. In addition to the ganglia of cranial and spinal nerves, labeled cells were also observed in the facial nerve trunk and in the dorso-lateral portion of the superior cervical ganglion. In the case of HRP injection into the central region of the auricle, labeled cells were principally observed in the ganglia of cranial nerves and to a lesser degree in the spinal ganglia. On the contrary, in the case of HRP injection into the peripheral region of the auricle, labeled cells were principally observed in the spinal ganglia, although some were seen in the ganglia of cranial nerves. This study suggests that the cutaneous innervation of the auricle is supplied by both the cranial and spinal nerves, and that the central region of the auricle is strongly innervated by the cranial nerves and the peripheral region of the auricle is strongly innervated by the spinal nerves.

Afferent Pathways↗
PubMed2006

[Landmark of facial nerve in middle ear surgery].

OBJECTIVE: To re-evaluate landmarks for facial nerve in middle ear surgery through temporal bone dissection and facial nerve surgery. METHODS: Some relative landmarks were found through 44 facial nerves dissection in cadaver and 106 cases of facial nerve decompression surgery. RESULTS: (1) Landmarks for vertical segment of the facial nerve: the vertical line in combined point between posterior and middle 1/3 horizontal semicircular canal clews the posterior edge of facial nerve; the prolong line of superior radian of incus short process clues to the anterior edge of the facial nerve, the facial nerve and horizontal semicircular canal are almost in the same plane. (2) Landmarks for horizontal segment of the facial nerve: the facial nerve tracks forward inferior to short process of incus and anterior to horizontal semicircular canal carina in 30 angel. The facial nerve, locating posterior and superior to cochleariform process and parallel with it, forms the step of middle-superior tympanic cavity and tracks forward to geniculate ganglion. (3) location of geniculate ganglion: The same distance prolong line of stapes head to cochleariform process clues to geniculate ganglion. (4) Location of the chorda tympani nerve: chorda tympani nerve, leaving tympanic sulcus at 3 clock of bone canaline left ear and at 9 clock of bone canaline right ear, tracks forward along tympani sulcus and then cross between long process of incus and manubrium. It lies in the border of pars tensa and pars flaccid and is about 5 - 8 mm from the stylomastoid foramen to where the chorda tympani nerve leaves the facial nerve. There is no difference of facial nerve structure in temporal bone dissection and in surgery. CONCLUSIONS: The fixed landmarks of middle ear are the frame of reference of facial nerve, in which horizontal semicircular canal is most invariable; and the safety of surgery will be improved by the reference of the facial nerve.

Ear, Middle↗
PubMed1996

MRI of the facial nerve in idiopathic facial palsy.

The purpose of this prospective study was to define the enhancement pattern of the facial nerve in idiopathic facial paralysis (Bell's palsy) on magnetic resonance (MR) imaging with routine doses of gadolinium-DTPA (0.1 mmol/kg). Using 0.5T imager, 24 patients were examined with a mean interval time of 13.7 days between the onset of symptoms and the MR examination. Contralateral asymptomatic facial nerves constituted the control group and five of the normal facial nerves (20.8%) showed enhancement confined to the geniculate ganglion. Hence, contrast enhancement limited to the geniculate ganglion in the abnormal facial nerve (3 of 24) was referred to as equivocal. Not encountered in any of the normal facial nerves, enhancement of other segments alone or associated with geniculate ganglion enhancement was considered to be abnormal and noted in 70.8% of the symptomatic facial nerves. The most frequently enhancing segments were the geniculate ganglion and the distal intracanalicular segment.

Adolescent↗
PubMed1995

Transganglionic degeneration in the gustatory system consequent to chorda tympani damage.

The chorda tympani taste nerve is prone to damage in humans. Chorda tympani damage results in taste loss accompanied by altered taste sensations, e.g., phantom tastes. To understand taste alterations this study explores the central and peripheral anatomical consequences of taste nerve injury in an animal model. The chorda tympani was severed in the middle ear of hamsters and the animals were allowed to survive for 2-161 days when sections of the brain were stained for degenerating axons with the Fink-Heimer method. Degenerating axons were present in the chorda tympani termination zone in the nucleus of the solitary tract of every case. Thus, peripheral nerve damage in the taste system results in degeneration of central axonal endings as in other sensory systems (e.g., trigeminal, vestibular). To evaluate whether the central degeneration results from ganglion cell death, geniculate ganglion cells were labeled with Fast blue by tongue injections before neurotomy, and the cells were counted 13-48 days after neurotomy. Numbers of labeled cells from experimental ganglia did not differ significantly from those in control ganglia. Moreover, the experimental cells could be double-labeled by tongue injections with a second marker, diamidino yellow or nuclear yellow, after 40 days postneurotomy. We conclude that degeneration of central axons after taste nerve section represents a long-lasting transganglionic process that likely disrupts the synaptology of the central taste system. The altered synaptology could relate to taste phenomena of central origin reported for nerve-injured patients. Geniculate ganglion cells generally survive neurotomy and can regenerate axons to the tongue.

Animals↗
PubMed1998

Innervation of single fungiform taste buds during development in rat.

To determine whether the innervation of taste buds changes during postnatal development, the number of geniculate ganglion cells that innervated single fungiform taste buds were quantified in the tip- and midregions of the tongue of adult and developing rats. There was substantial variation in both the size of individual taste buds and number of geniculate ganglion cells that innervated them. Importantly, taste bud morphology and innervation were highly related. Namely, the number of labeled geniculate ganglion cells that innervated a taste bud was highly correlated with the size of the taste bud (r = 0.91, P < .0003): The larger the taste bud, the more geniculate ganglion cells that innervated it. The relationship between ganglion cell number and taste bud volume emerged during the first 40 days postnatal. Whereas there was no difference in the average number of ganglion cells that innervated individual taste buds in rats aged 10 days postnatal through adulthood, taste bud volumes increased progressively between 10 and 40 days postnatal, at which age taste bud volumes were similar to adults. The maturation of taste bud size was accompanied by the emergence of the relationship between taste bud volume and number of innervating neurons. Specifically, there was no correlation between taste bud size and number of innervating geniculate ganglion cells in 10-, 20-, or 30-day-old rats, whereas taste bud size and the number of innervating ganglion cells in 40-day-old rats were positively correlated (r = .80, P < .002). Therefore, the relationship between taste bud size and number of innervating ganglion cells develops over a prolonged postnatal period and is established when taste buds grow to their adult size.

Afferent Pathways↗
PubMed2001

Herpes virus reactivation and gadolinium-enhanced magnetic resonance imaging in patients with facial palsy.

OBJECTIVE: This study investigated whether magnetic resonance imaging (MRI) patterns were different between patients with Bell's palsy and those with herpetic facial palsy in whom varicella-zoster virus (VZV) or herpes simplex virus type 1 (HSV-1) reactivation had been confirmed by polymerase chain reaction (PCR) or serologic assay. STUDY DESIGN: A retrospective study of 15 patients with acute peripheral facial palsy was performed to compare virologic tests and gadolinium (Gd)-enhanced MRI findings. RESULTS: Ramsay Hunt syndrome was diagnosed in one patient. By use of virologic tests, zoster sine herpete (VZV reactivation without zoster) was diagnosed in four patients and HSV-1 reactivation in three. Bell's palsy was diagnosed in the remaining seven patients. No significant difference in the frequency of Gd-enhanced MRI was observed between herpetic facial palsy and Bell's palsy. However, in those patients who underwent MRI on the day viral reactivation was confirmed by PCR, Gd enhancement of the meatal fundus was observed infrequently. In addition, when MRI was performed within 10 days of the onset of palsy, Gd enhancement was not detected at the geniculate ganglion in any patients with herpetic facial palsy. By contrast, both the meatal fundus and the geniculate ganglion were enhanced in all patients with Bell's palsy, regardless of when MRI was performed with respect to the onset of palsy. CONCLUSION: This study shows a difference in the pattern of Gd enhancement at the meatal fundus and the geniculate ganglion between patients with Bell's palsy and those with herpetic facial palsy. The results suggest that the meatal fundus or the geniculate ganglion may be affected first by virus reactivation in patients with herpetic facial palsy.

Acute Disease↗
PubMed1993

The vestibulocochlear ganglion in human embryos at stage 13.

In embryos at stage 13th vestibulocochlear ganglion forms a complex structure with the geniculate ganglion. The geniculate ganglion is placed rostrally and may be distinguished from the vestibulocochlear ganglion. Also at this stage there is a sign of differentiation of the vestibular and cochlear ganglia.

Ganglia↗
PubMed2004

Neuron/target plasticity in the peripheral gustatory system.

Taste bud volume on the anterior tongue in adult rats is matched by an appropriate number of innervating geniculate ganglion cells. The larger the taste bud, the more geniculate ganglion cells that innervate it. To determine if such a match is perturbed in the regenerated gustatory system under different dietary conditions, taste bud volumes and numbers of innervating neurons were quantified in adult rats after unilateral axotomy of the chorda tympani nerve and/or maintenance on a sodium-restricted diet. The relationship between taste bud size and innervation was eliminated in rats merely fed a sodium-restricted diet; individual taste bud volumes were smaller than predicted by the corresponding number of innervating neurons. Surprisingly, the relationship was disrupted in a similar way on the intact side of the tongue in unilaterally sectioned rats, with no diet-related differences. The mismatch in these groups was due to a decrease in average taste bud volumes and not to a change in numbers of innervating ganglion cells. In contrast, individual taste bud volumes were larger than predicted by the corresponding number of innervating neurons on the regenerated side of the tongue; again, with no diet-related differences. However, the primary variable responsible for disrupting the function on the regenerated side was an approximate 20% decrease in geniculate ganglion cells available to innervate taste buds. Therefore, the neuron/target match in the peripheral gustatory system is susceptible to surgical and/or dietary manipulations that act through multiple mechanisms. This system is ideally suited to model sensory plasticity in adults.

Animals↗
PubMed2005

Bell's palsy and Herpes simplex virus: fact or mystery?

HYPOTHESIS AND BACKGROUND: In recent years, progress has been made in the understanding of Bell's palsy, the most common form of acute facial weakness. Herpes simplex virus (HSV) reactivation within the geniculate ganglion with subsequent inflammation and entrapment of the nerve at the meatal foramen has been proposed to be the pathogenetic mechanism. We challenged its accuracy by analyzing our own data on the presence of viral genomic DNA of HSV-1 and 2, human herpes virus (HHV)-6A/B, as well as varizella zoster virus (VZV) in patients with Bell's palsy and in control patients without the disease. METHODS: Polymerase chain reaction was performed with primer sets specific for viral genomic DNA of HSV-1, HSV-2, and VZV in facial muscle biopsy specimens from patients with Bell's palsy. As control specimens, the Scarpa's ganglion of patients with Meniere's disease and the geniculate ganglion harvested at autopsy from patients without history of facial palsy. In a second study, we used polymerase chain reaction with primers specific for HSV-1, -2, and HHV-6A, -6B to analyze for the presence of these viruses in tear fluid samples from control patients and patients with acute Bell's palsy. RESULTS: HSV-1 and VZV genomic DNA were detected in 86 and 43%, respectively, of geniculate ganglion preparations from control specimen. We were not able to detect the presence of HSV-1, HSV-2, or VZV genomic DNA in ganglion scarpae or muscle biopsy results in control and Bell's palsy patients. HHV-6A could be detected in tear fluid samples in 40% of control patients and 30% of Bell's palsy patients. CONCLUSIONS: The sole presence of HSV genomic DNA within the sensory ganglion along the facial nerve does not explain the direct association with Bell's palsy. The missing link would be the identification of an active replicating virus, an investigation that has not yet been carried out.

Bell Palsy↗
PubMed1986

The distribution and significance of aberrant ganglion cells in the facial nerve trunk of the cat.

The distribution and peripheral connections of aberrant ganglion cells in the facial nerve trunk of the cat were studied by means of Klüver-Barrera staining and retrograde transport of horseradish peroxidase (HRP). By the Klüver-Barrera staining, aberrant ganglion cells were observed in the facial nerve trunk between the geniculate ganglion and the junction of the auricular branch of the vagus with the facial nerve trunk, although the number varied considerably with each animal. These cells were generally medium-sized and of round or oval shape, with densely stained Nissl substance, the features of which were essentially similar to those of the geniculate ganglion. In cases where HRP injections were made into the anterior wall of the auricle, several HRP-labeled cells were found ipsilaterally in the facial nerve trunk in addition to cell labeling of the geniculate ganglion. The present study in the cat demonstrated that at least some of the aberrant ganglion cells scattered in the facial nerve trunk are parental to the axons to the auricle, subserving the cutaneous sensory function.

Animals↗
PubMed2005

Bilateral traumatic facial paralysis associated with unilateral abducens palsy: a case report.

Bilateral traumatic facial paralysis is a very rare clinical condition. Abducens palsy, associated with bilateral traumatic paralysis, is even rarer and has not been well described in the literature. In this report, a 24-year-old male, who developed immediate bilateral facial and right abducens paralyses following a motor vehicle accident, is presented. The patient was referred for neurotologic evaluation 22 days after the injury. Electroneurography (ENoG) demonstrated 100 per cent degeneration at the first examination and, correspondingly, electromyography showed no regeneration potentials. Using high-resolution computed tomography (HRCT), a longitudinal fracture on the right and a mixed-type fracture on the left were identified. The patient had good cochlear reserve on both sides. The decision for surgery was based not on ENoG, because of the delayed referral of the patient, but on the HRCT, which showed clear fracture lines on both sides. The middle cranial fossa approach for decompression of the right facial nerve was performed on the 55th day following the trauma, and a combined procedure using the middle cranial fossa and transmastoid approaches was applied for decompression of the left facial nerve on the 75th day following the trauma. On the right, there was dense fibrosis surrounding the geniculate ganglion and the proximal tympanic segment whereas, on the left, bone fragments impinging on the geniculate ganglion, dense fibrosis surrounding the geniculate ganglion, and a less extensive fibrotic tissue surrounding the pyramidal segment were encountered. There were no complications or hearing deterioration. At the one-year follow up, the patient had House-Brackmann (HB) grade 1 recovery on the right, and HB grade 2 recovery on the left side, and the abducens palsy regressed spontaneously. The middle cranial fossa approach and its combinations can be performed safely in bilateral temporal bone fractures as labyrinthine sparing procedures if done on separate occasions.

Abducens Nerve Injury↗