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At least 19 recordsLinked to original sources
PubMed2000

Complications of temporomandibular joint arthroscopy: a retrospective analysis of 301 lysis and lavage procedures performed using the triangulation technique.

PURPOSE: This study evaluated the complications of temporomandibular joint (TMJ) arthroscopic lysis and lavage performed using the triangulation technique. PATIENTS AND METHODS: The 202 consecutive patients (301 joints) who underwent arthroscopic lysis and lavage between 1992 and 1995 were retrospectively surveyed. The preoperative diagnosis of all patients was anterior disc displacement without reduction. RESULTS: Complications were observed in 31 (10.3%) of 301 cases of arthroscopic lysis and lavage. Of these, otologic complications were found in 26 cases (8.6%): blood clots in the external auditory canal in 9; laceration of external auditory canal in 7; partial hearing loss in 5; ear fullness in 2; vertigo in 1; and perforation of tympanic membrane with laceration of external auditory canal in 1. Neurologic injuries were found in 5 cases (1.7%): fifth cranial nerve injuries in 3; and seventh cranial nerve injuries in 2. No other complications were observed. CONCLUSIONS: A high level of understanding of the regional anatomy helps reduce the complications associated with arthroscopic lysis and lavage in the TMJ.

Adolescent↗
PubMedDate not supplied

Rehabilitation of patients with postoperative deficits cranial nerves VIII through XII.

Increasingly aggressive surgical attack upon disease in and about the base of the skull will continue to produce various combinations of deficits of the 8th through 12th cranial nerves. Although isolated paralyses of these nerves usually can be managed with little difficulty, various combinations of paralyses can result in loss of airway, voice, or swallowing functions that are challenging to the head and neck surgeon. A thorough understanding of the disordered physiologic conditions that these lesions can produce, coupled with a logical medical and surgical approach to their management, may result in better rehabilitation of these patients.

Accessory Nerve Injuries↗
PubMed1987

Peripheral nerve injuries during carotid endarterectomy.

Peripheral nerve injuries associated with carotid endarterectomy are fairly common but not emphasized in reported results of carotid endarterectomy. The sensory nerves to the submandibular skin and ear lobe are often damaged. Motor nerves VII, IX, X, XI and XII may be injured at surgery. The commonest motor injuries involve the facial, vagus and hypoglossal nerves. Carotid endarterectomy was studied prospectively over 1 year to document the incidence of nerve injury. Nerve injury occurred in 12% of patients, with facial and vagus nerves being involved in 4% each. Careful surgical technique based on appropriate anatomical knowledge can prevent most of these complications.

Carotid Arteries↗
PubMed1999

Cranial and cervical nerve injuries after carotid endarterectomy: a prospective study.

BACKGROUND: The purpose of this study was to review the outcome of patients who had cranial and cervical nerve injuries after carotid endarterectomy (CEA). METHODS: This prospective study reviewed 200 consecutive CEAs. Preoperative and postoperative cranial nerve assessment was completed on all patients. Neurologic evaluation included routine direct fiberoptic laryngoscopy. Patients found to have no neurologic injury had no further follow-up. Patients with postoperative peripheral neurologic dysfunction were enrolled for regular long-term follow-up to assess delayed recovery. RESULTS: Overall, 25 (12.5%) nerve injuries were identified in 24 patients. There were 11 (5.5%) hypoglossal, 8 (4%) recurrent laryngeal, 2 (1%) superior laryngeal, 2 (1%) marginal mandibular, and 2 (1%) greater auricular nerve injuries. None of the patients were lost to follow-up. All nerve dysfunctions were transient, with all but 4 nerves recovering completely within 6 months. The recovery took from 1 week to 37 months, with a mean recovery time of 5.8 months. Two patients with recurrent laryngeal nerve dysfunction were found to have prolonged full recovery time (i.e., 31 and 37 months, respectively). Two patients successfully underwent contralateral CEA, although movement of the opposite vocal cord was not fully restored. CONCLUSIONS: Cranial nerve injury after CEA is a common occurrence and can be classified as a "major" or "minor" complication, depending on the severity of the clinical consequences. Extended follow-up will identify the specific subset of patients with a late complete nerve recovery.

Adult↗
PubMedDate not supplied

Cranial nerve II-VII injuries in fatal closed head trauma.

PURPOSE: To study the distribution and mechanism of traumatic injuries to the nerves supplying the eye and muscles protecting the visual apparatus. METHODS: Brain autopsy was carried out in 12 consecutive patients who died within three days after closed head injury. A segment of the brainstem with the entire intracranial portion of nerves II-VII was dissected out in each case and fixed in formalin. The specimens were stripped of the leptomeninges and inspected thoroughly under magnification. RESULTS: Injuries to the nerves were seen in nine subjects. The oculomotor nerve was completely torn off from the midbrain unilaterally in three and bilaterally in two cases. In one patient only a portion of the superficial fibres on the medial aspect of the nerve was ripped out from the brainstem. In two patients the fourth nerve was ruptured. The root of the fifth cranial nerve was contused and the fibres between the brainstem and Gasserian ganglion crushed and separated in one case. Bilateral avulsion of the root of the sixth nerve from the brainstem was found in two cases. The initial segment of the facial nerve was crushed in two subjects. No visible injury to the optic nerves was found. CONCLUSIONS: Cranial nerves related to the visual system are subject to serious injury in a large proportion of cases of severe head trauma resulting from automobile accidents. In the majority of cases damage results from ripping the roots of these nerves out of the brainstem.

Accessory Nerve Injuries↗
PubMed2005

[Operative treatment of the vestibular schwannoma (acoustic neuroma): correlation between the microsurgical approach and cranial nerve lesion].

INTRODUCTION: Vestibular schwannoma (VS) is a benign tumour of cerebellopontine angle which total microsurgical resection is considered as a complex surgery. In Bosnia, VS microsurgical resection is performed occasionally and exclusively at the University Neurosurgical Depart. in Sarajevo, but radiosurgery of these tumours is completely absent. METHODS AND RESULTS: The role of microsurgery in resection of VS is being presented. Through analyzed series of operated patients (MJLink), we evaluated the correlation of VII and VIII nerves postoperative lesion with different operative approaches. House-Brackmann grading scale is used for VII nerve deficit appraisal. Current postoperative results of recognized experts are compared with our series and the similar morbidity rates are found. DISCUSSION: Microsurgery is a dominant and superior way of VS treatment. However, the most frequently used microsurgical approaches (retrosigmoid, translabyrinthine and extradural subtemporal) are still connected with certain morbidity rate, especially regarding the postoperative VII and VIII nerves lesion. CONCLUSION: Team approach, intraoperative cranial nerves monitoring and microsurgery with utilizing different surgical approaches optimize the outcome of VS neurosurgical treatment. In Bosnia, we are just stepping in the field of serious approach to this problem.

Facial Nerve Injuries↗
PubMed1980

Otologic lightning bolts.

Lightning induced damage to the ear is multifaceted. The seventh and eighth cranial nerves, the labyrinthine system, and the tympanic membrane are most commonly injured. A case report demonstrating all these injuries is presented.

Ataxia↗
PubMed1985

Translabyrinthine removal of cerebellopontine angle meningiomas.

The authors report two cases of the microscopic total removal of meningiomas in the region of the cerebellopontine angle using the translabyrinthine approach. Although both tumors were larger than 4 cm, the only resulting neurological deficit was ipsilateral hearing loss. The translabyrinthine approach may be an alternative measure in dealing with these difficult lesions.

Adult↗
PubMed1987

[Preservation of hearing in surgery of acoustic neuroma].

Between 1981 and 1984, 44 patients underwent acoustic neuroma removal by a posterior cranial fossa approach in an attempt to preserve hearing. 7 tumors were small (less than 20 mm), 28 were medium (20 to 40 mm) and 9 large (greater than 40 mm). Of these 44 patients, 4 had normal hearing preoperatively, 15 had serviceable hearing, 10 poor hearing and 15 no hearing. Postoperative hearing was preserved in 11 cases. Of the 19 patients with normal or serviceable hearing, 8 (42%) had serviceable hearing preserved postoperatively. Hearing preservation was achieved in 43% of the cases of small tumors, 25% of those medium tumors and 11% with large tumors. This study confirms the value of the suboccipital approach, which can be used in an attempt to preserve hearing whenever the patient has serviceable hearing preoperatively and whenever the tumor size makes in feasible.

Adult↗
PubMed1995

Changes in brainstem calcitonin gene-related peptide after VIIth and VIIIth cranial nerve lesions in guinea pig.

The present study investigated the effect of seventh and eight cranial nerve lesions on the prominence of calcitonin gene-related peptide in the hypoglossal (XII), facial (VII), abducens (VI), and oculomotor (III) cranial nerve nuclei. Guinea pigs were anesthetized and subjected to unilateral cochlear removal, vestibular end organ ablation, and seventh nerve transection. After a survival period ranging from 4 h to 5 days, each animal was anesthetized and perfused intracardially. Frozen sections were collected through the brainstem and stained immunohistochemically for calcitonin gene-related peptide using a polyclonal antibody with the Vectastain ABC kit and protocol. Positive cells were counted in each nucleus bilaterally and analyzed for side to side differences. Nuclei XII and III showed no significant difference in the numbers of cells staining positively for calcitonin gene-related peptide between the ipsilateral and the contralateral sides to the lesion. However, nuclei VII and VI showed elevated numbers ipsilateral to the lesion on some days, but not all. For VII, there was no significant difference before 24 h, but there were significant differences 1-5 days after the lesion. Similarly, in VI, there was no difference before 24 h, but differences were significant beginning with day 1 and continuing through day 3, and finally disappearing by day 4. Changes in the numbers of CGRP positive cells in VII measurable 24 h after the lesion and continuing for at least 5 days afterward indicate a central nervous system retrograde response to peripheral motor nerve injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Abducens Nerve↗
PubMed2004

[Subtemporal approach according to house versus Wigand in intrameatal CPA tumors type A].

BACKGROUND: The subtemporal approach is indicated in intrameatal CPA tumors type A in order to preserve hearing. The exploration of the inner auditory canal for tumor exposure varies. It reaches from a locally limited uncovering of the bony inner auditory canal to a complete removal of the surrounding bony bed with the circular skeletization (360 degrees ) according to Wigand of the 7 (th) and 8 (th) nerve. Concerning the preservation of the function of the cranial nerve as well as an avoidable hyperelevation of the temporal cerebral lobe with a possible consecutive organic brain syndrome, both approaches have often been discussed controversially. METHOD: In a quality assurance analysis, we examined patients suffering from a unilateral, intrameatally limited CPA tumor type A in tumor stages 1 to 5. The functions of the 7 (th) and 8 (th) cranial nerves were assessed according to the consensus conference "Systems for reporting results in acoustic neuroma", Tokyo, November 2001, under consideration of the recommendations of the "American Academy of Otolaryngology, Head and Neck Surgery -- Committee on hearing and equilibrium guidelines for the evaluation of hearing preservation in acoustic neuroma", 1995, as well as indications for a possible organic brain syndrome. The results then were compared to current literature. RESULTS: 37 patients with an intrameatal confined CPA tumor after subtemporal tumor exstirpation were evaluated. In these patients, the inner auditory canal was only exposed in the area of the bony tectum (90 degrees - 120 degrees ) adjusted to the volume of the tumor, as described by House: 1 patient with tumor stage 1, 2 patients stage 2, 12 patients stage 3, 16 patients stage 4 and 6 patients with a tumor stage 5. The N. VII was anatomically preserved in 100 %. Immediately after surgery the function of N. VII was assessed in 32 % of the cases as stage I, 43 % stage II, 3 % stage IIIa, 14 % stage IIIb, 3 % stage IV, 0 % stage V, 5 % stage VI. All patients in stage VI had a restricted function of N. VII in stage II or IIIa already before surgery. N. VIII could be preserved anatomically in 78 % of the cases. 1 to 6 months postoperatively the hearing was at stage A in 10 % of the cases, at 25 % in stage B, 33 % in stage C, 16 % in stage D, 5 % in stage E and 11 % in stage F. One patient demonstrated signs of a possible organic brain syndrome postoperatively even after 12 months of latency (headache, unsteady walking, attention disorders). CONCLUSION: When comparing own data with the clinical results from literature, no differences can be found concerning the function of the 7 (th) and 8 (th) cranial nerves. There are no data concerning the incidence of a potential organic brain syndrome. The advantage of the House method is a noticeably reduced drilling time as well as possibly a reduced elevation of the temporal cerebral lobes. The Wigand method, however, allows a better overview and is needed for extrameatally growing tumors anyway.

Cranial Nerve Injuries↗