RESUMEN
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Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Pérdida Auditiva/etiología , Neuroma Acústico/cirugía , Oído Medio/cirugía , Otoscopía , Parálisis Facial/diagnóstico , Complicaciones PosoperatoriasRESUMEN
Middle ear ossicle malformations are an uncommon event. Among them, the congenital absence of the stapes is a very rare condition that is seldom described in the literature. We report the cases of two women, aged 19 and 22 , who presented with a long history of conductive deafness. An exploratory tympanotomy was performed and the absence of the stapes superstructure and an abnormal position of the facial nerve could be observed. A bone anchored hearing aid (BAHA) was implanted in both patients with good results. It is believed that stapes agenesis is related to an abnormal development of the facial nerve, which by the 5th to 6th week of gestation would interpose between the otic capsule and the stapes blastema, preventing these structures from contacting. A long history of nonprogressive hearing loss from birth or early childhood is the key to reach a diagnosis. Several treatment options have been described. The authors opted for a hearing aid due to the high risk of facial nerve lesion, with good functional results.
Asunto(s)
Nervio de la Cuerda del Tímpano , Neoplasias de los Nervios Craneales , Enfermedades del Nervio Facial , Neuroma , Neoplasias de los Nervios Craneales/diagnóstico , Neoplasias de los Nervios Craneales/cirugía , Enfermedades del Nervio Facial/diagnóstico , Enfermedades del Nervio Facial/cirugía , Femenino , Humanos , Persona de Mediana Edad , Neuroma/diagnóstico , Neuroma/cirugíaRESUMEN
Aunque el déficit de origen traumático del séptimo par craneal es una entidad común en la práctica neuroquirúrgica, la parálisis facial bilateral asociada a fracturas temporales supone un episodio infrecuente. Describimos el caso de un paciente de 38 años que sufre un traumatismo craneoencefálico severo (Glasgow Coma Scale de 7). En la TC inicial se apreció una fractura de peñasco longitudinal derecha y transversal izquierda. El paciente ingresó en la unidad de cuidados intensivos y, tras la extubación, se comprobó la existencia de una diplejía facial bilateral. El déficit bilateral del séptimo par craneal posee una etiología distinta al déficit unilateral. En estos casos, la ausencia de asimetría facial puede dificultar el diagnóstico, por lo que la TC de alta resolución y el estudio electromiográfico son útiles para su detección (AU)
Although traumatic injury of the facial nerve is a relatively common condition in neurosurgical practice, bilateral lesions related to fracture of temporal bones are seldom seen. Were port the case of a 38-year-old patient admitted to Intensive Care Unit after severe head trauma requiring ventilatory support (Glasgow Coma Scale of 7 on admission). A computed tomography (CT) scan confirmed a longitudinal fracture of the right temporal bone and a transversal fracture of the left. After successful weaning from respirator, bilateral facial paralysis was observed. The possible aetiologies for facial diplegia differ from those of unilateral injury. Due to the lack of facial asymmetry, it can be easily missed in critically ill patients, and both the high-resolution CT scan and electromyography studies can be helpful for correct diagnosis (AU)
Asunto(s)
Humanos , Masculino , Adulto , Parálisis Facial/etiología , Traumatismos Craneocerebrales/complicaciones , Fractura Craneal Basilar/complicaciones , Traumatismos del Nervio Facial/complicaciones , Cuidados Críticos/métodosRESUMEN
Although traumatic injury of the facial nerve is a relatively common condition in neurosurgical practice, bilateral lesions related to fracture of temporal bones are seldom seen. We report the case of a 38-year-old patient admitted to Intensive Care Unit after severe head trauma requiring ventilatory support (Glasgow Coma Scale of 7 on admission). A computed tomography (CT) scan confirmed a longitudinal fracture of the right temporal bone and a transversal fracture of the left. After successful weaning from respirator, bilateral facial paralysis was observed. The possible aetiologies for facial diplegia differ from those of unilateral injury. Due to the lack of facial asymmetry, it can be easily missed in critically ill patients, and both the high resolution CT scan and electromyographic studies can be helpful for correct diagnosis.