Facial nerve neuroma appearing as a middle cranial fossa mass.A 65-year-old woman had a history of hearing loss of 1 year's duration and intermittent facial paralysis for at least 18 years. Magnetic resonance imaging magnetic resonance imaging (MRI), noninvasive diagnostic technique that uses nuclear magnetic resonance to produce cross-sectional images of organs and other internal body structures. demonstrated a large mass in the middle cranial fossa The middle fossa, deeper than the anterior cranial fossa, is narrow in the middle, and wide at the sides of the skull. It is bounded in front by the posterior margins of the small wings of the sphenoid, the anterior clinoid processes, and the ridge forming the anterior on the left (figure 1). The mass was diagnosed as a facial nerve neuroma neuroma /neu·ro·ma/ (ndbobr-ro´mah) a tumor growing from a nerve or made up largely of nerve cells and nerve fibers.neurom´atous acoustic neuroma arising from the geniculate ganglion. This mass did not produce a significant mass effect, which indicated a longstanding process. Computed tomography revealed a destructive process in the superior portion of the left petrous petrous /pet·rous/ (pet´rus) resembling a rock; hard; stony. pet·rous adj. 1. Of stony hardness. 2. bone (figure 2). Facial nerve neuromas arising from the geniculate ganglion tend to grow anteriorly and superiorly, eroding the petrous bone. Rarely do these lesions reach a large size or extend intracranially. [1] In this case, the lesion extended into the fundus fundus /fun·dus/ (fun´dus) pl. fun´di [L.] the bottom or base of anything; the bottom or base of an organ, or the part of a hollow organ farthest from its mouth. of the internal acoustic canal, which explains the patient's symptoms. Reference (1.) Kienzle GD, Goldenberg MH, Just NW, Arbit E. Facial nerve neurinoma presenting as middle cranial fossa mass: CT appearance. J Comput Assist Tomogr 1986;10:391-4. |
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