Facial neuroma.A 73-year-old man reported a 6-year history of intermittent severe pain in the midface. The patient characterized the pain as a sharp, electric sensation. The pain was worse when he was chewing, speaking, and otherwise moving his face. He also noted a left-sided hearing loss. Examination of the left ear revealed that a soft-tissue mass had filled the posterosuperior one-third of the middle ear (figure). Portions of the malleus malleus /mal·le·us/ (mal´e-us) [L.] the outermost of the auditory ossicles, and the one attached to the tympanic membrane; its club-shaped head articulates with the incus mal·le·us n. pl. and incus incus /in·cus/ (ing´kus) [L.] the middle of the three ossicles of the ear, which, with the stapes and malleus, serves to conduct vibrations from the tympanic membrane to the inner ear. Called also adj. Feeling or showing no interest or involvement; unconcerned: an uninvolved bystander. Adj. 1. portion of the tympanic membrane was normal and mobile on pneumatic otoscopy. Audiometry revealed that the patient had an air-conduction pure-tone average of 48 dB and a bone-conduction average of 23 dB. His facial function was normal bilaterally. Palpation palpation /pal·pa·tion/ (pal-pa´shun) the act of feeling with the hand; the application of the fingers with light pressure to the surface of the body for the purpose of determining the condition of the parts beneath in physical diagnosis. of the neck and salivary glands detected no masses or lesions. [FIGURE OMITTED] Computed tomography demonstrated a soft-tissue mass in the middle ear space and a bony expansion of the fallopian canal from the geniculate ganglion to the stylomastoid foramen. 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. showed a contrast-enhancing lesion in the same distribution in addition to a large arterial loop that had compressed the trigeminal ganglion on the left. A diagnosis of facial 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 and trigeminal neuralgia secondary to microvascular compression was made. The patient underwent stereotactic radiosurgery for treatment of the trigeminal neuralgia to good effect. Because his facial function remained normal, observation was the treatment of choice for the facial neuroma. Robert D. Cullen, MD; William H. Slattery, MD From the House Ear Clinic, Los Angeles. |
|
||||||||||||||||||||
Printer friendly
Cite/link
Email
Feedback
Reader Opinion