Predicting recovery in Bell's palsy.
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Biomedical subjects
Publications and source records attributed to N Uri.
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In an attempt to assess objectively the integrity of the auditory pathways in patients suffering from Bell's palsy, an audiometric evaluation was performed and auditory brain-stem evoked potentials (ABEP) were obtained from 24 patients within the first week from the onset of facial weakness. Despite negative audiometric findings, significant ABEP abnormalities (greater than 2.5 SDs) were observed for 25% of the sample. In each case the ABEP deviation suggested prolonged brain-stem conduction time; for some patients the aberration was only apparent with an increased stimulus repetition rate. The ABEP measures were found to be independent of the side or severity of the paralysis, the acoustic reflex, or reported dysacusis. The ABEP was of no value in predicting recovery of facial muscle function. It is suggested that the facial paralysis may be only the overt manifestation of a generalized pathologic condition.
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Congenital middle ear encephalocele (CMEE) is a rare entity, previously reported in only 29 patients. It might originate from dehiscence of the tegmen tympani or antri or the bony plate of the posterior fossa. The common presenting symptoms are spontaneous cerebrospinal fluid (CSF) otorrhea and/or rhinorrhea, persistent "serious otitis media," conductive hearing loss, and, occasionally, recurrent meningitis. We report a case of CMEE initially seen with progressive facial paresis, review the previously reported cases of CMEE, and discuss the pathogenesis and surgical management.
Choanal atresia is a well-known entity with various surgical approaches. The introduction of nasal endoscopic surgery made the endoscopic approach the most popular one because of excellent visualization and a good view of the choana to remove enough vomerian septal bone. Seven patients with choanal atresia were treated with 9 endoscopic procedures. Some practical operative details are described that can minimize the chance for restenosis.