Author(s): Jungehuelsing M, Sittel C, Fischbach R, Wagner M, Stennert E
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Abstract OBJECTIVE: To present and discuss the clinical presentation and treatment in patients with long-duration unilateral facial paralysis and normal magnetic resonance imaging (MRI) findings. DESIGN: Case series. SETTING: Ear, nose, and throat department of the University of Cologne, Cologne, Germany. PATIENTS: A total of 486 patients with unilateral facial paralysis who were treated from 1986 to 1998. Besides the usual diagnostic workup, a complete electrophysiological evaluation, including investigations such as needle electromyography and neuromyography (also known as electroneurography), of the facial nerve was performed at repeated intervals. In 19 patients, a malignant tumor was delineated with ultrasonography or MRI. In 8 of these patients, the initially performed MRI did not detect any parotid gland lesion causing the paralysis, whereas long duration of the paralysis and electroneurography indicated malignancy. RESULTS: Exploration surgery was performed as total parotidectomy in these 8 patients and malignant parotid gland tumors were proved in all 8 patients. CONCLUSIONS: Individuals with facial nerve paralysis without any signs of regeneration 6 months after the onset of paralysis and/or persistent electrophysiological evidence of ongoing neuronal degeneration should undergo surgical exploration of the parotid gland and facial nerve, even if MRI studies show no tumoral lesion.
This article was published in Arch Otolaryngol Head Neck Surg
and referenced in OMICS Journal of Radiology