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Marc-elie Nader - One of the best experts on this subject based on the ideXlab platform.
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Delayed facial nerve decompression for severe refractory cases of Bell’s palsy: a 25-year experience
Journal of Otolaryngology - Head & Neck Surgery, 2018Co-Authors: Ilyes Berania, Mohamed Awad, Issam Saliba, Jean-jacques Dufour, Marc-elie NaderAbstract:Background This study aims to assess the effectiveness of delayed facial nerve decompression for Bell’s palsy (BP). Methods We performed a retrospective case review of all patients having undergone facial nerve decompression for severe refractory BP between 1984 and 2009 at our tertiary referral center. Demographics, timing between onset of symptoms and surgical decompression, degree of facial nerve dysfunction pre- and post-operatively, follow-up length after surgery and postoperative complications were recorded. Facial nerve dysfunction was assessed using the House-Brackmann (HB) scale. Electroneuronography, electromyography and imaging results were assessed when available. Results Eighteen patients had surgery between 21 and 60 days after onset of BP (group I), and 18 patients had surgery more than 60 days after onset of symptoms (group II). In group II, 11 patients had surgery between 61 and 89 days and 7 patients after 90 days. Groups I and II showed similar functional gain and rates of improvement to HB 3 or better (11/18 vs. 11/18, p > 0.05). In group II, patients operated 60 to 89 days after onset of BP showed a significantly higher rate of improvement to HB 3 or better (9/11 vs. 2/6, p = 0.049) with higher functional gain compared to those operated after 90 days ( p = 0.0293). Conclusions When indicated, facial nerve decompression for BP is usually recommended within the first 2 weeks of onset of facial paralysis. Nonetheless, our results suggest that patients with severe BP could benefit from decompression surgery within 90 days after onset of symptoms in the absence of an opportunity to proceed earlier to surgery. Further investigation is still required to confirm our findings. Trial registration Retrospective registered. IRB# 2016–6154, CE 15.154 – CA
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delayed facial nerve decompression for severe refractory cases of bell s palsy a 25 year experience
Journal of Otolaryngology-head & Neck Surgery, 2018Co-Authors: Ilyes Berania, Mohamed Awad, Issam Saliba, Jean-jacques Dufour, Marc-elie NaderAbstract:This study aims to assess the effectiveness of delayed facial nerve decompression for Bell’s palsy (BP). We performed a retrospective case review of all patients having undergone facial nerve decompression for severe refractory BP between 1984 and 2009 at our tertiary referral center. Demographics, timing between onset of symptoms and surgical decompression, degree of facial nerve dysfunction pre- and post-operatively, follow-up length after surgery and postoperative complications were recorded. Facial nerve dysfunction was assessed using the House-Brackmann (HB) scale. Electroneuronography, electromyography and imaging results were assessed when available. Eighteen patients had surgery between 21 and 60 days after onset of BP (group I), and 18 patients had surgery more than 60 days after onset of symptoms (group II). In group II, 11 patients had surgery between 61 and 89 days and 7 patients after 90 days. Groups I and II showed similar functional gain and rates of improvement to HB 3 or better (11/18 vs. 11/18, p > 0.05). In group II, patients operated 60 to 89 days after onset of BP showed a significantly higher rate of improvement to HB 3 or better (9/11 vs. 2/6, p = 0.049) with higher functional gain compared to those operated after 90 days (p = 0.0293). When indicated, facial nerve decompression for BP is usually recommended within the first 2 weeks of onset of facial paralysis. Nonetheless, our results suggest that patients with severe BP could benefit from decompression surgery within 90 days after onset of symptoms in the absence of an opportunity to proceed earlier to surgery. Further investigation is still required to confirm our findings. Retrospective registered. IRB# 2016–6154, CE 15.154 – CA
Villegas González, Mario Jesús - One of the best experts on this subject based on the ideXlab platform.
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Valor de las exploraciones neurotológicas en el diagnóstico, localización y seguimiento de los neurinomas del acústico
'Universitat Autonoma de Barcelona', 2004Co-Authors: Villegas González, Mario JesúsAbstract:El neurinoma del acústico (NA) es una neoplasia benigna que se origina de la rama vestibular del VIII par craneal en el conducto auditivo interno (CAI) y en el ángulo pontocerebeloso (APC). Constituye el 8 al 9% de las tumoraciones intracraneales y el 80 al 90% de las tumoraciones del APC. Los estudios epidemiológicos demuestran que la incidencia clínica anual de NA varía de entre el 0.7 a 1 por cada 100,000 habitantes. El crecimiento de estas tumoraciones es impredecible por lo que el tratamiento quirúrgico es requerido en la mayoría de los casos. Los reportes de la literatura señalan la importancia de diagnosticar a las tumoraciones tempranamente, debido a la relación existente entre el menor tamaño tumoral y una mejor evolución postoperatoria.Consideramos que el desarrollo de los NA en el trayecto del VIII par craneal (desde el fondo del CAI hasta el APC) estará relacionado con los síntomas de presentación y los síntomas al momento del diagnóstico, y que estas tumoraciones producirán alteraciones específicas durante la realización de las exploraciones neurotológicas que harán sospechar al clínico de la existencia del NA, con lo cual se podrá realizar un diagnóstico temprano de la tumoración. Para estudiar las características de los NA en diferentes estadios incluimos a 133 pacientes, los cuales fueron divididos en tres grupos en relación al tamaño de los neurinomas del acústico confirmados a través de la resonancia magnética nuclear (RMN):- Grupo I: Tumores intracanaliculares puros- Grupo II: Tumores - Grupo III: Tumores > a 2.5 cm en APC o tamaño grande en APCTodos los pacientes fueron sometidos a las siguientes exploraciones neurotológicas:- Audiometría tonal y vocal- Potenciales evocados auditivos de tronco cerebral- Videonistagmografía y pruebas calóricas- Electroneuronografía facialEn esta tesis estudiamos los síntomas que refirieron los pacientes durante su evolución hasta el momento del diagnóstico según el grupo tumoral y realizamos una revisión bibliográfica de cada síntoma en su relación con los NA. Así mismo, estudiamos las bases fisiológicas y anatómicas en las que las exploraciones neurotológicas están fundadas para determinar la relación existente entre las alteraciones encontradas durante la realización de los estudios y los diferentes grupos tumorales, con el fin de diagnosticar a los NA en una fase más temprana, con la consiguiente reducción de la morbilidad, la preservación del nervio facial y la conservación de la audición útil.Acoustic neuromas (AN) are benign tumors that arise form the vestibular bundle of the eighth cranial nerve in the internal auditory canal (IAC) and cerebellopontine angle (CPA). Represent eight to nine percent of intracranial tumors and account for 80% to 90% of tumors of the CPA. The epidemiologic studies show a yearly clinical incidence of diagnosed acoustic neuroma 0,7 to 1 per 100,000 habitants. The growth great of these tumors are unpredictable, thus surgical resection is required in most cases of AN. The literature shows the importance of make an early diagnosis due the relation between the smaller tumor size and the better postoperative evolution.We have considered that the developed of the AN in the eighth cranial nerve (from fundus of the IAC to CPA) is related with the evolution of the symptoms, and these tumors will produce specifics alterations in the neurotologic explorations that could be suspect the existence of AN, made possible an early diagnosis of the tumor.For the study of the characteristics of the AN tumor in different stages, we included 133 patients. These patients were divided in three groups according to the size of the tumor in the magnetic resonance imaging (MRI):- Grupo I: intracanalicular tumors (exclusively)- Grupo II: Tumor - Grupo III: Tumor > 2.5 cm in CPAC o large size in CPAAll patients underwent thorough neurotologic evaluation, wich included:- Pure-tone audiometry and speech audiometry- Auditory brainstem response- Videonystagmography- Facial Electroneuronography- Magnetic resonance imaging (MRI)The aim of this thesis is to study the symptoms referred by the patients during their evolution until the diagnosis of AN could be done and make a bibliographic revision of each symptom and its relation with the tumor. Likewise, we study the anatomical and physiological basis of the neurotologic explorations to determine the relationship among the pathological findings discovered during the realization of the procedure and the tumoral gorup, with the aim of an early detection of the AN tumor, in order to reduce morbidity with the preservation of the facial nerve and conservation of the serviceable hearing
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Valor de las exploraciones neurotológicas en el diagnóstico, localización y seguimiento de los neurinomas del acústico
Bellaterra : Universitat Autònoma de Barcelona, 2004Co-Authors: Villegas González, Mario JesúsAbstract:Consultable des del TDXTítol obtingut de la portada digitalitzadaEl neurinoma del acústico (NA) es una neoplasia benigna que se origina de la rama vestibular del VIII par craneal en el conducto auditivo interno (CAI) y en el ángulo pontocerebeloso (APC). Constituye el 8 al 9% de las tumoraciones intracraneales y el 80 al 90% de las tumoraciones del APC. Los estudios epidemiológicos demuestran que la incidencia clínica anual de NA varía de entre el 0.7 a 1 por cada 100,000 habitantes. El crecimiento de estas tumoraciones es impredecible por lo que el tratamiento quirúrgico es requerido en la mayoría de los casos. Los reportes de la literatura señalan la importancia de diagnosticar a las tumoraciones tempranamente, debido a la relación existente entre el menor tamaño tumoral y una mejor evolución postoperatoria. Consideramos que el desarrollo de los NA en el trayecto del VIII par craneal (desde el fondo del CAI hasta el APC) estará relacionado con los síntomas de presentación y los síntomas al momento del diagnóstico, y que estas tumoraciones producirán alteraciones específicas durante la realización de las exploraciones neurotológicas que harán sospechar al clínico de la existencia del NA, con lo cual se podrá realizar un diagnóstico temprano de la tumoración. Para estudiar las características de los NA en diferentes estadios incluimos a 133 pacientes, los cuales fueron divididos en tres grupos en relación al tamaño de los neurinomas del acústico confirmados a través de la resonancia magnética nuclear (RMN): - Grupo I: Tumores intracanaliculares puros - Grupo II: Tumores a 2.5 cm en APC o tamaño grande en APC Todos los pacientes fueron sometidos a las siguientes exploraciones neurotológicas: - Audiometría tonal y vocal - Potenciales evocados auditivos de tronco cerebral - Videonistagmografía y pruebas calóricas - Electroneuronografía facial En esta tesis estudiamos los síntomas que refirieron los pacientes durante su evolución hasta el momento del diagnóstico según el grupo tumoral y realizamos una revisión bibliográfica de cada síntoma en su relación con los NA. Así mismo, estudiamos las bases fisiológicas y anatómicas en las que las exploraciones neurotológicas están fundadas para determinar la relación existente entre las alteraciones encontradas durante la realización de los estudios y los diferentes grupos tumorales, con el fin de diagnosticar a los NA en una fase más temprana, con la consiguiente reducción de la morbilidad, la preservación del nervio facial y la conservación de la audición útil.Acoustic neuromas (AN) are benign tumors that arise form the vestibular bundle of the eighth cranial nerve in the internal auditory canal (IAC) and cerebellopontine angle (CPA). Represent eight to nine percent of intracranial tumors and account for 80% to 90% of tumors of the CPA. The epidemiologic studies show a yearly clinical incidence of diagnosed acoustic neuroma 0,7 to 1 per 100,000 habitants. The growth great of these tumors are unpredictable, thus surgical resection is required in most cases of AN. The literature shows the importance of make an early diagnosis due the relation between the smaller tumor size and the better postoperative evolution. We have considered that the developed of the AN in the eighth cranial nerve (from fundus of the IAC to CPA) is related with the evolution of the symptoms, and these tumors will produce specifics alterations in the neurotologic explorations that could be suspect the existence of AN, made possible an early diagnosis of the tumor. For the study of the characteristics of the AN tumor in different stages, we included 133 patients. These patients were divided in three groups according to the size of the tumor in the magnetic resonance imaging (MRI): - Grupo I: intracanalicular tumors (exclusively) - Grupo II: Tumor 2.5 cm in CPAC o large size in CPA All patients underwent thorough neurotologic evaluation, wich included: - Pure-tone audiometry and speech audiometry - Auditory brainstem response - Videonystagmography - Facial Electroneuronography - Magnetic resonance imaging (MRI) The aim of this thesis is to study the symptoms referred by the patients during their evolution until the diagnosis of AN could be done and make a bibliographic revision of each symptom and its relation with the tumor. Likewise, we study the anatomical and physiological basis of the neurotologic explorations to determine the relationship among the pathological findings discovered during the realization of the procedure and the tumoral gorup, with the aim of an early detection of the AN tumor, in order to reduce morbidity with the preservation of the facial nerve and conservation of the serviceable hearing
Ilyes Berania - One of the best experts on this subject based on the ideXlab platform.
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Delayed facial nerve decompression for severe refractory cases of Bell’s palsy: a 25-year experience
Journal of Otolaryngology - Head & Neck Surgery, 2018Co-Authors: Ilyes Berania, Mohamed Awad, Issam Saliba, Jean-jacques Dufour, Marc-elie NaderAbstract:Background This study aims to assess the effectiveness of delayed facial nerve decompression for Bell’s palsy (BP). Methods We performed a retrospective case review of all patients having undergone facial nerve decompression for severe refractory BP between 1984 and 2009 at our tertiary referral center. Demographics, timing between onset of symptoms and surgical decompression, degree of facial nerve dysfunction pre- and post-operatively, follow-up length after surgery and postoperative complications were recorded. Facial nerve dysfunction was assessed using the House-Brackmann (HB) scale. Electroneuronography, electromyography and imaging results were assessed when available. Results Eighteen patients had surgery between 21 and 60 days after onset of BP (group I), and 18 patients had surgery more than 60 days after onset of symptoms (group II). In group II, 11 patients had surgery between 61 and 89 days and 7 patients after 90 days. Groups I and II showed similar functional gain and rates of improvement to HB 3 or better (11/18 vs. 11/18, p > 0.05). In group II, patients operated 60 to 89 days after onset of BP showed a significantly higher rate of improvement to HB 3 or better (9/11 vs. 2/6, p = 0.049) with higher functional gain compared to those operated after 90 days ( p = 0.0293). Conclusions When indicated, facial nerve decompression for BP is usually recommended within the first 2 weeks of onset of facial paralysis. Nonetheless, our results suggest that patients with severe BP could benefit from decompression surgery within 90 days after onset of symptoms in the absence of an opportunity to proceed earlier to surgery. Further investigation is still required to confirm our findings. Trial registration Retrospective registered. IRB# 2016–6154, CE 15.154 – CA
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delayed facial nerve decompression for severe refractory cases of bell s palsy a 25 year experience
Journal of Otolaryngology-head & Neck Surgery, 2018Co-Authors: Ilyes Berania, Mohamed Awad, Issam Saliba, Jean-jacques Dufour, Marc-elie NaderAbstract:This study aims to assess the effectiveness of delayed facial nerve decompression for Bell’s palsy (BP). We performed a retrospective case review of all patients having undergone facial nerve decompression for severe refractory BP between 1984 and 2009 at our tertiary referral center. Demographics, timing between onset of symptoms and surgical decompression, degree of facial nerve dysfunction pre- and post-operatively, follow-up length after surgery and postoperative complications were recorded. Facial nerve dysfunction was assessed using the House-Brackmann (HB) scale. Electroneuronography, electromyography and imaging results were assessed when available. Eighteen patients had surgery between 21 and 60 days after onset of BP (group I), and 18 patients had surgery more than 60 days after onset of symptoms (group II). In group II, 11 patients had surgery between 61 and 89 days and 7 patients after 90 days. Groups I and II showed similar functional gain and rates of improvement to HB 3 or better (11/18 vs. 11/18, p > 0.05). In group II, patients operated 60 to 89 days after onset of BP showed a significantly higher rate of improvement to HB 3 or better (9/11 vs. 2/6, p = 0.049) with higher functional gain compared to those operated after 90 days (p = 0.0293). When indicated, facial nerve decompression for BP is usually recommended within the first 2 weeks of onset of facial paralysis. Nonetheless, our results suggest that patients with severe BP could benefit from decompression surgery within 90 days after onset of symptoms in the absence of an opportunity to proceed earlier to surgery. Further investigation is still required to confirm our findings. Retrospective registered. IRB# 2016–6154, CE 15.154 – CA
Jean-jacques Dufour - One of the best experts on this subject based on the ideXlab platform.
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Delayed facial nerve decompression for severe refractory cases of Bell’s palsy: a 25-year experience
Journal of Otolaryngology - Head & Neck Surgery, 2018Co-Authors: Ilyes Berania, Mohamed Awad, Issam Saliba, Jean-jacques Dufour, Marc-elie NaderAbstract:Background This study aims to assess the effectiveness of delayed facial nerve decompression for Bell’s palsy (BP). Methods We performed a retrospective case review of all patients having undergone facial nerve decompression for severe refractory BP between 1984 and 2009 at our tertiary referral center. Demographics, timing between onset of symptoms and surgical decompression, degree of facial nerve dysfunction pre- and post-operatively, follow-up length after surgery and postoperative complications were recorded. Facial nerve dysfunction was assessed using the House-Brackmann (HB) scale. Electroneuronography, electromyography and imaging results were assessed when available. Results Eighteen patients had surgery between 21 and 60 days after onset of BP (group I), and 18 patients had surgery more than 60 days after onset of symptoms (group II). In group II, 11 patients had surgery between 61 and 89 days and 7 patients after 90 days. Groups I and II showed similar functional gain and rates of improvement to HB 3 or better (11/18 vs. 11/18, p > 0.05). In group II, patients operated 60 to 89 days after onset of BP showed a significantly higher rate of improvement to HB 3 or better (9/11 vs. 2/6, p = 0.049) with higher functional gain compared to those operated after 90 days ( p = 0.0293). Conclusions When indicated, facial nerve decompression for BP is usually recommended within the first 2 weeks of onset of facial paralysis. Nonetheless, our results suggest that patients with severe BP could benefit from decompression surgery within 90 days after onset of symptoms in the absence of an opportunity to proceed earlier to surgery. Further investigation is still required to confirm our findings. Trial registration Retrospective registered. IRB# 2016–6154, CE 15.154 – CA
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delayed facial nerve decompression for severe refractory cases of bell s palsy a 25 year experience
Journal of Otolaryngology-head & Neck Surgery, 2018Co-Authors: Ilyes Berania, Mohamed Awad, Issam Saliba, Jean-jacques Dufour, Marc-elie NaderAbstract:This study aims to assess the effectiveness of delayed facial nerve decompression for Bell’s palsy (BP). We performed a retrospective case review of all patients having undergone facial nerve decompression for severe refractory BP between 1984 and 2009 at our tertiary referral center. Demographics, timing between onset of symptoms and surgical decompression, degree of facial nerve dysfunction pre- and post-operatively, follow-up length after surgery and postoperative complications were recorded. Facial nerve dysfunction was assessed using the House-Brackmann (HB) scale. Electroneuronography, electromyography and imaging results were assessed when available. Eighteen patients had surgery between 21 and 60 days after onset of BP (group I), and 18 patients had surgery more than 60 days after onset of symptoms (group II). In group II, 11 patients had surgery between 61 and 89 days and 7 patients after 90 days. Groups I and II showed similar functional gain and rates of improvement to HB 3 or better (11/18 vs. 11/18, p > 0.05). In group II, patients operated 60 to 89 days after onset of BP showed a significantly higher rate of improvement to HB 3 or better (9/11 vs. 2/6, p = 0.049) with higher functional gain compared to those operated after 90 days (p = 0.0293). When indicated, facial nerve decompression for BP is usually recommended within the first 2 weeks of onset of facial paralysis. Nonetheless, our results suggest that patients with severe BP could benefit from decompression surgery within 90 days after onset of symptoms in the absence of an opportunity to proceed earlier to surgery. Further investigation is still required to confirm our findings. Retrospective registered. IRB# 2016–6154, CE 15.154 – CA
Issam Saliba - One of the best experts on this subject based on the ideXlab platform.
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Delayed facial nerve decompression for severe refractory cases of Bell’s palsy: a 25-year experience
Journal of Otolaryngology - Head & Neck Surgery, 2018Co-Authors: Ilyes Berania, Mohamed Awad, Issam Saliba, Jean-jacques Dufour, Marc-elie NaderAbstract:Background This study aims to assess the effectiveness of delayed facial nerve decompression for Bell’s palsy (BP). Methods We performed a retrospective case review of all patients having undergone facial nerve decompression for severe refractory BP between 1984 and 2009 at our tertiary referral center. Demographics, timing between onset of symptoms and surgical decompression, degree of facial nerve dysfunction pre- and post-operatively, follow-up length after surgery and postoperative complications were recorded. Facial nerve dysfunction was assessed using the House-Brackmann (HB) scale. Electroneuronography, electromyography and imaging results were assessed when available. Results Eighteen patients had surgery between 21 and 60 days after onset of BP (group I), and 18 patients had surgery more than 60 days after onset of symptoms (group II). In group II, 11 patients had surgery between 61 and 89 days and 7 patients after 90 days. Groups I and II showed similar functional gain and rates of improvement to HB 3 or better (11/18 vs. 11/18, p > 0.05). In group II, patients operated 60 to 89 days after onset of BP showed a significantly higher rate of improvement to HB 3 or better (9/11 vs. 2/6, p = 0.049) with higher functional gain compared to those operated after 90 days ( p = 0.0293). Conclusions When indicated, facial nerve decompression for BP is usually recommended within the first 2 weeks of onset of facial paralysis. Nonetheless, our results suggest that patients with severe BP could benefit from decompression surgery within 90 days after onset of symptoms in the absence of an opportunity to proceed earlier to surgery. Further investigation is still required to confirm our findings. Trial registration Retrospective registered. IRB# 2016–6154, CE 15.154 – CA
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delayed facial nerve decompression for severe refractory cases of bell s palsy a 25 year experience
Journal of Otolaryngology-head & Neck Surgery, 2018Co-Authors: Ilyes Berania, Mohamed Awad, Issam Saliba, Jean-jacques Dufour, Marc-elie NaderAbstract:This study aims to assess the effectiveness of delayed facial nerve decompression for Bell’s palsy (BP). We performed a retrospective case review of all patients having undergone facial nerve decompression for severe refractory BP between 1984 and 2009 at our tertiary referral center. Demographics, timing between onset of symptoms and surgical decompression, degree of facial nerve dysfunction pre- and post-operatively, follow-up length after surgery and postoperative complications were recorded. Facial nerve dysfunction was assessed using the House-Brackmann (HB) scale. Electroneuronography, electromyography and imaging results were assessed when available. Eighteen patients had surgery between 21 and 60 days after onset of BP (group I), and 18 patients had surgery more than 60 days after onset of symptoms (group II). In group II, 11 patients had surgery between 61 and 89 days and 7 patients after 90 days. Groups I and II showed similar functional gain and rates of improvement to HB 3 or better (11/18 vs. 11/18, p > 0.05). In group II, patients operated 60 to 89 days after onset of BP showed a significantly higher rate of improvement to HB 3 or better (9/11 vs. 2/6, p = 0.049) with higher functional gain compared to those operated after 90 days (p = 0.0293). When indicated, facial nerve decompression for BP is usually recommended within the first 2 weeks of onset of facial paralysis. Nonetheless, our results suggest that patients with severe BP could benefit from decompression surgery within 90 days after onset of symptoms in the absence of an opportunity to proceed earlier to surgery. Further investigation is still required to confirm our findings. Retrospective registered. IRB# 2016–6154, CE 15.154 – CA