Cranial nerve V2 and Vidian nerve trauma secondary to lateral pterygoid recess encephalocele repair.
Autor: | Chislett SP; Sinus & Nasal Institute of Florida, St. Petersburg, FL., Limjuco AP; Sinus & Nasal Institute of Florida, St. Petersburg, FL.; Bethlehem ENT Associates, Bethlehem, PA., Solyar AY; Sinus & Nasal Institute of Florida, St. Petersburg, FL., Lanza DC; Sinus & Nasal Institute of Florida, St. Petersburg, FL. |
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Jazyk: | angličtina |
Zdroj: | International forum of allergy & rhinology [Int Forum Allergy Rhinol] 2020 Jan; Vol. 10 (1), pp. 81-88. Date of Electronic Publication: 2019 Nov 27. |
DOI: | 10.1002/alr.22448 |
Abstrakt: | Background: The incidence of adverse sequelae related to trauma of cranial nerve V Methods: Hypoesthesia, paresthesia, and dry eye and their impact on patient quality of life were sought through chart review and a self-reported 0 to 5 Likert scale for each symptom. Results: Thirty-five patients underwent repair of spontaneous cerebrospinal-fluid (CSF) rhinorrhea, with 11 consecutive patients undergoing endoscopic PRR. Mean follow-up for PRR was 32.5 months (range, 2.4 to 103.3 months). Although definitive management resulted in 100% success, 1 required secondary treatment. Eight patients were available for long-term follow-up (72.7%) and completed a symptom severity questionnaire using a Likert-scale. All patients observed either hypoesthesia, paresthesia, or dry eye of varying gradation (scale, 0 to 5). None described disabling symptoms, and some reported gradual improvement. Numbness, paresthesia, and dry eye were reported by 6 of 8 (75%), 5 of 8 (62.5%), and 4 of 8 (50%) patients, respectively. The mean Likert score among the 8 patients who completed this questionnaire noticing hypoesthesia, paresthesia, and dry eye was 2.6, 1.3, and 1.8, respectively. Conclusion: Meticulous surgical technique is paramount for successful PRR and minimizing nerve injury, yet the anatomic variation of the lateral pterygoid recess can be challenging, and neural injury is a real risk. Preoperatively, patients should be counseled that although V2 or VN injury is common, most patients describe resulting symptoms to be rarely bothersome. (© 2019 ARS-AAOA, LLC.) |
Databáze: | MEDLINE |
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