The process of determining the prognosis and subsequent facial nerve decompression has become an important factor in determining the patient’s quality of life. In this study, the prognosis of facial paralysis was verified in detail based on the timing of electroneurography (ENOG) and nerve conduction study (NCS). The ENOG and NCS of 368 facial palsy patients were analyzed. House–Brackmann (HB) scale after 6 months was used as an outcome. For the ENOG, nasalis muscle/levator labii superioris alaeque nasi (NL), and orbicularis oculi (OO) muscle were used and NCS performed using temporal, zygomatic, and buccal branches. ENOG at the OO performed 4–6 d after onset was ≤10% (p = .002, 10.0-fold) and showed unfavorable results (when the standard was ≥30%). In addition, the ENOG at the NL performed 13–15 d after onset was ≤10% (p = .001, 10.5-fold) and showed unfavorable results (when the standard was ≥30%). The results indicated that ENOG at the OO performed 4–6 d after onset and ENOG at the NL performed 13–15 d after onset had more prognostic value for the outcomes of acute peripheral facial palsy.
Objectives. Nasal valve surgery for internal nasal valve (INV) compromise has become increasingly popular. However, this rise in popularity has sparked debates regarding its indications and disputes over insurance coverage, primarily due to the lack of a gold-standard evaluation method. Therefore, we aimed to identify objective parameters for the INV compromise.Methods. We analyzed 186 INVs in 93 patients who underwent nasal valve surgery. The data comprised facial computed tomography (CT) images, acoustic rhinometry, the modified Cottle test, and symptom scores. Patients were categorized based on their symptoms and the results of the modified Cottle test. We measured the INV angle, area, volume, lateral wall thickness, septal angle, and nasal bone area using CT.Results. The compromised INV group, characterized by nasal obstruction with a positive modified Cottle test, exhibited smaller INV areas in both coronal and axial views, reduced INV volume in the axial view, and a thinner lateral wall in the coronal view (all P<0.05). Acoustic rhinometry indicated a smaller minimal cross-sectional area and volume in the compromised INV group (both P<0.001). Regression analysis demonstrated significant associations between a compromised INV and reduced INV area on the axial view, as well as the minimal cross-sectional area measured by acoustic rhinometry.Conclusion. Relying solely on the INV angle in CT scans has limitations in assessing compromised INV. Alternatively, the INV area on axial CT scans and the minimal cross-sectional area measured by acoustic rhinometry may serve as objective parameters for evaluating INV compromise.
Schwannomas are benign tumors that can develop in any part of a nerve containing Schwann cells. Skull base schwannomas are rare, representing approximately 4% of extracranial schwannomas. Among these, vidian nerve schwannomas are particularly uncommon, with only a few documented cases. In this report, we describe the case of a 58-year-old female patient who presented with an incidental finding of a skull base mass. The patient’s only symptoms were intermittent headaches and dry eyes. No mass was detected during the physical examination. Radiographic evaluation revealed a neoplasm within the vidian canal, and the lesion’s characteristics suggested a schwannoma. The patient underwent endoscopic resection, and subsequent histopathological analysis confirmed the diagnosis of schwannoma. Follow-up imaging and physical examination showed no evidence of recurrence. This case report highlights a schwannoma located in the vidian canal and extending into the foramen rotundum, which was successfully managed with endoscopic surgery.