Q1) Latrogenic traumatic facial nerve palsy is most commonly caused during:
A. Myringoplasty
B. Stapedectomy
C. Mastoidectomy
D. Ossiculoplasty
ANSWER & EXPLANATION
Answer: C. Mastoidectomy
Explanation: Latrogenic traumatic facial nerve palsy can be caused by stapedectomy, tympanoplasty and mastoidectomy but most commonly due to mastoidectomy.
Also know:
There are various causes of facial nerve paralysis and can be divided into central and peripheral.
- Central – brain abscess, pontine gliomas, poliomyelitis and multiple sclerosis
- Intracranial – acoustic neuroma, meningioma, congenital cholesteatoma, metastatic carcinoma, meningitis
- Intratemporal –
a) Idiopathic – Bell’s palsy, Melkersson’s syndrome
b) Infections – ASOM, CSOM, herpes zoster oticus, malignant otitis externa
c) Trauma – mastoidectomy, stapedectomy, fractures of temporal bone
d) Neoplasms - Extracranial – malignancy of parotid, surgery of parotid, accidental injury in parotid region, neonatal facial injury
- Systemic diseases – DM, hypothyroidism, uraemia, PAN, WG, sarcoidosis, leprosy, leukemia, demyelinating diseases
Q2) Gradenigo’s syndrome involves all of the following cranial nerves, EXCEPT:
A. IV
B. V
C. VI
D. VII
ANSWER & EXPLANATION
Answer: A. IV
Explanation: Gradenigo’s syndrome is characterized by facial pain, particularly in the first division of the trigeminal nerve and diplopia due to sixth cranial nerve palsy. It is associated with disease at the apex of the petrous temporal bone where the abducens nerve is closely related to the trigeminal nerve. Facial nerve palsy and deafness (VIII nerve palsy) is also considered to be a part of this syndrome.
Causes includes:
Inflammation (petrositis, possibly spreading from a local infection such as otitis or mastoiditis)
Tumors ( cholesteatoma, chordoma, meningioma, nasopharyngeal carcinoma, metastatic disease)
Skull base fracture.