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ENT
Geniculate Hemangioma
Built from Haynes-Glasscock-Shambaugh Surgery of the Ear, Seventh Edition
What’s inside
7 sections · 61 slides
The lesion
- Definition and site of origin
- Geniculate capillary plexus
- Incidence and demographics
- Hemangioma or venous malformation
- Facial nerve course through the temporal bone
- Skull base floor and the middle cranial fossa
- Mechanism of facial nerve dysfunction
Clinical presentation
- Facial nerve dysfunction as the hallmark
- Patterns of facial nerve dysfunction
- Presenting features in the systematic review
- Presenting features in the House series
- GGH compared with geniculate ganglion schwannoma
- Distinguishing GGH from Bell's palsy
- Red flags prompting further workup
- Cochlear dysfunction and cochlear fistula
- Less common presenting symptoms
Radiology
- Radiographic differential diagnosis
- High-resolution CT findings
- MRI findings
- Imaging of a geniculate ganglion hemangioma
- Imaging of facial nerve schwannoma
- Cholesteatoma and perineural spread on imaging
- Axial CT of the petrous temporal bone
Adjunctive testing
- Role of electroneuronography
- Clinical and electrical discordance
Histopathology
- Haematoxylin and eosin findings
- Immunohistochemical profile
- Histology and CD34 immunostaining
- Gross operative appearance
Management
- Management options
- Evidence on observation
- Why observation is not recommended
- Choosing approach and extent of resection
- Middle cranial fossa approach
- Alternative and extended approaches
- Intraoperative hearing preservation
- Cochlear fistula and the case for subtotal resection
- Preserving or sacrificing the facial nerve
- Grafting and facial reanimation
Outcomes
- Limits of the outcome evidence
- Facial nerve and hearing outcomes among published studies examining geniculate ganglion hemangiomas
- Predictors of postoperative facial function
- Duration of weakness and House-Brackmann grade
- Facial nerve outcomes in the reported series
- Outcomes after facial nerve grafting
- Mechanisms of hearing loss
- Hearing outcomes after surgery
- Recurrence after surgical treatment
- Key points
- Conclusion
- References
- References (continued)
- Haynes-Glasscock-Shambaugh Surgery of the Ear, Seventh Edition
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