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Study Offers Hope In Prevention Of Facial Paralysis

In a first ever study conducted, researchers highlight that surgeons can now remove a dangerous cholesteatoma in such a way that the facial nerve is not injured//. This study, which investigates facial nerve dehiscence when cholesteatoma is also present, attempts to describe where and how often the facial nerve is most commonly missing its bony, covering. This can provide surgeons with adequate knowledge, helping them prevent a potential complication, facial paralysis.

The facial nerve, the nerve responsible for moving essentially all of the muscles of the human face, takes an unusual route from the brain to the face. It travels directly through the temporal bone, and as such, it comes into close contact with the inner ear and balance organs which also reside in the temporal bone. In fact, sometimes the facial nerve can be seen directly in the floor of the ‘middle ear space,’ the space just behind the human ear drum. Usually the nerve has a bony covering over it that helps protect it from injury or infection, but sometimes this bony covering is missing. When this protective bone is gone, the nerve is said to be ‘dehiscent.’

Unfortunately, when the nerve is dehiscent, it is much more vulnerable to a variety of disease processes that frequently affect the ear. Infection, trauma, and sometimes even surgery can all potentially damage the facial nerve, and a non-functioning nerve can lead to a devastating and often permanent facial paralysis.

One particular disease process, cholesteatoma, makes the ear and the facial nerve especially vulnerable to injury. Cholesteatoma is an abnormal pocket of trapped skin and tissue in the ear, usually just behind the eardrum. When this trapped skin cannot flake away from the underlying newly forming skin as it is supposed to, excessive debris and keratin can build up as the skin continues to grow. Over time, this trapped debris can become quite large, almost behaving like a small benign tumor, and it c
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