Vulnerable site of the facial nerve. From histopathology of seven temporal bones.
In the present work, a series of studies was made of seven temporal bones taken from 5 newborns within 6 h of death. In the 5 cases considered in this study, all of which had suffered from severe circulatory disease of congenital or unknown origin, destruction of the facial nerve as well as severe congestions were noted. The following findings were common to all seven temporal bones. (1) Bleeding together with destruction of the nerve had originated in the mid-section of the tympanic portion and increased distally up to the distal portion of the mastoid. (2) Bleeding was restricted mainly to the inner side of the perineurium or in the nerve trunk. (3) There was little bleeding in the epineurium, with the exception of both temporal bones in one of the cases. Although destruction of nerve fibres and the perineurium was prominent in all cases, in six of the temporal bones, traces of nerve trunk remained as a mould, with or without erythrocytes. In one temporal bone in case 5, which survived only 16 days, most of the nerve fibres had changed into fibrous tissue around which bleeding and small vessels containing erythrocytes were prominent. From these findings, it is postulated that the pathological change in the Fallopian canal of six of the temporal bones resulted from acute congestion after birth (due to acute reduction of oxygen density in the arterial blood resulting from severe congenital heart disease), while that of the remaining temporal bone resulted from chronic congestion which had already existed during gestation. It may be concluded that disturbance of blood flow is likely to occur from and distal to the tympanic portion of the Fallopian canal and that this may be due to the peculiar structure of the blood vessels in this area.
Minatogawa
T
T
Department of Otolaryngology, Hyogo College of Medicine, Japan.
Iritani
H
H
Kumoi
T
T
Ito
H
H
D001847:Bone Diseases / Q000150:complications; D007758:Ear, Inner / Q000294:innervation; D004432:Ear, Middle / Q000294:innervation; D004912:Erythrocytes / Q000473:pathology; D005154:Facial Nerve / Q000473:pathology*; D005155:Facial Nerve Diseases / Q000209:etiology; D005260:Female; D006470:Hemorrhage / Q000150:complications; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009412:Nerve Fibers / Q000473:pathology; D013701:Temporal Bone / Q000098:blood supply / Q000294:innervation*