HSC Section 3 - Trauma, Critical Care and Sleep Medicine

O

Surgical excision 1 FN reconstruction 1 /- adjuvant therapy

Diagnosis Category Diagnosis Clinical Signs/Symptoms Etiology Diagnostics Acute Management Intracranial tumor Vestibular Schwannoma Vestibulocochlear symptoms, FP Schwann cell tumor of CNVIII Facial nerve Schwannoma FP common, other vestibulocochlear symptoms Schwann cell tumor of CNVII CT temporal bones vestibulocochlear tests Neurotology evaluation XRT or surgery Leptomeningeal carcinomatosis Pain, seizure, headache Metastatic carcinoma to meninges cerebral, cranial nerve, spinal root MRI with gadolinium, cerebrospinal fluid cytology

*High-dose steroids possible decompression within 3–14 d

Tumor infiltration or compression MRI 1 contrast Eye care High dose steroids Antiviral

Birth trauma Known history Blunt trauma, forceps None Eye care Iatrogenic Parotid or soft tissue surgery or orthognathic surgery Otologic surgery Immediate FP after surgery Known history Delayed reactivation Direct transection or neuropraxia of FN. Reactivation of virus (BP) Exploration Primary coaptation Interposition graft * Same as BP Malignant tumors Parotid CA

Penetrating trauma Known history Foreign body or knife Explore, *

Chemo/radiotherapy, supportive

ENoG, EMG audiologic testing

MRI with gadolinium Neurotology evaluation CT temporal bones

Fracture transverse or parallel to facial nerve

Acute or slowly progressive FP

Known history of blunt head trauma

Trauma Temporal bone fracture

Head & neck CA

( continued )

Table 1

45