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2 results

  • Facial nerve decompression via middle fossa approach for hyperostosis cranialis interna: a feasible therapeutic approach

  • J J Waterval, R J Stokroos, R B J De Bondt, J J Manni
  • Journal:
    The Journal of Laryngology & Otology / Volume 123 / Issue 10 / October 2009
    Published online by Cambridge University Press:
    17 April 2009, pp. 1177-1180
    Print publication:
    October 2009

  • Hyperostosis cranialis interna is an autosomal dominant disorder characterised by endosteal hyperostosis and osteosclerosis of the skull base and calvaria, leading to compression and dysfunction of cranial nerves I, II, VII and VIII.

    Case report:

    We report the use of bilateral surgical decompression of the internal auditory canals to treat hyperostosis cranialis interna in an eight-year-old girl presenting with bilateral facial palsy due to hyperostosis cranialis interna.

    Intervention and outcome:

    Using a middle fossa craniotomy approach, both internal auditory canals were unroofed and cranial nerves VII and VIII were decompressed, with a one-year interval between sides. The mimic function recovered. One year post-operatively, the right and left facial sides had been restored to House–Brackmann grades I and II, respectively.

    Conclusion:

    This is the first report of the use of surgical decompression of the internal auditory canal in a case of hyperostosis cranialis interna. Surgical decompression of the internal auditory canal is recommended therapeutically, but may also be performed prophylactically in younger patients with hyperostosis cranialis interna.

  • The management of dysphasia in skeletal hyperostosis

  • S. Akhtar, P. E. O’Flynn, A. Kelly, P. M. W. Valentine
  • Journal:
    The Journal of Laryngology & Otology / Volume 114 / Issue 2 / February 2000
    Published online by Cambridge University Press:
    08 March 2006, pp. 154-157
    Print publication:
    February 2000

  • Diffuse idiopathic skeletal hyperostosis (DISH), or Forestier’s disease, is an ossifying condition frequently encountered in otolaryngology as it affects 12–28 per cent of the adult population. This form of hyperostosis can manifest clinically with dysphagia, food impaction, hoarseness, stridor, myelopathies and other neurological problems. Judicious management of severe dysphagia proves challenging. The failure of conservative care often leaves surgery as the only option. In this report an anterolateral transcervical surgical approach to the confluent osteophytes is discussed and the value of videofluoroscopic swallow highlighted