![]() ![]() To the authors' knowledge, this is the first report to describe decompression of the internal auditory canal via a retrosigmoid approach for symptomatic facial and cochlear nerve compression in a patient with CED.Ĭamurati-Engelmann disease cranial nerve palsy hyperostosis internal auditory canal retrosigmoid approach. Opening of the internal auditory canal (IAC) and Fallopian canal Skeletonize the IAC 180-270º at the porus All bone from the porous to Bill’s bar is removed. There were no more episodes of facial nerve palsy or spasm. Head 00100 salivary gland 00102 repair of cleft lip 00103 blepharoplasty 00104 electroshock 00120 ear. Hearing and vestibular function were unchanged. Postoperative facial nerve function was intact. The code is for excision of a bone tumor of the skull which does not include a vestibular schwannoma. Craniectomy with excision of tumor or other bone lesion of skull. Because of the progressive nature of the aforementioned cranial neuropathies in combination with the correlating severe radiological compression, a surgical decompression of the facial nerve and vestibulocochlear nerve was performed via a retrosigmoid approach with intraoperative monitoring. This code is for decompression of a cranial nerve, not excision of a cranial nerve tumor such as a vestibular schwannoma. Radiological evaluation showed a significant thickening of the skull base with serious bilateral internal auditory canal stenosis. There were no symptoms of increased intracranial pressure or vertigo. This report describes a 27-year-old patient with suspected CED who developed progressive intermittent facial nerve paresis, hemifacial spasms, and a decrease in hearing. ![]() Symptoms include contractures and pain in affected extremities but can also include manifestations of cranial hyperostosis such as intracranial hypertension, Chiari malformation, exophthalmia, frontal bossing, and several cranial neuropathies due to cranial foraminal stenosis. Camurati-Engelmann disease (CED) is a rare condition characterized by hyperostosis of the long bones and skull base.
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