Furthermore, the size of the tumor may be underestimated in the main specimen in cases with an extensive tumor involving separately submitted tissues (such as dura, facial nerve, and stylomastoid
Surgical approaches have been performed in the preauricular area during the parotidectomy, reduction of the condylar fracture, decompression of the stylomastoid
foramen for releasing the facial palsy, and the treatment of temporomandibular joint (TMJ) ankylosis [2,3].
artery supplies the fallopian canal distally .
In this particular case, the left facial nerve infranuclear palsy was due to erosion of the bony descending mastoid segment of the left intratemporalfacial nerve canaland direct nerveinvolvement by the tumor mass at and distal to the stylomastoid
From an inferior view, there are ten skull base foramina conventionally described as constant: greater palatine, lesser palatine, lacerum, ovale, spinosum, external opening of the carotid canal, stylomastoid
, jugular, mastoid, and external opening of the hypoglossal canal (Drake et al.).
Chung et al (10) point out that, on CT, a tumor near the posterolateral portion of the retromandibular vein, extending toward the stylomastoid
foramen, should introduce the possibility of schwannoma into the differential diagnosis.
Then, spread of infection into the temporal bone occurs through the fissures of Santorini and the tympanomastoid suture, leading to involvement of the stylomastoid
and jugular foramina and eventually affecting cranial nerve function.
An electromyographic (EMG) study of the facial musculature on the 24th day after the onset confirmed the absence of response to stimulation at the stylomastoid
From the geniculate ganglion to the stylomastoid
foramen, no obvious facial nerve bony canal destruction was detected.
(4) Facial nerve is susceptible to trauma as it exits from stylomastoid
for a men where soft tissue compression can lead to damage of facial nerve (CHARGE Syndrome).
Thus the facial pain as well as the pain at nerve exit from the stylomastoid
foramen would be explained by the involvement nerve trunk nociceptors, while the pain in the retroauricular region and the neck would be generated by algogenic stimuli from the sheaths of facial nerve delivered to trigeminocervical nuclear complex via nervi nervorum.
The facial nerve exits the temporal bone at the stylomastoid
foramen and enters the parenchyma of the parotid gland after it gives off the posterior auricular, posterior digastric, and stylohyoid muscle branches.