[Informative value of ultrasound in the diagnosis of intraneural perineurioma]

OBJECTIVE

To describe clinical and sonographic features of confirmed intraneural perineurioma in 5 patients.

MATERIAL AND METHODS

We report clinical and sonographic features and retrospective follow-up data in 5 patients with intraneural perineurioma verified by biopsy.

RESULTS

In all cases, symptoms were represented by a slowly progressive painless mononeuropathy with muscle atrophy and impaired tendon reflexes. Ultrasound examination revealed locally enlarged cross-sectional area of the nerve that was confirmed by intraoperative visualization.

CONCLUSION

Intraneural perineurioma should be obligatory suspected in case of fusiform thickening of the nerve with locally changed echogenicity. Pooled multiple-center studies with large samples are needed to determine sensitivity and specificity of the main ultrasound parameters including changes in cross-sectional area and echogenicity of the nerve.

[Neurotization of the cornea as pathogenically targeted method of treating neurotrophic keratitis in patients with facial paralysis]

Combined lesions of the facial and trigeminal cranial nerves are typical after neurosurgical treatment. Violation of the innervation of orbicularis muscle leads to inability to completely close the eyelids, while denervation of the cornea is often manifested as a long-term ongoing and recurring neurotrophic keratitis. The restoration of corneal innervation is a pathogenetically targeted treatment for this pathology. For this purpose, neurotrophic keratitis could be reversed via the method of corneal neurotization using contralateral n. ophthalmicus. The presented clinical case demonstrates the results of the first operation of neurotization of the cornea in a patient with combined lesions of the facial and trigeminal nerves.