Facial palsy in Hand-Schüller-Christian's disease.

Abstract

HAND-Schuller-Christian's disease is a disseminated granulomatosis of unknown etiology. The clinical appearances are characterized by granulomas affecting mainly the skeletal system, especially the skull. The skin, the lymph node system, mucous membranes, and viscera may also be involved. The disease runs a typically chronic course with a tendency to remission. The histological appearance of the granulomas is fairly polymorphous. The cellular tissue is predominated, during the early stages, by reticulum cells, eosinophilic leukocytes, plasma cells, and polynuclear giant cells. At later stages there are foam cells containing cholesterol. The symptoms and signs are varied, but the otological signs occupy a preferential position, both by virtue of their common presence and their early appearance. Thus, many cases are seen first by the otologist (among the approximately 700 reported cases several have been published by otologists). I have1collected 500 cases from the literature and reviewed the manifold ear, nose, and