S127 – Idiopathic Facial Nerve Paralysis: Analysis of 3T MRI Images

Abstract

Objectives 1) To describe the findings on 3 Tesla (T) MRI in patients with idiopathic facial nerve paralysis (IFP). 2) To compare 3T MRI and 1.5 T MRI images of the facial nerve in patients with and without facial paralysis. Methods A retrospective review of 3T MRI image from 2005–2008 for temporal bone imaging revealed 123 patients; 4 patients underwent imaging for facial paralysis. Images from 3T MRI and 1.5T MRI for these 4 patients were retrospectively assessed by a board-certified neuroradiologist and otolaryngologist blinded to the affected side and compared to normative controls. Results All patients with facial palsy demonstrated significant enhancement of the affected nerve on post-gadolinium T1 weighted images. In 3 patients with residual facial weakness (>12 months) demonstrated facial nerve enhancement at the geniculate ganglion and descending portions. In 1 patient, despite resolution of IFP, the nerve continued to enhance at the geniculate ganglion and descending portion of the facial nerve compared to the contralateral nerve. The 3T MRI images demonstrated improved visualization of the entire course of the facial nerve in both normal and IFP patients. Interestingly, in both normal and affected patients, the uninvolved facial nerve also demonstrated slight contrast enhancement throughout its entire course, although not as pronounced as the affected side. Conclusions 3T imaging provides significantly improved visualization of the temporal facial nerve in both normal and patients with IFP. Gadolinium enhanced 3T imaging allowed better anatomical delineation of both normal and affected facial nerves when compared to 1.5T MRI.