Facial nerve injury during temporal artery biopsy

Annals of The Royal College of Surgeons of England (Impact Factor: 1.27). 05/2014; 96(4):257-260. DOI: 10.1308/003588414X13814021679438
Source: PubMed


Temporal artery biopsy is considered the gold standard investigation of giant cell arteritis and is recommended in suspected cases despite a sensitivity of 81-91%. This review highlights the potential risk of facial nerve injury during temporal artery biopsy and introduces recent advances in the emerging role of imaging modalities. When these non-invasive techniques are used in conjunction with American College of Rheumatology scoring, which includes clinical features and biochemical test results, temporal artery biopsy may be avoided in selected cases.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Temporal arteritis is a true ocular emergency that may initially present with systemic manifestations to primary care practitioners. If improperly diagnosed, the condition may lead to optic nerve damage, ischemic stroke, myocardial infarction, and permanent vision loss. This article reviews common findings and provides a recommended treatment course to prevent any permanent vision loss.
    No preview · Article · Sep 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: Giant cell arteritis (GCA) is a medium to large vessel vasculitis with potentially sight and life threatening complications. Our understanding of the pathogenesis, diagnosis and treatment of GCA has advanced rapidly in recent times. The validity of using the American College of Rheumatology guidelines for diagnosis of GCA in a clinical setting has been robustly challenged. Erythrocyte sedimentation rate, an important marker of inflammation, is lowered by the use of statins and non-steroidal anti-inflammatory drugs. Conversely, it may be falsely elevated with a low hematocrit. Despite the emergence of new diagnostic modalities, temporal artery biopsy remains the gold standard. Evidence suggests that shorter biopsy lengths and biopsies done weeks to months after initiation of steroid therapy are still useful. New imaging techniques such as positron emission tomography (PET) have shown that vascular inflammation in GCA is more widespread than originally thought. GCA, Takayasu arteritis, and polymyalgia rheumatica are no longer thought to exist as distinct entities and are more likely parts of a spectrum of disease. A range of immunosuppressive drugs have been used in conjunction with corticosteroids to treat GCA; in particular, interleukin-6 inhibitors are showing promise as a therapy.
    No preview · Article · Jan 2016 · Survey of Ophthalmology