Abstract ID: 26-567
Concurrent Cranial Nerve V and VII Palsies: Anatomical Pathways, Clinical Implications, and Oncologic Associations
Author: Frank Mei Base Hospital / Institution: 2 Department of Orbital and Ophthalmic Plastic Surgery, UCLA Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA
Presentation Type: ePoster Presentation
Purpose
Peripheral isolated concomitant palsy of cranial nerves (CN) V and VII is rare due to their anatomic dissociation outside the brainstem. Though uncommon, such deficits can cause significant corneal morbidity from combined sensory loss and blink dysfunction. This study aims to clarify anatomical pathways facilitating tumor spread between CN V and VII and highlight high‑risk zones.
Methods
This case series includes clinical data from three patients presenting with concurrent CN V and VII palsy.
Results
Four anatomical pathways were identified as potential conduits for perineural tumor spread between CN V and VII, occurring peripherally in the parotid bed and temporal region, and centrally in Meckel’s cave and the pterygopalatine fossa. Across the three cases, perineural spread occurred via both peripheral and central routes, including retrograde extension from CN VII to V through V3 to the trigeminal ganglion, involvement of the cavernous sinus and greater petrosal nerve, and spread along the vidian nerve into the pterygopalatine fossa.
Conclusion
This series highlights the role of anatomical intersections – parotid bed, temporal region, Meckel’s cave, and pterygopalatine fossa – in the pathophysiology of concurrent CN V and VII palsy. Recognizing key overlap regions enhances diagnostic accuracy, guides targeted imaging, and informs management.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Javier | Moreno-Aleman Sanchez | Department of Orbital and Ophthalmic Plastic Surgery, UCLA Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA |
| Angela | Oh | Department of Orbital and Ophthalmic Plastic Surgery, UCLA Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA |
| Tatiana | Rosenblatt | Department of Orbital and Ophthalmic Plastic Surgery, UCLA Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA |
| Katherine M. | Lucarelli | Department of Orbital and Ophthalmic Plastic Surgery, UCLA Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA |
| Daniel | Rootman | Department of Orbital and Ophthalmic Plastic Surgery, UCLA Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA |