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Facial reanimation after temporal bone fracture
N Goksu1, A Y Bayazit, L Beder
1Gazi University, Faculty of Medicine, Department of Ear Nose Throat, Kolejtepe, Gaziantep, Turkey.
Revue De Laryngologie - Otologie - Rhinologie
|March 25, 1999
Summary
Early diagnosis and surgical correction of facial paralysis from temporal bone fractures significantly improve outcomes. Prompt treatment within one month of trauma led to near-complete facial function recovery in most patients.
Area of Science:
- Neurosurgery
- Otolaryngology
- Trauma Surgery
Background:
- Temporal bone fractures often accompany severe head injuries, potentially delaying facial paralysis diagnosis.
- Facial nerve involvement is a common complication, impacting patient quality of life.
Purpose of the Study:
- To highlight the critical need for early diagnosis and intervention in facial paralysis secondary to temporal bone fractures.
- To evaluate the efficacy of surgical decompression based on fracture location and hearing status.
Main Methods:
- Retrospective analysis of sixteen patients with temporal bone fractures and facial paralysis operated on within one month of injury.
- Surgical approaches (transmastoid, middle fossa, translabyrinthine) were chosen based on fallopian canal involvement and pre-operative hearing.
- Pre-operative facial nerve function grading (House-Brackmann scale) and hearing assessment were performed.
Main Results:
- Fifteen of sixteen patients achieved normal facial function post-operatively; one patient had grade III weakness.
- Patients with serviceable hearing underwent transmastoid or middle fossa decompression.
- Patients with unserviceable hearing were treated with the translabyrinthine approach.
Conclusions:
- Early surgical correction of severe, sudden-onset facial paralysis following temporal bone fracture is recommended.
- Surgical technique selection should judiciously consider the specific site of facial canal injury and the patient's auditory function.