[Radiologic aspects of temporal-bone fractures with facial paresis]

The value of the radiobiological diagnosis in establishing the localization of a facial palsy resulting from temporal bone fractures has been investigated in 49 cases. Radiological confirmation was found in 21 out of 37 cases of longitudinal fracture and in 11 out of 12 patients (90%) with a transverse fracture. The fracture line was seen by polytomography alone in 1 out of 21 (5%) longitudinal fractures and in 5 out of 11 (45%) transverse fractures. A precise readiological localization of the facial nerve lesion was only possible if the fracutre line was running across the long axis of the pyramid. The surgical revision of 37 patients has shown that the labyrinthine segment of the facial nerve was injured in 93% of longitudinal fractures and in 70% of the transverse fractures. Therefore, one should always be prepared to expose the labyringhine segment of the facial nerve when revising a facial nerve palsy due to a fracture of the temporal bone.