Otoneurological problems in head injuries and their management

Area of Science:

• Otolaryngology
• Neurosurgery
• Audiology

Background:

• Facial nerve injury management requires considering factors like onset time, electrical response, and concurrent damage.
• Cerebrospinal fluid (CSF) otorrhea, ossicular disruption, and cholesteatoma are critical associated conditions influencing treatment decisions.

Purpose of the Study:

• To analyze treatment outcomes for facial nerve injuries based on specific clinical presentations.
• To evaluate the efficacy of conservative versus surgical interventions for associated complications.

Main Methods:

• Retrospective review of patients with facial nerve injury and associated conditions.
• Categorization of injuries based on CSF otorrhea, ossicular disruption, and cholesteatoma.
• Analysis of treatment approaches including conservative management and surgical interventions.

Main Results:

• Four patients with CSF otorrhea showed positive response to conservative treatment.
• One patient with cholesteatoma required mastoidectomy, and another needed surgery due to failed conservative otorrhea treatment.
• Seven patients with conductive deafness from ossicular disruption, specifically incudostapedial joint separation, underwent surgical repair.

Conclusions:

• Conservative management can be effective for CSF otorrhea in facial nerve injury.
• Surgical intervention is necessary for facial nerve injuries complicated by cholesteatoma or persistent otorrhea.
• Surgery for incudostapedial joint separation is effective in treating associated conductive deafness.