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Surgical intervention in traumatic facial nerve paralysis
1Department of Otorhinolaryngology, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, 56000, Cheras, Kuala Lumpur.
The Medical Journal of Malaysia
|January 31, 2004
Summary
This review of traumatic facial paralysis from temporal bone fractures found longitudinal fractures were most common. Surgical decompression improved facial nerve function in most patients, though one case showed persistent severe paralysis.
Area of Science:
- Otolaryngology
- Neurosurgery
- Trauma Surgery
Background:
- Traumatic facial nerve paralysis can result from temporal bone fractures.
- Surgical intervention is sometimes required for these cases.
- Understanding fracture patterns and surgical outcomes is crucial for patient management.
Purpose of the Study:
- To review cases of traumatic facial paralysis requiring surgery.
- To determine the pattern of temporal bone fractures causing facial paralysis.
- To evaluate surgical outcomes following decompression.
Main Methods:
- A four-year retrospective review (June 1998-June 2002) of patients with traumatic facial paralysis.
- Analysis of fracture types, associated symptoms, surgical approach, and intraoperative findings.
- Assessment of facial nerve function recovery using the House Brackmann grading system postoperatively.
Main Results:
- Six cases of traumatic facial paralysis were identified.
- Longitudinal fractures were most common (66%), often associated with hearing loss (83%).
- Transmastoid decompression was performed; edema and bony impingement were noted intraoperatively. Significant functional recovery was observed in 66% of cases by 12 months, with one case showing poor recovery.
Conclusions:
- Longitudinal temporal bone fractures are a significant cause of traumatic facial paralysis.
- Transmastoid decompression is an effective surgical approach for selected cases.
- Early surgical intervention may improve facial nerve function recovery, but outcomes can vary.