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Facial paralysis in temporal bone trauma.

K X McKennan1, R A Chole

  • 1Sacramento Ear, Nose, and Throat Surgical and Medical Group, Inc., CA 95816.

The American Journal of Otology
|March 1, 1992
PubMed
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Traumatic facial paralysis with delayed onset typically resolves without surgery, showing a 94% recovery rate. Immediate-onset paralysis, however, has a poorer prognosis and may require surgical intervention.

Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Facial Nerve Surgery

Background:

  • Traumatic facial paralysis can be immediate or delayed in onset.
  • The prognosis and management strategies differ significantly between these two types.
  • Understanding these differences is crucial for effective patient care.

Purpose of the Study:

  • To evaluate the outcomes of delayed-onset traumatic facial paralysis.
  • To determine if surgical decompression is routinely necessary for delayed-onset cases.
  • To compare the prognosis of delayed-onset versus immediate-onset traumatic facial paralysis.

Main Methods:

  • Retrospective review of 36 patients with traumatic facial paralysis.
  • Categorization into delayed-onset (19 patients) and immediate-onset (17 patients) groups.

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  • Analysis of recovery outcomes based on onset type and treatment (surgical vs. non-surgical).

    • Main Results:

    • 94% of patients with delayed-onset facial paralysis achieved normal recovery (House grade 1) without surgery.
    • Only 6% of delayed-onset cases showed incomplete recovery (mild weakness/synkinesis, House grade 2).
    • Immediate-onset facial paralysis presented a poorer prognosis, with facial nerve transections in penetrating injuries and different injury patterns in closed head injuries.

    Conclusions:

    • Delayed-onset traumatic facial paralysis generally does not require routine surgical decompression.
    • Immediate-onset traumatic facial paralysis carries a worse prognosis and may necessitate surgical exploration.
    • Surgical approaches like translabyrinthine or middle-fossa dissection may be required for indicated cases.