[Guidelines for the treatment of facial-nerve injuries]

The electroneuronographic registration of the summating potentials of the face muscles has been used to assess the prognosis in 72 traumatic facial nerve lesions. The following guide-lines have evolved from the experience gained: (1) a conservative attitude is indicated if the degeneration of the motor fibus is less than 90% 6 days following onset of the palsy and (2) a surgical revision of the facial nerve is indicated if the degeneration of the motor fibres reaches more than 90% during the first 6 days following onset of the palsy. The clinical differentiation in early and delayed traumatic facial palsy cannot be used as a prognostic sign. The amount and rapidity of degeneration of the motor fibres has more prognostic value than the latency between trauma and onset of the palsy. The importance of electroneuronography for the prognosis of iatrogenic facial nerve lesions as well as the value of a careful follow-up of regeneration in facial nerve lesions with preserved continuity of the nerve are discussed.