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Updated: Mar 8, 2026
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Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
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Facial nerve paralysis associated with temporal bone masses.
Hironobu Nishijima1, Kenji Kondo1, Ryoji Kagoya1
1Department of Otolaryngology- Head and Neck surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-8655, Japan.
Auris, Nasus, Larynx
|February 6, 2017
Summary
Facial nerve paralysis from benign temporal bone masses (TBMs) presents differently than Bell's palsy. Unexpectedly mild facial weakness relative to nerve function tests suggests TBMs, requiring consideration in diagnosis.
Area of Science:
- Otolaryngology
- Neurology
- Neurosurgery
Background:
- Facial nerve paralysis (FNP) can stem from various causes, including benign temporal bone masses (TBMs) and Bell's palsy.
- Differentiating FNP etiology is crucial for appropriate management and prognosis.
Purpose of the Study:
- To characterize the clinical and electrophysiological features of FNP caused by benign TBMs.
- To compare these features with those of Bell's palsy to identify distinguishing factors.
Main Methods:
- Retrospective review of 914 patient records, identifying 31 cases of FNP due to benign TBMs.
- Assessment of FNP severity using the House-Brackmann (HB) grading system.
- Electroneurography (ENoG) to evaluate facial nerve function.
Main Results:
- Benign TBMs causing FNP included facial nerve schwannoma (FNS), cholesteatomas, and hemangiomas.
- Severity of FNP varied by TBM type: moderate (HB II-IV) for FNS, severe (HB V-VI) for cholesteatomas and hemangiomas.
- Correlation analysis revealed that for a given ENoG value, HB grade was better in FNS and cholesteatoma compared to Bell's palsy.
Conclusions:
- The clinical presentation of FNP due to benign TBMs is influenced by the specific mass pathology.
- A discrepancy where the HB grade appears better than the ENoG value warrants considering TBMs in the differential diagnosis of FNP.
- Facial nerve function assessment (HB grade and ENoG) shows distinct patterns between TBMs and Bell's palsy.
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