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Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
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Intraoperative electrical stimulation for persistent, post-traumatic facial paralysis.

Monique North1, Jeffrey Weishaar2, John P Leonetti2

  • 1Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA.

Ear, Nose, & Throat Journal
|April 24, 2023
PubMed
Summary

Facial nerve paralysis from temporal bone fractures can be treated surgically. Delayed intervention impacts recovery, but intraoperative facial nerve stimulation may improve outcomes even after a significant delay.

Keywords:
facial nerveintraoperative electrical stimulationparalysistemporal bone

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Area of Science:

  • Neurosurgery
  • Otolaryngology
  • Trauma Surgery

Background:

  • Temporal bone fractures frequently cause facial nerve paralysis.
  • Treatment varies based on nerve trauma severity, from conservative to surgical.
  • Delayed surgical intervention is linked to poorer recovery rates.

Purpose of the Study:

  • To present a case of delayed facial nerve palsy following temporal bone fracture.
  • To evaluate the efficacy of intraoperative facial nerve stimulation in such cases.

Main Methods:

  • A 14-year-old male with temporal bone fracture and delayed facial paralysis was treated.
  • A transmastoid middle cranial fossa (MCF) approach was utilized.
  • Intraoperative electrical stimulation of the perigeniculate facial nerve was performed.

Main Results:

  • Facial function improved from House Brackmann (HB) grade VI to grade II within 6 months.
  • This improvement occurred despite a 53-day delay between trauma and surgery.

Conclusions:

  • Intraoperative facial nerve stimulation may be beneficial for persistent post-traumatic facial paralysis.
  • This technique shows promise even with delayed surgical intervention.