Nonoperative management of traumatic facial nerve palsy

Forty-five patients with facial nerve palsy resulting from head injury were treated nonoperatively between 1975 and 1981. Of 31 patients who had polytomography, temporal bone fractures were demonstrated in 29. In 44 of 45 injuries, satisfactory clinical improvement in motor function was noted, including 65% (overall) who showed complete recovery. Fracture direction on polytomography, results of electromyography (performed in ten cases), and time of onset of paralysis were not correlated with outcome. The present findings suggest a limited role for early surgery in closed traumatic facial nerve palsy.