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Blast injuries to the facial nerve
1Department of Otolaryngology, University of Miami School of Medicine, FL.
Summary
Penetrating facial nerve injuries with immediate paralysis may not always involve nerve transection. Electroneuronography can help guide treatment for these traumatic facial nerve injuries.
Area of Science:
- Neurosurgery
- Otolaryngology
- Trauma Surgery
Background:
- Facial nerve injuries often result from trauma.
- Immediate, total paralysis typically prompts surgical exploration and repair.
Purpose of the Study:
- To evaluate the necessity of surgical exploration for extratemporal facial nerve injuries caused by bullets.
- To assess the utility of electroneuronography in managing these cases.
Main Methods:
- Retrospective review of five patients with bullet injuries to the extratemporal facial nerve.
- Surgical exploration in four patients.
- Serial electroneuronography in three patients.
Main Results:
- Only one of four surgically explored patients had complete facial nerve transection.
- Two patients showed complete nerve degeneration within one week post-injury.
- One patient with no complete degeneration showed partial recovery.
Conclusions:
- Immediate, total facial paralysis from penetrating bullet injuries does not always indicate nerve transection.
- Electroneuronography is a valuable tool for assessing injury severity and guiding treatment.
- A non-operative approach guided by electroneuronography may be appropriate in select cases.