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Facial nerve palsy in mastoid surgery
1Department of Otolaryngology, Groote Schuur Hospital, Cape Town, R.S.A.
The Journal of Laryngology and Otology
|February 1, 1997
Summary
Facial nerve injury during mastoid surgery occurs in about 1% of cases. Prompt management, including decompression and conservative care, leads to good recovery for most patients with facial palsy.
Area of Science:
- Otolaryngology
- Neurosurgery
- Surgical Complications
Background:
- Facial nerve injury risk in mastoid surgery has decreased but remains significant.
- Current incidence of facial nerve injury is approximately 1%.
Purpose of the Study:
- Quantify the incidence of facial nerve injury during mastoid surgery.
- Evaluate outcomes of different management strategies for facial nerve palsy.
- Present a management protocol for facial nerve injury.
Main Methods:
- Retrospective review of 1024 mastoidectomies performed between 1985 and 1994.
- Analysis of 17 identified cases of facial nerve palsy (complete and incomplete).
- Review of management protocols including decompression, grafting, and conservative therapy.
Main Results:
- 17 cases of facial nerve palsy identified (7 complete, 10 incomplete).
- Complete palsies treated with decompression alone showed better recovery (House Brackmann Grade 2 or better) than those with decompression and grafting.
- Incomplete palsies treated conservatively showed excellent recovery (House Brackmann Grade 2 or better).
Conclusions:
- Mastoid surgery continues to pose a risk of facial nerve injury.
- Early decompression and conservative management are effective for incomplete facial nerve palsies.
- A structured management protocol is crucial for optimizing outcomes in facial nerve injury post-mastoidectomy.
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