Total Transcanal Endoscopic Approach for Selective Facial Nerve Decompression in Traumatic Facial Nerve Palsy

Introduction: The most common mechanism of post-traumatic facial nerve palsy are road accidents and falls. Treatment schemes as well as proper timing of surgery are still controversial. Purpose: The aim of the study was the evaluation of the effects of surgical treatment in patients with post-traumatic facial nerve palsy. Treatment results were correlated with epidemiological factors, mechanism of injury, level of nerve damage, time of surgery and its extent. Material and methods: 9 patients with facial nerve palsy after head trauma were analyzed. In all patients complete paresis of the VII nerve occurred immediately after the injury. In 5 patients the nerve was damaged in the course of the longitudinal fracture of the temporal bone, in 3 as a result of its transverse fracture while in one woman there was no evident fracture line. In all cases, surgical treatment was performed between 4 days and 13 weeks after the trauma. In all cases transmastoid approach was used. Edema lesions of the nerve dominated in 6 patients, in two cases a bone fragment was noted along its course, in one person nerve was disrupted but primary reconstruction was not possible - the man was excluded from further analysis. The results of treatment were assessed by House'a-Brackmann (HB) scale 12 months after the procedure. Results: Very good (HBI) or good (HBII) recovery of facial nerve function was achieved in 2 and 4 out of 8 patients respectively. Surgical timing, the extent of surgery, patient’s age, mechanism of injury and level of nerve damage had no effect on the final outcome. Conclusions: The management of post-traumatic facial nerve palsy should be individual. The commonly accepted recommendation on surgical treatment is to undertake it in patients with immediate-onset and complete paralysis. Patients who, due to their severe general condition, cannot undergo early facial nerve decompression may benefit from delayed treatment for up to 3 months after the injury. KEY WORDS: facial nerve palsy, facial nerve decompression, craniofacial injury, temporal bone fracture

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Facial nerve decompression via posterior tympanotomy approach in traumatic facial nerve palsy

Indian Journal of Neurotrauma ◽

10.1016/s0973-0508(10)80019-x ◽

2010 ◽

Vol 7 (1) ◽

pp. 85-87 ◽

Cited By ~ 1

Author(s):

P Paul ◽

K Sabrigirish ◽

B Choudhury ◽

K Upadhyay ◽

S Raina

Keyword(s):

Facial Nerve ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Nerve Decompression ◽

Posterior Tympanotomy ◽

Facial Nerve Decompression

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Facial Nerve Decompression in 30 Patients Who Showed Delayed Recovery from Peripheral Facial Nerve Palsy

Practica Oto-Rhino-Laryngologica ◽

10.5631/jibirin.115.37 ◽

2022 ◽

Vol 115 (1) ◽

pp. 37-41

Author(s):

Yoshihiko Kumai ◽

Momoko Ise ◽

Yorihisa Orita

Keyword(s):

Facial Nerve ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Nerve Decompression ◽

Delayed Recovery ◽

Peripheral Facial Nerve Palsy ◽

Facial Nerve Decompression

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Total Transcanal Endoscopic Facial Nerve Decompression for Traumatic Facial Nerve Palsy

Yonsei Medical Journal ◽

10.3349/ymj.2018.59.3.457 ◽

2018 ◽

Vol 59 (3) ◽

pp. 457 ◽

Cited By ~ 2

Author(s):

Aveline Aloyce Kahinga ◽

Ji Hyuk Han ◽

In Seok Moon

Keyword(s):

Facial Nerve ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Nerve Decompression ◽

Facial Nerve Decompression

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Current management of idiopathic facial palsy (Bell’s palsy)

Polski Przegląd Otorynolaryngologiczny ◽

10.5604/01.3001.0010.1027 ◽

2017 ◽

Vol 6 (2) ◽

pp. 25-30

Author(s):

Arkadiusz Paprocki ◽

Robert Bartoszewicz ◽

Kazimierz Niemczyk

Keyword(s):

Facial Nerve ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Combined Treatment ◽

Bell’S Palsy ◽

Diagnostic Techniques ◽

Etiologic Factor ◽

Bell's Palsy ◽

Idiopathic Facial Palsy ◽

Facial Nerve Decompression

Idiopathic facial nerve palsy, known also as Bell’s palsy, is a common condition encountered in everyday otolaryngological practice, and although the prognosis is fair, in case of incomplete recovery remains a marked physical disability for the patient. Despite of the development of diagnostic techniques, in most cases it is still impossible to point the etiologic factor, and therapy has to remain on empirical treatment. Material and method: In this article the review of literature on pathogenesis and therapy of idiopathic facial nerve palsy, published in years 2006–2016 was performed, presenting the articles with direct implications for everyday clinical practice. Results: According to presented articles, the importance of usage of combined treatment with steroids and antivirals, extended diagnostics for the presence of metabolic disorders(IGT) and surgical treatment with early facial nerve decompression in cases with severe degeneration of the fibers or recurrent paralysis were emphasized

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Otologic Wegener's Granulomatosis with Facial Nerve Palsy

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949810700702 ◽

1998 ◽

Vol 107 (7) ◽

pp. 555-559 ◽

Cited By ~ 27

Author(s):

Paul Dagum ◽

Joseph B. Roberson

Keyword(s):

Facial Nerve ◽

Wegener’S Granulomatosis ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Correct Diagnosis ◽

Cranial Nerves ◽

Serum Levels ◽

Antineutrophil Cytoplasmic Antibody ◽

Wegener's Granulomatosis ◽

Facial Nerve Decompression

Wegener's granulomatosis, characterized by necrotizing granulomas and vasculitis of the respiratory tract and kidney, frequently first presents with otologic symptoms. We report a case of primary otologic Wegener's granulomatosis in a patient who presented with symptoms of acute otomastoiditis and associated facial nerve palsy. The patient subsequently developed neuropathies of various cranial nerves. The patient underwent urgent mastoidectomy with facial nerve decompression. Nonspecific inflammatory disease of the mastoid mucosa delayed the correct diagnosis of Wegener's granulomatosis, which was confirmed by an elevated level of cytoplasmic-pattern antineutrophil cytoplasmic antibody (cANCA). We contrast the specificity of middle ear mucosal disease and cANCA serum levels in the diagnosis of Wegener's granulomatosis.

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Surgical management of facial nerve palsy: our experience

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20175563 ◽

2017 ◽

Vol 4 (1) ◽

pp. 38

Author(s):

Devang P. Gupta ◽

Shreya Rai ◽

K. S. Dinesh

Keyword(s):

Early Diagnosis ◽

Facial Nerve ◽

Surgical Management ◽

Diagnostic Tests ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Surgical Approaches ◽

High Prevalence ◽

Facial Nerve Decompression ◽

The Ideal

Background: Facial nerve palsy is a challenging task to deal with in patients as it has medical as well as social implications. The aim of this study was to examine the efficacy of different surgeries for facial palsy according to pathology and the ideal time for surgery. Methods: This prospective study was conducted with the help of a structured proforma for history and examination. Defined diagnostic tests were performed and depending on complexities of cases, different surgical approaches were done. Results: A total of 50 patients with secondary facial nerve palsies were included in our study and after thorough evaluation surgical management was planned. Ninety two percent were treated with facial nerve decompression, 4% with neurorrhaphy of the nerve and another 4% with cable graft. Conclusions: High prevalence of facial nerve palsy in today’s era necessitates early diagnosis and management in order to prevent complications and thereby reducing the risk of permanent disfigurement.

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