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
Post-traumatic bilateral longitudinal temporal bone fracture with bilateral facial nerve palsy: a rare case
