scholarly journals Bilateral Traumatic Facial Paralysis with Hearing Impairment and Abducens Palsy

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Imane Ouhbi ◽  
Taoufik Abdellaoui ◽  
Noureddine Errami ◽  
Fouad Benariba
Keyword(s):  
Hearing Impairment ◽  
Temporal Bone ◽  
Facial Paralysis ◽  
Conservative Management ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Abducens Nerve ◽  
Abducens Palsy ◽  
Temporal Bone Fracture ◽  
Nerve Paralysis

The temporal bone is often affected in basilar skull fractures. Fractures involving the petrous portion are particularly significant, as they may be associated with neurovascular sequelae. Bilateral facial paralysis secondary to bilateral temporal bone fracture is a rare clinical entity, even more so when associated with other cranial nerve damage such as abducens nerve paralysis and hearing impairment. Only 4 similar cases have been reported in the literature to date. In this paper, we describe a 28-year-old male patient with bilateral facial paralysis, unilateral abducens palsy, and bilateral hearing loss due to bitemporal fractures that developed after a motor vehicle accident. Conservative management was preferred. The 6-month follow-up showed remarkable improvement. This report highlights the effectiveness of conservative management in posttraumatic complete facial and abducens palsy.

Comparison of the application of artificial ossicles and autologous ossicles in the reconstruction of a damaged ossicular chain

2018 ◽  
Vol 132 (10) ◽  
pp. 885-890
Author(s):  
L Zhao ◽  
J Li ◽  
S Gong
Keyword(s):  
Facial Nerve ◽  
Temporal Bone ◽  
Pure Tone ◽  
Bone Fractures ◽  
Pure Tone Audiometry ◽  
Ossicular Chain ◽  
Facial Nerve Paralysis ◽  
Temporal Bone Fracture ◽  
Nerve Paralysis ◽  
Ossicular Reconstruction

AbstractObjectiveTo evaluate the therapeutic effect that the titanium partial ossicular reconstruction prosthesis and autologous ossicles have on hearing loss after reconstruction of a damaged ossicular chain.MethodsForty-two medical records of treatments carried out from 2013 to 2015 for ossicular chain damage with facial nerve paralysis due to temporal bone fractures were reviewed. The study assessed: causes of damage, pre-operative pure tone audiometry findings, types of intra-operative ossicular chain damage, intra-operative ossicular chain repair methods (titanium partial ossicular reconstruction prosthesis or autologous ossicles) and post-operative pure tone audiometry results.ResultsThe titanium partial ossicular reconstruction prosthesis was used in 26 cases; the average air–bone gap was 32.3 ± 5.3 dB pre-operatively and 12.8 ± 5.3 dB post-operatively. Autologous ossicles were used in 16 cases; the average air–bone gap was 33.4 ± 4.5 dB pre-operatively and 17.8 ± 7.8 dB post-operatively.ConclusionOssicular chain reconstruction is an effective way of improving hearing in patients with ossicular chain damage. The results suggest that repair with either the titanium partial ossicular reconstruction prosthesis or autologous ossicles can improve hearing following ossicular chain injury with facial nerve paralysis caused by a temporal bone fracture.

Reliability of temporal bone high-resolution CT in patients with facial paralysis in temporal bone fracture

2018 ◽  
Vol 39 (2) ◽  
pp. 150-152 ◽  
Author(s):  
Yuefeng Chen ◽  
Kai Zhang ◽  
Yanfeng Xu ◽  
Yanxu Che ◽  
Linna Guan ◽  
...  
Keyword(s):  
High Resolution ◽  
Temporal Bone ◽  
Facial Paralysis ◽  
Bone Fracture ◽  
Temporal Bone Fracture ◽  
High Resolution Ct

Levator recession and minimal lateral tarsorrhaphy for the management of lagophthalmos and corneal exposure in facial palsy

2019 ◽  
pp. 112067211988198
Author(s):  
Bahram Eshraghi ◽  
Hadi Ghadimi ◽  
Mojgan Nikdel
Keyword(s):  
Facial Paralysis ◽  
Facial Palsy ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Case Series ◽  
Levator Muscle ◽  
Vehicle Accident ◽  
Parotid Surgery ◽  
Common Etiology ◽  
Additional Procedure

Purpose: Recession of levator muscle can potentially decrease the severity of corneal exposure by reducing margin-reflex distance 1. The purpose of this study is evaluation of effects of levator recession on lagophthalmos in facial palsy. Materials and methods: In a non-comparative case series of consecutive patients with exposure keratopathy due to facial paralysis between 2012 and 2017, levator recession was performed through lid crease incision. Small-size (⩽3 mm) lateral tarsorrhaphy was performed on a case-by-case basis for those with moderate-to-severe keratopathy. Preoperative and postoperative measurements of margin-reflex distance 1 and lagophthalmos were compared using paired t-test. Results: Thirty-four patients (14 men and 20 women) were enrolled with an average age of 52.3 years. Mean follow-up was 13.3 months (range, 6–36 months). The most common etiology of facial paralysis was Bell’s palsy (22 cases), followed by motor vehicle accident (8), parotid surgery (3), and brain tumor surgery (1). No additional procedure was performed for eight patients, while lateral tarsorrhaphy was performed in 26 cases. Mean margin-reflex distance 1 decreased from 5.0 ± 0.4 mm to 4.0 ± 0.5 mm ( p < 0.001) and mean lagophthalmos decreased from 3.3 ± 0.9 mm to 1.8 ± 0.9 mm ( p < 0.001). Subgroups of patients with additional lateral tarsorrhaphy and without tarsorrhaphy experienced the same amount of reduction in margin-reflex distance 1 and lagophthalmos. Conclusion: Recession of levator muscle was effective in reduction of margin-reflex distance 1 and lagophthalmos in facial palsy patients. This procedure can be added to the surgical armamentarium for management of patients with facial palsy and lagophthalmos.

Abducens Nerve Avulsion and Facial Nerve Palsy After Temporal Bone Fracture: A Rare Concomitance of Injuries

2016 ◽  
Vol 88 ◽  
pp. 689.e5-689.e8 ◽  
Author(s):  
Tej D. Azad ◽  
Anand Veeravagu ◽  
Carleton Eduardo Corrales ◽  
Kevin K. Chow ◽  
Nancy J. Fischbein ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Temporal Bone ◽  
Bone Fracture ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Abducens Nerve ◽  
Temporal Bone Fracture

scholarly journals Ipsilateral facial nerve injury with contralateral labyrinthine concussion and subdural hematoma in a case of longitudinal temporal bone fracture

2017 ◽  
Vol 16 (4) ◽  
pp. 594-596
Author(s):  
Khim Soon Vong ◽  
Mohd Khairi Md Daud
Keyword(s):  
Hearing Loss ◽  
Head Trauma ◽  
Subdural Hematoma ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Medical Science ◽  
Trauma Patients ◽  
Temporal Bone Fracture ◽  
Vehicle Accident ◽  
Hearing Assessment

Head trauma can lead to hearing loss. Both sensorineural and conductive hearing loss has been reported in cases of head injury. We report a case of labyrinthine concussion and subdural hematoma in the opposite ear of a patient who had head trauma after involved in motor vehicle accident. A complete hearing assessment for head trauma patients should be advised as it can avoid misdiagnosis and negligence in management.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.594-596

scholarly journals Bilateral Facial Paralysis Caused by Bilateral Temporal Bone Fracture: A Case Report and a Literature Review

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Sultan Şevik Eliçora ◽  
Aykut Erdem Dinç ◽  
Sultan Bişkin ◽  
Murat Damar ◽  
Ergin Bilgin
Keyword(s):  
Temporal Bone ◽  
Facial Paralysis ◽  
Bone Fracture ◽  
Decompression Surgery ◽  
Occupational Accident ◽  
Rare Clinical Entity ◽  
Temporal Bone Fracture ◽  
Grade 5 ◽  
The Right ◽  
Temporal Bones

Bilateral facial paralysis caused by bilateral temporal bone fracture is a rare clinical entity, with seven cases reported in the literature to date. In this paper, we describe a 40-year-old male patient with bilateral facial paralysis and hearing loss that developed after an occupational accident. On physical examination, House-Brackmann (HB) facial paralysis of grade 6 was observed on the right side and HB grade 5 paralysis on the left. Upon temporal bone computed tomography (CT) examination, a fracture line exhibiting transverse progression was observed in both petrous temporal bones. Our patient underwent transmastoid facial decompression surgery of the right ear. The patient refused a left-side operation. Such patients require extensive monitoring in intensive care units because the presence of multiple injuries means that facial functions are often very difficult to evaluate. Therefore, delays may ensue in both diagnosis and treatment of bilateral facial paralysis.

Bilateral traumatic facial paralysis associated with unilateral abducens palsy: a case report

2005 ◽  
Vol 119 (2) ◽  
pp. 144-147 ◽  
Author(s):  
Tuncay Ulug ◽  
S Arif Ulubil
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
Motor Vehicle ◽  
Bone Fractures ◽  
Middle Cranial Fossa ◽  
Geniculate Ganglion ◽  
Abducens Palsy ◽  
Middle Cranial Fossa Approach ◽  
Cranial Fossa ◽  
The Right

Bilateral traumatic facial paralysis is a very rare clinical condition. Abducens palsy, associated with bilateral traumatic paralysis, is even rarer and has not been well described in the literature. In this report, a 24-year-old male, who developed immediate bilateral facial and right abducens paralyses following a motor vehicle accident, is presented. The patient was referred for neurotologic evaluation 22 days after the injury. Electroneurography (ENoG) demonstrated 100 per cent degeneration at the first examination and, correspondingly, electromyography showed no regeneration potentials. Using high-resolution computed tomography (HRCT), a longitudinal fracture on the right and a mixed-type fracture on the left were identified. The patient had good cochlear reserve on both sides. The decision for surgery was based not on ENoG, because of the delayed referral of the patient, but on the HRCT, which showed clear fracture lines on both sides. The middle cranial fossa approach for decompression of the right facial nerve was performed on the 55th day following the trauma, and a combined procedure using the middle cranial fossa and transmastoid approaches was applied for decompression of the left facial nerve on the 75th day following the trauma. On the right, there was dense fibrosis surrounding the geniculate ganglion and the proximal tympanic segment whereas, on the left, bone fragments impinging on the geniculate ganglion, dense fibrosis surrounding the geniculate ganglion, and a less extensive fibrotic tissue surrounding the pyramidal segment were encountered. There were no complications or hearing deterioration. At the one-year follow up, the patient had House-Brackmann (HB) grade 1 recovery on the right, and HB grade 2 recovery on the left side, and the abducens palsy regressed spontaneously. The middle cranial fossa approach and its combinations can be performed safely in bilateral temporal bone fractures as labyrinthine sparing procedures if done on separate occasions.

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