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Functional outcome of the facial nerve paralysis after late surgical decompression in otic capsule-sparing fracture

Abstract

Temporal bone fracture (TBF) following head trauma is a well-known cause of facial nerve paralysis (FNP) and almost 22% of all skull fractures are TBF. It has been estimated that 25–70% of TBF are associated with FNP and otic capsule-violating fracture of the petrous portion of the temporal bone is more commonly associated with FNP, although otic capsule-sparing fracture is more common. (a) The incidence of FNP is reported to be 10–25% of otic capsule-sparing fracture. (b) With otic capsule-sparing fractures, FNP is often delayed 2–3 days, and is incomplete and temporary, with good recovery during a period of 6–8 weeks. Most clinicians seldom consider a surgical intervention in delayed FNP; however, surgical exploration may be required for complete recovery. The optimal timing for surgical exploration of traumatic FNP to best preserve facial function is currently controversial. Decompression surgery still has a beneficial effect if performed within 14 days of injury. However, late exploratory surgery is recommended in patients who do not experience recovery of facial nerve function, patients who cannot be operated on early, and who present 1–3 months after TBF with more than 95% denervation on electroneurography. Here, we report a case of delayed-onset FNP of otic capsule-sparing fracture with an excellent outcome after late surgical decompression at 6 months after trauma.

References

  1. Chan EH, Tan HM, Tan TY. Facial palsy from temporal bone lesions. Ann Acad Med Singapore 2005;34:322–329.

    CAS  PubMed  Google Scholar 

  2. Wysocki J. Cadaveric dissections based on observations of injuries to the temporal bone structures following head trauma. Skull Base 2005;15:99–107.

    Article  Google Scholar 

  3. Gladwell M, Viozzi C. Temporal bone fractures: a review for the oral and maxillofacial surgeon. J Oral Maxillofac Surg 2008;66:513–522.

    Article  Google Scholar 

  4. Işik HS, Bostanci U, Yildiz O, Ozdemir C, Gökyar A. Retrospective analysis of 954 adult patients with head injury: an epidemiological study. Ulus Travma Acil Cerrahi Derg 2011;17:46–50.

    Article  Google Scholar 

  5. Bascarevic V, Samardzic M, Rasulic L, Simic V. Reconstructive surgery of facial nerve injuries. Acta Chir Lugosl 2003;50:63–67.

    Article  CAS  Google Scholar 

  6. Chang CY, Cass SP. Management of facial nerve injury due to temporal bone trauma. Am J Otol 1999;20:96–114.

    Article  CAS  Google Scholar 

  7. Sanuş GZ, Tanriöver N, Tanriverdi T, Uzan M, Akar Z. Late decompression in patients with acute facial nerve paralysis after temporal bone fracture. Turk Neurosurg 2007;17:7–12.

    PubMed  Google Scholar 

Download references

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Correspondence to Saleh K. Aboud MRCS (ENT) (Glasgow), MS (ORL-HNS).

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Aboud, S.K., Aini, A. & Abdullah, A. Functional outcome of the facial nerve paralysis after late surgical decompression in otic capsule-sparing fracture. Egypt J Otolaryngol 29, 280–282 (2013). https://doi.org/10.7123/01.EJO.0000433253.94335.33

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  • DOI: https://doi.org/10.7123/01.EJO.0000433253.94335.33

Keywords

  • facial nerve decompression
  • facial nerve paralysis
  • otic capsule-sparing fracture