Surgical Management of Facial Paralysis Following Temporal Bone Fractures.
- Author:
Su Jin HAN
1
;
Won Sang LEE
;
Myung Hyun CHUNG
;
Hee Nam KIM
;
Ho Ki LEE
Author Information
1. Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea. hokilee@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Temporal bone fracture;
Facial nerve;
Facial paralysis
- MeSH:
Decompression;
Facial Nerve;
Facial Paralysis*;
Fibrosis;
Neuroma;
Otolaryngology;
Peripheral Nerves;
Retrospective Studies;
Temporal Bone*
- From:Korean Journal of Otolaryngology - Head and Neck Surgery
2005;48(1):24-29
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Controversy persists in regard to the management of traumatic facial paralysis. We reviewed the cases of decompression of traumatic facial nerve according to the type of fracture, injury site of nerve, injured state of nerve, surgical timing, surgical approach and opening of epineurium to determine good prognostic factors and propose in this article a rationale of management. SUBJECTS AND METHOD: The authors reviewed retrospectively 35 cases of the decompression of traumatic facial paralysis at the Department of Otorhinolaryngology, Yonsei University College of Medicine from January 1991 to December 2002. RESULTS: The most common site of the injury was perigeniculate area. The most common fracture type was longitudinal fracture. The results of immediate facial nerve decompression were excellent in functional recovery. The surgical findings of injured facial nerve were, in order, edematous swelling, bony impingement, fibrosis and partial transection, traumatic neuroma. Decompression with nerve sheath slitting appeared to provide better outcomes. The approach for decompression according to the injured sites was sufficiently adequate. CONCLUSION: According to our surgical experiences of traumatic facial paralysis, the important prognostic factors are timing of surgical intervention, injured state of the nerve and the slitting of the nerve sheath.
