Comparison between early and delayed facial nerve decompression in traumatic facial nerve paralysis - A retrospective study

Irugu, David Victor Kumar; Singh, Anoop; Ch, Sravan; Panuganti, Achyuth; Acharya, Anand; Varma, Hitesh; Thota, Ramya; Falcioni, Maurizio; Reddy, Sridhar

doi:10.1590/2317-1782/20182017063

Cited by 12 publications

(11 citation statements)

References 14 publications

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“…[2,4,[12][13][14]17,20] ere are many reports that decompression was effective, especially when interventions were performed in the acute phase. [3,5,6,9,18,19] However, most patients with temporal bone fractures due to severe head injury suffer from intracranial or systemic complications and present with impaired consciousness. Facial nerve function assessment is challenging for patients with impaired consciousness, [1] and poor clinical conditions delay intervention.…”

Section: Discussionmentioning

confidence: 99%

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A case of facial nerve palsy caused by severe head injury treated by translabyrinthine approach

Suzuki¹,

Noda²,

Ota³

et al. 2023

Surgical Neurology International

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Background: Several treatments for traumatic facial paralysis have been reported, but the role of surgery is still controversial. Case Description: A 57-year-old man was admitted to our hospital with head trauma due to a fall injury. A total body computed tomography (CT) scan showed a left frontal acute epidural hematoma associated with a left optic canal and petrous bone fractures with the disappearance of the light reflex. Hematoma removal and optic nerve decompression were performed immediately. The initial treatment was successful with complete recovery of consciousness and vision. The facial nerve paralysis (House and Brackmann scale grade 6) did not improve after medical therapy, and thus, surgical reconstruction was performed 3 months after the injury. The left hearing was lost entirely, and the facial nerve was surgically exposed from the internal auditory canal to the stylomastoid foramen through the translabyrinthine approach. The facial nerve’s fracture line and damaged portion were recognized intraoperatively near the geniculate ganglion. The facial nerve was reconstructed using a greater auricular nerve graft. Functional recovery was observed at the 6-months follow-up (House and Brackmann grade 4), with significant recovery in the orbicularis oris muscle. Conclusion: Interventions tend to be delayed, but it is possible to select a treatment method of the translabyrinthine approach.

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Section: Discussionmentioning

confidence: 99%

“…[ 2 , 4 , 12 - 14 , 17 , 20 ] There are many reports that decompression was effective, especially when interventions were performed in the acute phase. [ 3 , 5 , 6 , 9 , 18 , 19 ]…”

Section: Discussionmentioning

confidence: 99%

A case of facial nerve palsy caused by severe head injury treated by translabyrinthine approach

Suzuki¹,

Noda²,

Ota³

et al. 2023

Surgical Neurology International

View full text Add to dashboard Cite

show abstract

“…2,16,17 In a study, they stated that the surgery performed before 6 weeks had better results and that early treatment of bone spicules, slipped ossicles, and step deformities, and the fact that fibrosis in the nerve after 6 weeks prevented regeneration were effective in this result. 18 One review reported that patients who underwent surgery before 2 weeks had a better prognosis. 19 In addition, it has been reported that as the denervation time increases, muscle fibrosis and atrophy increase.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Surgical Treatment in Traumatic Facial Paralysis

Erkan

Erkan²,

Tokuçoğlu

2021

Journal of Craniofacial Surgery

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Introduction: In the etiology of facial nerve palsy, trauma is the most important. Our aim was to present our experience gained by evaluating the surgical approaches we have used in extratemporal and intratemporal facial nerve injuries and their long-term results, also to contribute to the consensus that will be formed on this subject. Materials and Methods: Thirteen patients among 24 patients who underwent surgery with a diagnosis of traumatic facial paralysis were evaluated in this study. The clinical response of these patients to treatment was examined by classifying them according to the House-Brackmann classification in the preoperative and postoperative periods. Results: Of the 13 patients, 9 had fractures due to temporal bone trauma, and 4 had nerve damage in the extratemporal part of the facial nerve. in the treatment, facial nerve decompression was performed using the middle fossa approach in 9 patients with temporal bone fractures. in the 4 patients with extratemporal facial nerve injury, graft repair or primary suturing was performed. in the postoperative period, the stages of the patients were III or below in 12 patients (92%), and only 1 (8%) patient remained in stage IV. Discussion: When the postop conditions of the patients were examined according to House-Brackmann staging, it was observed that surgical treatment caused a significant improvement in the functions of the facial nerve. Conclusions: Our results showed that surgery was an effective treatment method in patients with indications for traumatic facial paralysis.

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“…Permanent facial palsy can occur in up to 7% of patients undergoing parotidectomy [6,7]. Another potential complication is paresthesia, also described in superficial parotidectomy.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Facial Nerve Functionality and Survival Rates of Patients with Parotid Salivary Gland Carcinoma Submitted to Surgery, Facial Nerve Reconstruction, and Adjuvant Radiotherapy

Bernaola-Paredes

Novelli

Albuja-Rivadeneira

et al. 2023

Surgical Techniques Development

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Background and Objectives: Parotid cancer (PC), when treated surgically, may have associated damage to the functionality of the facial nerve. The role of radiotherapy in the recovery of facial motricity remains controversial. This study aimed to evaluate the impact of radiotherapy (RT) on facial nerve functionality in patients who underwent parotidectomy and facial nerve microsurgical reconstruction. Materials and Methods: Four groups of patients were composed: (a) those who underwent parotidectomy without facial nerve reconstruction and RT; (b) those with nerve reconstruction and without RT; (c) those without nerve reconstruction and RT; and (d) those with nerve reconstruction and RT. Results: 49 patients were male, and 43 were female. A total of 89 underwent parotidectomy, 45 partials, and 44 total. Thus, in nine patients, the sural nerve was used for microsurgical reconstruction. Moreover, 48 patients had a normal facial pattern, 15 with paresthesia, and 29 with permanent paralyses after the House–Brackmann (HB) scale evaluation. Conclusions: The evaluation of nerve functionality after parotidectomy by the House–Brackmann scale is a feasible way to evaluate facial motricity that has already decreased in these patients. Finally, longitudinal studies must be performed to clarify the role of each therapy in the multimodal approach and their clinical impact in facial nerve function.

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Comparison between early and delayed facial nerve decompression in traumatic facial nerve paralysis - A retrospective study

Cited by 12 publications

References 14 publications

A case of facial nerve palsy caused by severe head injury treated by translabyrinthine approach

A case of facial nerve palsy caused by severe head injury treated by translabyrinthine approach

Effectiveness of Surgical Treatment in Traumatic Facial Paralysis

Analysis of Facial Nerve Functionality and Survival Rates of Patients with Parotid Salivary Gland Carcinoma Submitted to Surgery, Facial Nerve Reconstruction, and Adjuvant Radiotherapy

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