Primary Neurorraphy of the Frontotemporal Branch of the Facial Nerve in Pediatric Patients

Abstract

Injuries to the frontotemporal nerve cause visual field deficits, in addition to mental and emotional problems due to the associated facial paralysis. This study aimed to evaluate children treated with primary neurorrhaphy of the frontotemporal nerve and to identify the factors that affect treatment outcome. This retrospective study included children that underwent primary neurorrhaphy between 2015 and 2021 due to frontotemporal nerve injury. Medical records, including patient sex and age, the time from injury to surgery, injury zone, the postsurgery week that frontalis muscle activity was first observed, and the postsurgery week that full symmetry with the opposite eyebrow was achieved, were reviewed. The relationship between treatment success, and age group, sex, postinjury timing of surgery (≤72 versus >72 h), and injury zone, was analyzed. The study included 17 patients (9 males and 8 females) with a mean age of 8.8 years. In all, 11 (64.7%) patients achieved full symmetry following surgery and 3 (17.6%) patients gained some muscle activity, but not symmetrically. Among the patients, 9 underwent surgery within 24 hours of injury, versus 5 patients 3 to 7 days postinjury and 3 patients >1 week after injury. Age, sex, and timing of surgery were not significantly correlated with treatment success. There were significant differences in outcome according to injury zone. Surgical success can be obtained with timely primary neurorrhaphy in pediatric patients with traumatic frontotemporal nerve injury. The most important factor affecting the outcome of primary neurorrhaphy for frontotemporal nerve injury is the injury zone. Level of Evidence: Level III—case-control study.