The timing of surgical treatment of traumatic facial paralysis: a systematic review

Xie, Shaobing; Wu, Xuewen; Zhang, Yanni; Xu, Zhenhang; Yang, Tao; Sun, Huawei

doi:10.1080/00016489.2016.1201862

Cited by 25 publications

(12 citation statements)

References 11 publications

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“…TBF was found in 13 ears in this research, 4 ears were accompanied with FN injury, the perigeniculate area and tympanic segment was most commonly involved in the injury, which was in according with previous researches [4,11]. Though the timing of treatment of traumatic FN paralysis was under controversy [23], the case of traumatic FN paralysis combined with TOD was a good indicator for timely surgery, especially for the cases with severe immediate-onset facial paralysis and lack of response to the corticosteroid therapy. A few approaches can be used for FN decompression depending on the injury sites, including transmastoid approach and the middle cranial fossa approach, however, it is a challenging to control these areas through traditional surgical approaches [11].…”

Section: Discussionsupporting

confidence: 75%

Endoscopic Ear Surgery for the Management of Traumatic Ossicular Disruption with Intact Tympanic Membrane

Zhang¹,

Long²,

Deng³

et al. 2020

Preprint

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Background Traumatic ossicular disruption (TOD) usually had a severe conductive hearing loss, the exploratory tympanotomy is critical for the diagnosis and improve hearing. Endoscopic ear surgery (EES) is becoming popular in the last decade, we conducted a retrospective study to explore the efficacy of EES for management of TOD and the accompanied injuries.Methods A retrospective study was performed on 18 ears (16 patients) of TOD with intact TM from May 2017 to Jun 2019 in our department. EES was conducted to check the ossicular chain anomalies, and to perform the ossiculoplasty and facial nerve (FN) decompression depending on the intraoperative findings. Hearing outcomes and surgical complications were assessed at 6 months postoperatively. Results The incus injury was the most common type of TOD, which was observed in 14 ears (77.8%), stapes suprastructure fracture was observed in 4 ears (22.2%). FN injury was found in 4 out of 13 ears with temporal bone fracture (TBF), the injury sites were mainly located in the perigeniculate area and the tympanic segment of FN. It showed the postoperative average pure-tone average (PTA) gain was 22.9 ± 9.5 dB, and the average ABG closure was 22.2 ± 8.3 dB, ABG closure to 20 dB or less and ABG closure to 10 dB or less were achieved in 18 ears (100%) and 14 ears (77.8%), respectively. The facial function achieved favorable recovery of House-Brackmann (H-B) grade Ⅰ (3 ears) and grade Ⅱ (1 ear) in all the 4 cases in 6 months after surgery. No iatrogenic FN paralysis and significant sensorineural hearing loss were observed. Conclusions ESS was effective in diagnosis and management of TOD and the accompanied otologic injuries, such as FN paralysis, it showed favorable surgical outcomes. ESS provides an alternative method to manage TOD with the advantage of excellent vision and less invasion.

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Section: Discussionsupporting

confidence: 75%

Endoscopic Ear Surgery for the Management of Traumatic Ossicular Disruption with Intact Tympanic Membrane

Zhang¹,

Long²,

Deng³

et al. 2020

Preprint

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“… 28 For traumatic facial palsy, surgical decompression within two weeks of onset had good results, and surgical exploration within two months lead to acceptable outcomes. 29 …”

Section: Resultsmentioning

confidence: 99%

“…In a comparative study between VII-to-VII and XII-to-VII coaptation for facial nerve reanimation, XII-to-VII showed a higher probability of functional restoration, but also had higher complication rates and required second-stage surgery. 29 …”

Section: Resultsmentioning

confidence: 99%

Acute Peripheral Facial Palsy: Recent Guidelines and a Systematic Review of the Literature

Kim

Lee

2020

J Korean Med Sci

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Background This study reviews recent literature on facial palsy guidelines and provides systematic reviews on related topics of interest. Methods An electronic database search was performed to identify recent guidelines dealing with facial nerve palsy, systematic reviews and recent meta-analysis published between 2011 and 2019 (inclusive). The literature search used the search terms “Bell's palsy,” “Ramsay-Hunt syndrome,” “Facial palsy,” “Facial paralysis,” “Facial paresis,” “Guideline,” “Meta-analysis,” “Systematic review,” and “Randomized controlled trial.” Only studies written in English were used. Results The characteristics of treatment trends for facial palsy have been reviewed over the past decade. The most prominent change noted may be the shift from the conventional House-Brackmann facial nerve grading system to the Sunnybrook and eFACE systems. In addition, the results of serial meta-analyses indicate increasing agreement with the use of surgical decompression of the facial nerve. Beyond steroids or combined steroid-antiviral treatment, various novel drugs and treatments have been tried. For long-standing facial paralysis and postparetic synkinesis sequelae after facial palsy, facial reanimation has been highlighted and the necessity of new paradigms have been raised. Conclusion For peripheral facial paralysis, various changes have been made, not only in the facial nerve grading systems, but also in medical treatments, from surgical procedures to rehabilitation, during the last decade.

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“…Preoperatively 12% (6) patients were in grade II, 12% (6) in grade III, 48% (24) in grade IV, 28% (14) in grade V. At the end of study that is 12 months 88% (44) patients had successful outcome with surgery however 12% (6) did not due to late presentation leading to complete laceration of the nerve in comparison to a study done by Luan et al 60 patients who were surgically treated, 39 achieved grade I of facial nerve function, 18 achieved grade II, two achieved grade III, and one achieved grade IV according to the HB grading system, thus 65% (39) of the patients achieved grade I facial nerve function. 9 On the basis of the outcome observed in the present surgical series, the recovery of satisfactory facial nerve function could be achieved, regardless of timing of surgery performed, within the first 3 months after the onset of paralysis which was similar to a study done by Darrouzet et al 10 This study demonstrates that unless there is a disruption of the main trunk, necessitating primary end to end anastomosis or grafting, the type of injury does not have any clear effect on the facial outcome, as long as appropriate surgical management is applied.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of facial nerve palsy: our experience

Gupta

Rai

Dinesh

2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Facial nerve palsy is a challenging task to deal with in patients as it has medical as well as social implications. The aim of this study was to examine the efficacy of different surgeries for facial palsy according to pathology and the ideal time for surgery. Methods: This prospective study was conducted with the help of a structured proforma for history and examination. Defined diagnostic tests were performed and depending on complexities of cases, different surgical approaches were done. Results: A total of 50 patients with secondary facial nerve palsies were included in our study and after thorough evaluation surgical management was planned. Ninety two percent were treated with facial nerve decompression, 4% with neurorrhaphy of the nerve and another 4% with cable graft. Conclusions: High prevalence of facial nerve palsy in today’s era necessitates early diagnosis and management in order to prevent complications and thereby reducing the risk of permanent disfigurement.

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The timing of surgical treatment of traumatic facial paralysis: a systematic review

Cited by 25 publications

References 11 publications

Endoscopic Ear Surgery for the Management of Traumatic Ossicular Disruption with Intact Tympanic Membrane

Endoscopic Ear Surgery for the Management of Traumatic Ossicular Disruption with Intact Tympanic Membrane

Acute Peripheral Facial Palsy: Recent Guidelines and a Systematic Review of the Literature

Surgical management of facial nerve palsy: our experience

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