Publication:

Traumatic facial nerve palsy: evaluation and surgical management

Background Acute facial paralysis can result from various causes, among which intra temporal facial palsy is relatively common. Of all the cranial nerves, the facial nerve is most susceptible to injury due to its long course within the skull. Diagnosis of facial palsy is usually made by a good clinical history, examination and radiological investigations. Electrophysiological tests are important for prognosis and optimal time for surgery. The aim is to study the evaluation and surgical management in traumatic cause of facial nerve palsy.

Methods This prospective cross-sectional study was carried out in 50 patients presented with facial nerve palsy due to trauma in civil hospital Ahmedabad over a period of 1 year from May 2018 to 2019. Patients were examined and graded using House and Brackmann grading system. All the patients were evaluated and treated by surgical decompression. Follow up was carried out upto 6 months.

Results The cause of facial nerve palsy in all 50 patients was accidental head trauma. All the patients were managed by surgical decompression. 46 out of 50 patients managed surgically had good recovery with restoration of complete facial nerve function. 4 out 50 patients had poor recovery due to late presentation.

Conclusions Early initiation of treatment is important for favorable recovery of facial nerve function after trauma. Surgical treatment is indicated in suspected bony impingement of nerve. Surgical decompression if done early usually results in very good recovery.