Facial Nerve Decompression for Facial Nerve Palsy with Temporal Bone Fracture: Analysis of 25 Cases

Nam, Han Ga Wi; Hwang, Hyung Sik; Moon, Seung Myung; Shin, Il Young; Sheen, Seung Hun; Jeong, Je Hoon

Abstract

PURPOSE
The aim of this study is to present a retrospective review of patients who had a sudden onset of facial palsy after trauma and who underwent facial nerve decompression.
METHODS
The cases of 25 patients who had traumatic facial palsy were reviewed. Facial nerve function was graded according to the House-Brackmann grading scale. According to facial nerve decompression, patients were categorized into the surgical (decompression) group, with 7 patients in the early decompression subgroup and 2 patients in the late decompression subgroup, and the conservative group(16 patients).
RESULTS
The facial nerve decompression group included 8 males and 1 female, aged 2 to 86 years old, with a mean age of 40.8. In early facial nerve decompression subgroup, facial palsy was H-B grade I to III in 6 cases (66.7%); H-B grade IV was observed in 1 case(11.1%). In late facial nerve decompression subgroup, 1 patient (11.1%) had no improvement, and the other patient(11.1%) improved to H-B grade III from H-B grade V. A comparison of patients who underwent surgery within 2 weeks to those who underwent surgery 2 weeks later did not show any significant difference in improvement of H-B grades (p>0.05). The conservative management group included 15 males and 1 female, aged 6 to 66 years old, with a mean age of 36. At the last follow up, 15 patients showed H-B grades of I to III(93.7%), and only 1 patient had an H-B grade of IV(6.3%).
CONCLUSION
Generally, we assume that early facial nerve decompression can lead to some recovery from traumatic facial palsy, but a prospective controlled study should and will be prepared to compare of conservative treatment to late decompression.