Traumatic facial nerve paralysis

Traumatic facial nerve paralysis: case presentation and personal experience
Dr. Masoumeh Saidi

The management of facial paralysis continues to evolve. Understanding the facial nerve anatomy and the different methods of evaluating the degree of facial nerve injury are crucial for successful management.

Second most common cause of FN paralysis behind Bell ’s palsy is trauma that Represents %15 of all cases of FN paralysis. Most common cause of traumatic facial nerve injury is temporal bone fracture. Penetrating Trauma, Typically results in FN injury in the extra temporal segments. Gunshot wounds cause both intratemporal and extra temporal injuries.GS wounds to temporal bone result in FN paralysis in %50 of cases.

– When the facial nerve is transected, direct coaptation leads to the best outcome, followed by interpositional nerve grafting. In cases where motor end plates are still intact but a primary repair or graft is not feasible, a nerve transfer should be employed. When complete muscle atrophy has occurred, regional muscle transfer or free flap reconstruction is an option. When dynamic reanimation cannot be undertaken, static procedures offer some benefit.

– This presentation gives an overview of the diagnostic and therapeutic facial nerve palsy and some patients with traumatic facial palsy and their treatment.