Evaluation and Treatment Options of Post Traumatic Facial Nerve Palsy
Facial nerve paralysis by trauma is common cause after idiopathic. Facial palsy as a result of intra cranial, intra temporal and extra temporal blunt injury or fracture and both. Sudden and immediate facial nerve palsy needs early surgical intervention for better outcome. Facial nerve decompression and terminoterminal anastmosis surgical intervention had done in present study. It is a prospective study was done between 2004 to 2006 in Department of Otolaryngology and Head & Neck Surgery in Gandhi Medical College and Associate Hamidia Hospital, Bhopal, (M.P.). The complete clinic examination, otoscopic, audio logical, topodiagnostic, and radiological evaluation were done in all the patients. The outcome of these patients was done on the HouseBrackmann nerve grading system.
All patients have infra nuclear type of facial nerve palsy. The maximum incidence of facial nerve paralysis found in the age group between 21 to 30 years. The most common mode of injury was motor vehicle accident in ten patients (60%) and thirteen (76%) patients show complete facial nerve palsy, three (18%) patients were temporal bone fracture and two patients were suffered head injury. Out of 17 patients, 13 patients were normal hearing. Suprachordal (47%) involvement is the most common site of lesion in traumatic facial nerve paralysis.
Sudden and immediate onset facial nerve paralysis needs early surgical intervention for better outcome. Facial nerve decompression was better outcome comparing to termino terminal anastmosis. The facial nerve paralysis prognosis depends upon degree of paralysis, duration of paralysis, site of injury and patients’ factors.