Hearing preserved traumatic delayed facial nerve paralysis without temporal bone fracture: neurosurgical perspective and experience in the management of 25 cases

Abstract Background Delayed FNP due to HT is a rarely encountered clinical entity, and optimal treatment still remains to be elucidated. Methods Twenty-five patients with delayed traumatic FNP without TBF, who had serviceable hearing, were included in our study. Thirteen patients underwent surgical...

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Bibliographic Details
Published in:Surgical neurology 2009-03, Vol.71 (3), p.304-310
Main Authors: Sanus, Galip Zihni, MD, Tanriverdi, Taner, MD, Tanriover, Necmettin, MD, Ulu, Mustafa Onur, MD, Uzan, Mustafa, MD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Audiometry
Child
Decision Making
Decompression, Surgical
Electrodiagnosis
Facial Nerve Injuries - diagnosis
Facial Nerve Injuries - surgery
Facial nerve paralysis
Facial Paralysis - surgery
Facial Paralysis - therapy
Female
Follow-Up Studies
Head trauma
Hearing
Humans
Male
Middle Aged
Neurology
Surgery
Temporal Bone
Temporal bone fracture
Time Factors
Treatment Outcome
Young Adult
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Summary:Abstract Background Delayed FNP due to HT is a rarely encountered clinical entity, and optimal treatment still remains to be elucidated. Methods Twenty-five patients with delayed traumatic FNP without TBF, who had serviceable hearing, were included in our study. Thirteen patients underwent surgical decompression, whereas 12 were managed medically depending on the ENoG findings, which were obtained within the first 3 weeks after the onset of the facial paralysis. Pre- and postmanagement evaluation of the FN function was graded according to HB grading scale. Results The mean follow-up period was 6.5 ± 4.06 years. Complete or nearly complete recovery of FN function had occurred in 66.6% and 76.9% in medically and surgically treated groups, respectively. Most of the patients showed good outcome, and the presented data supports that the choice of treatment in patients with hearing preserved delayed traumatic FNP without TBF depends mainly on the ENoG findings. Conclusions Although timing of surgery in traumatic delayed FNP remains to be elucidated, we think that surgical exploration should be considered if serial ENoG demonstrates more than 90% nerve degeneration.
ISSN:0090-3019
1879-3339
DOI:10.1016/j.surneu.2008.02.007