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

측두골 골절후 발생한 안면마비 환자의 안면신경감압술: 25명 환자들의 증례분석

  • Nam, Han Ga Wi (Department of Neurosurgery, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Hwang, Hyung Sik (Department of Neurosurgery, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Moon, Seung-Myung (Department of Neurosurgery, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Shin, Il Young (Department of Neurosurgery, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Sheen, Seung Hun (Department of Neurosurgery, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Jeong, Je Hoon (Department of Neurosurgery, Bucheon Hospital, College of Medicine, Soonchunhyang University)
  • 남한가위 (한림대학교 동탄성심병원 신경외과학교실) ;
  • 황형식 (한림대학교 동탄성심병원 신경외과학교실) ;
  • 문승명 (한림대학교 동탄성심병원 신경외과학교실) ;
  • 신일영 (한림대학교 동탄성심병원 신경외과학교실) ;
  • 신승훈 (한림대학교 동탄성심병원 신경외과학교실) ;
  • 정제훈 (순천향대학교 부천병원 신경외과학교실)
  • Received : 2013.08.13
  • Accepted : 2013.08.28
  • Published : 2013.09.30

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.

Keywords

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