Management of Facial Palsy Secondary to Temporal Bone Fracture

Aim: The aim of this study was the analysis of clinical and paraclinical facial palsies occurring after fracture of the temporal bone so as therapeutic indications and outcomes.

Methods: We conducted a prospective and Evaluative study during three years in the department of ENT of the hospital of 20 august. Including all patients presented to the emergency unit with temporal bone Trauma with facial paralysis.

Results: 24 patients including 21% grade III, 21% grade IV, 14% grade V, 34% grade VI, most often secondary to fracture of the right temporal bone with 56% and in 7% of cases it is bilateral. The electromyogram showed 7% of cases it is a moderate axonotmesis, 25% of cases moderate to severe axonotmesis, 34% neurotmesis. The Schirmer test noted hyposecretion in 53%. We performed 13 cases of surgical decompression of the three portions of the facial by the retro-auricular trans-mastoidal approach and one case of hypoglossal-facial anastomosis. The follow-up was monthly. The evolution was favorable in 80% with almost normal facial and auditory functions and an average decline of 2.7 years.

Conclusion: FP grade and it’s time to installation are two crucial clinical elements in the treatment decision. Most authors agree to favor medical treatment for incomplete PF and secondary onset. Total and immediate FP, with a spontaneously adverse prognosis, classically call for surgical treatment.

Keywords: Facial palsy; Temporal bone fracture; Decompression