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The effect of surgical timing on functional outcomes of traumatic facial nerve paralysis

 Jin Kim  ;  In Seok Moon  ;  Dae-Bo Shim  ;  Won Sang Lee 
 Journal of Trauma, Vol.68(4) : 924-929, 2010 
Journal Title
 Journal of Trauma 
Issue Date
Electromyography ; Facial Nerve Injuries/physiopathology ; Facial Nerve Injuries/surgery* ; Facial Nerve Injuries/therapy ; Facial Paralysis/physiopathology ; Facial Paralysis/surgery* ; Facial Paralysis/therapy ; Female ; Humans ; Male ; Neurologic Examination ; Prognosis ; Recovery of Function ; Retrospective Studies ; Temporal Bone/injuries ; Temporal Bone/surgery ; Time Factors ; Treatment Outcome
BACKGROUND: The optimal timing for surgical exploration of traumatic facial paralysis to best preserve facial function is currently controversial. This article reviews the final outcomes of facial function in patients with traumatic intratemporal facial nerve injury according to the timing of surgical exploration. METHODS: We performed a retrospective review of 58 patients with complete facial nerve paralysis caused by temporal bone fractures as a result of head trauma between 1998 and 2007. Patients were divided into three groups according to the type of trauma. The only difference between patients in each group was the timing of the surgical exploration. Characteristics assessed in the study included type of trauma, location of facial nerve injury, timing of surgical intervention, audiometric findings, surgical approach, and long-term follow-up of recovery of facial nerve function, as assessed by two facial nerve grading systems. RESULTS: The final functional gains in early-operated patients were 3.7 +/- 0.59 on the House-Brackmann (HB) scale and 75.6 +/- 10.88 on the Sunnybrook scale. The outcome in late-operated patients was 2.17 +/- 0.52 on the HB scale and 34.7 +/- 16.95 on the Sunnybrook scale, and that of nonoperated patients was 2.0 +/- 0.63 on the HB scale and 26.8 +/- 6.27 on the Sunnybrook scale. CONCLUSION: This study demonstrated that some patients with traumatic facial nerve paralysis who had nerve conduction studies consistent with a poor prognosis regained considerable facial function after early surgical intervention. However, late exploration after facial nerve paralysis did not result in positive outcomes, regardless of the type of temporal bone fracture or the site of injury, and no difference was observed compared with conservative treatment.
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1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin(김진)
Moon, In Seok(문인석) ORCID logo https://orcid.org/0000-0002-3951-5074
Shim, Dae Bo(심대보)
Lee, Won Sang(이원상)
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