Predicting recovery of facial nerve function following injury from a basilar skull fracture

Abstract

Twenty-five patients with posttraumatic facial nerve palsy were studied. Partial recovery of function had occurred in 95% of these patients by 18 months after injury. At 5 months posttrauma, there was some recovery in 92.5% of those with a partial lesion compared with 10% of those with a complete lesion. This difference attains statistical significance. Complete recovery of nerve function had occurred by 10.5 months in 53.5% of the patients; in 62% of patients with a partial lesion, complete recovery had occurred by 4 months compared with 0% in those with a complete lesion. This difference also attains statistical significance. There was no statistically significant difference in recovery of function between patients with an immediate as opposed to a delayed onset of facial nerve palsy. It was determined that the degree of palsy had a statistically significant influence on recovery of facial nerve function, whereas the time of onset did not. The data presented support a conservative approach to these injuries and it is recommended that the possibility of surgical treatment should be entertained in patients with complete facial palsy persisting for 12 to 18 months after injury.

Facial Nerve Decompression After Temporal Bone Fracture—The Bangalore Protocol

“…Comparison to summaries of the literature finds that these results seem slightly more encouraging than previously reported. Adgebite et al (8) and Brodie and Thompson (9) disagree on the relative prognosis of immediate vs. delayed paralysis after temporal bone trauma. Outcomes as reported in the literature are further complicated by the tendency to combine HB2 and HB1 (9) as we have done here, or to combine HB2-HB5 together (10) as in a large meta-analysis of 35 patient series.…”

Management and outcomes of facial paralysis from intratemporal blunt trauma: A systematic review

“…Manuscript review eliminated an additional 110 articles, leaving 57 articles. From this group, 35 articles met inclusion criteria 2, 3, 6, 8–10, 12–15, 17, 20, 24, 27, 32–35, 38–40, 42–55…”

“…Multiple factors influence management decisions for nonpenetrating temporal bone trauma with resultant facial paresis. The onset of nerve dysfunction, whether immediate or delayed, and the degree of facial paresis, whether complete or partial, has frequently been reported as a determinant of management strategy 1, 5–18. Additionally, electrodiagnostic testing and imaging results have also been cited as criteria governing decision‐making 1, 7, 9, 12, 19–43.…”

Lesões traumáticas de nervos cranianos

“…58 A paralisia tardia geralmente decorre de pressão exercida sobre o nervo por hematoma, edema ou mesmo tecido de granulação no interior do canal fa lopiano. 59 A paralisia facial pode ser detectada no paciente inconsciente mediante a aplicação de estímulos dolorosos e observação da movimentação facial.…”