total facial nerve decompression for severe traumatic facial nerve paralysis a review of 10 cases总面神经减压对严重创伤性面神经麻痹回顾10例.pdfVIP

Hindawi Publishing Corporation International Journal of Otolaryngology Volume 2012, Article ID 607359, 5 pages doi:10.1155/2012/607359 Clinical Study Total Facial Nerve Decompression for Severe Traumatic Facial Nerve Paralysis: A Review of 10 Cases Sertac Yetiser Department of Otolaryngology, Head and Neck, Anadolu Medical Center, Kocaeli, 41400 Gebze, Turkey Correspondence should be addressed to Sertac Yetiser, syetiser@ Received 17 July 2011; Revised 13 September 2011; Accepted 14 September 2011 Academic Editor: Peter S. Roland Copyright © 2012 Sertac Yetiser. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Management of traumatic facial nerve disorders is challenging. Facial nerve decompression is indicated if 90–95% loss of function is seen at the very early period on ENoG or if there is axonal degeneration on EMG lately with no sign of recovery. Middle cranial or translabyrinthine approach is selected depending on hearing. The aim of this study is to present retrospective review of 10 patients with sudden onset complete facial paralysis after trauma who underwent total facial nerve decompression. Operation time after injury is ranging between 16 and105 days. Excitation threshold, supramaximal stimulation, and amplitude on the paralytic side were worse than at least %85 of the healthy side. Six of 11 patients had HBG-II, one patient had HBG-I, 3 patients had HBG-III, and one patient had HBG-IV recovery. Stretch, compression injuries with disruption of the endoneurial tubules undetectable at the time of surgery and lack of timely decompression may be associated with suboptimal results in our series. 1. Introduction