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Traumatic facial nerve paralysis dilemma. Decision making and the novel role of endoscope

Journal of Otology 2022年第3期17卷 116-122页

作者： Mohamed Elkahwagi mohammed abdelbadie salem Waleed Moneir Hassan Allam ORL-HNS Mansoura university Egypt

Objective: The management of traumatic facial nerve paralysis(FNP) has remained a controversial issue with conflicting findings arguing between surgical decompression and conservative ***, recent advances in endoscopic surgery may consolidate the management plan for this ***: This prospective clinical study included patients with posttraumatic FNP at a tertiary referral center. Patients were categorized in two main groups: surgical and conservative. Indications for surgery included patients with immediate and complete FNP, no improvement in facial function on medical treatment, with electroneurography showing >90% degeneration or electromyography showing fibrillation potential. Patients who did not satisfy this criterion received the conservative approach. The transcanal endoscopic approach(TEA) or endoscopic assisted transmastoid approach was performed for facial nerve decompression in the surgical ***: The main outcome was facial function improvement, assessed using the House Brackmann grading scale(HBGS) 6 months after surgery, and hearing state assessed using the air bone gap(ABG).Results: The study included 38 patients, of whom 15 underwent had surgical decompression and 23underwent conservative therapy. A significant improvement in facial nerve function from a mean of4.66 ± 0.97 to 1.71 ± 0.69(P = 0.001) and ABG from a median of 30(10-40) to 20(10-25)(P = 0.002)was ***: Decision-making in cases of traumatic FNP is critical. The geniculate ganglion and tympanic segment were the most commonly affected areas in FNP cases. The TEA represents the most direct and least invasive approach for this area.

关键词： Posttraumatic Facial nerve Decompression Endoscopic Transcanal Electrodiagnostic

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