A case of facial nerve palsy caused by severe head injury treated by translabyrinthine approach.
Facial nerve reconstruction
Greater auricular nerve graft
Mastoidectomy
Severe head trauma
Translabyrinthine approach
Journal
Surgical neurology international
ISSN: 2229-5097
Titre abrégé: Surg Neurol Int
Pays: United States
ID NLM: 101535836
Informations de publication
Date de publication:
2023
2023
Historique:
received:
30
10
2022
accepted:
10
01
2023
entrez:
10
3
2023
pubmed:
11
3
2023
medline:
11
3
2023
Statut:
epublish
Résumé
Several treatments for traumatic facial paralysis have been reported, but the role of surgery is still controversial. A 57-year-old man was admitted to our hospital with head trauma due to a fall injury. A total body computed tomography (CT) scan showed a left frontal acute epidural hematoma associated with a left optic canal and petrous bone fractures with the disappearance of the light reflex. Hematoma removal and optic nerve decompression were performed immediately. The initial treatment was successful with complete recovery of consciousness and vision. The facial nerve paralysis (House and Brackmann scale grade 6) did not improve after medical therapy, and thus, surgical reconstruction was performed 3 months after the injury. The left hearing was lost entirely, and the facial nerve was surgically exposed from the internal auditory canal to the stylomastoid foramen through the translabyrinthine approach. The facial nerve's fracture line and damaged portion were recognized intraoperatively near the geniculate ganglion. The facial nerve was reconstructed using a greater auricular nerve graft. Functional recovery was observed at the 6-months follow-up (House and Brackmann grade 4), with significant recovery in the orbicularis oris muscle. Interventions tend to be delayed, but it is possible to select a treatment method of the translabyrinthine approach.
Sections du résumé
Background
UNASSIGNED
Several treatments for traumatic facial paralysis have been reported, but the role of surgery is still controversial.
Case Description
UNASSIGNED
A 57-year-old man was admitted to our hospital with head trauma due to a fall injury. A total body computed tomography (CT) scan showed a left frontal acute epidural hematoma associated with a left optic canal and petrous bone fractures with the disappearance of the light reflex. Hematoma removal and optic nerve decompression were performed immediately. The initial treatment was successful with complete recovery of consciousness and vision. The facial nerve paralysis (House and Brackmann scale grade 6) did not improve after medical therapy, and thus, surgical reconstruction was performed 3 months after the injury. The left hearing was lost entirely, and the facial nerve was surgically exposed from the internal auditory canal to the stylomastoid foramen through the translabyrinthine approach. The facial nerve's fracture line and damaged portion were recognized intraoperatively near the geniculate ganglion. The facial nerve was reconstructed using a greater auricular nerve graft. Functional recovery was observed at the 6-months follow-up (House and Brackmann grade 4), with significant recovery in the orbicularis oris muscle.
Conclusion
UNASSIGNED
Interventions tend to be delayed, but it is possible to select a treatment method of the translabyrinthine approach.
Identifiants
pubmed: 36895239
doi: 10.25259/SNI_995_2022
pii: 10.25259/SNI_995_2022
pmc: PMC9990793
doi:
Types de publication
Case Reports
Langues
eng
Pagination
47Informations de copyright
Copyright: © 2023 Surgical Neurology International.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
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