Management of facial palsy after temporal bone fracture via the transmastoid approach

CONCLUSION: The outcomes of extended subtotal facial nerve decompression via the transmastoid approach were good for facial palsy after temporal bone fracture (TBF). Surgical decompression should be carried out as soon as possible within 8 weeks after trauma. OBJECTIVE: To present outcomes of facial palsy after TBF via the transmastoid approach and to describe our experience of management of facial palsy in TBF. METHODS: A consecutive clinical series was reviewed retrospectively. Eighteen cases that underwent extended subtotal facial nerve decompression (decompression from the stylomastoid foramen to the labyrinthine segment) due to facial palsy after TBF involving the perigeniculate ganglion region were analyzed. The patients were operated between 2 and 14 weeks after trauma. RESULTS: In all, 83.3% of the 18 cases recovered to normal or near-normal level (House-Brackmann (HB) grade I or II). Among the 12 cases operated within 8 weeks after trauma, 11 cases (91.7%) recovered to normal or near-normal level. In contrast, four of the six patients (66.7%) who were operated between 9 and 14 weeks after trauma recovered to HB grade I or II.