Surgical treatment of peripheral facial paralysis:analysis of 40 cases

Objective To investigate the pathogenicity,mechanisms,surgical approaches and clinical curative effect of peripheral facial nerve paralysis.Methods Facial nerve decompression was performed on patients with temporal bone fracture and Bell parlsy.Facial nerve anastomosis was performed on patients with facial nerve damage.The transplanted facial nerve connecting operation was performed on patients who can not receive dialyneury.Neurotrophic medicine and acupuncture treatment were also done.Results Surgical treatment effect showed no statistical significant differences between the patients who had been ill for a month and one to three months(P0.05).Surgical treatment effect of patients between within three months to three months had statistical significant differences(P0.05).Twenty-eight cases with temporal bone fracture and 4 cases with Bell parlsy were performed with facial nerve decompression.Two cases injured in extracranial segment were applied with facial nerve anastomosis.Four cases caused by surgical trauma with acoustic neuroma and facial nerve sheath tumors underwent facial-accessory nerve anastomosis and facial-hypoglossal nerve anastomasis,and the other 2 cases caused by surgical injury with parotid tumors were applied with facial nerve grafting.The recovered functions of facial nerve were judged by House and Brackmann grading system.Twenty one cases reached the first degree according to House-Brackmann facial nerve function scores after facial nerve decompression.Seven cases reached the second to third degree and 4 cases reached the fourth to fifth degree.Fourth cases performed facial-accessory nerve anastomosis and facial-hypoglossal nerve anastomasis reached the third to fourth degree,and the 2 cases after parotidectomy reached the fourth degree.Conclusions Surgical therapy should be undertaken in 3 months in patients with facial nerve paralysis.Facial nerve decompression is safe and effective,especially in cases caused by temporal bone fracture.But cases performing facial nerve transplantation is not useful.