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Year: 2005  Vol. 9   Num. 2  - Apr/June Print:
Original Article
Texto Text in Portuguese
The Surgical Treatment of Facial Nerve Palsies
Il Trattamento Chirurgico delle Paralisi del Nervo Facciale
Alberto Rinaldi Ceroni, MD, Giovanni Carlo Modugno, MD, Gian Gaetano Ferri, MD.
Key words:
facial nerve, surgery, palsy, fracture, temporal bone.

Introduction: The identification of the most appropriate therapeutic approach to be adopted in cases of direct or indirect lesion of the facial nerve is still matter of discussion. Hypoglossal-facial anastomosis is generally chosen in reconstructive surgery, while facial nerve decompression is indicated in traumatic and inflammatory diseases (especially temporal bone fractures). Objectives: To find the best therapeutic strategy to adopt in case of post-traumatic facial nerve palsies underlining the role carried out by clinical, radiological and electrophysiological information. Methods: Between 1989 and 2001, 32 patients affected by post-traumatic facial nerve palsy have been examined. In a limited group of patients (29) with longitudinal fracture a multivariate statistical analysis has been performed in order to find unfavourable prognostic factors. Results: Among 16 patients submitted to a transmastoid extra-labyrinthine facial nerve decompression, in 75% of the cases a satisfactory functional recovery (grade I-II according to House-Brackmann classification) has been achieved. Conclusions: It is not easy, even due to methodologic reasons, to get a number of patients great enough to definitively clarify many controversial aspects regarding the best surgical treatment of facial nerve palsies. A multicentric recruitment and observation of this rare kind of disease could contribute in that direction; moreover, it will be very important the possibility to reach a larger standardization of all clinical parameters useful in the complete comprehension of the problem, eventually with the utilization of Consensus Conferences.



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