2017-18 HSC Section 3 Green Book

Reprinted by permission of Am J Otolaryngol. 2017; 38(3):269-271.

American Journal of Otolaryngology – Head and Neck Medicine and Surgery 38 (2017) 269 – 271

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American Journal of Otolaryngology – Head and Neck Medicine and Surgery jour nal homepage: www.el sevie r. com/ locate/ amj oto

Original Contributions Surgical timing for facial paralysis after temporal bone trauma ☆ Peng Xu a , ⁎ , Aiyan Jin a , Baoqiang Dai a , Ruijie Li b , Yefeng Li c a Department of Otolaryngology, Cangzhou Central Hospital, Cangzhou 061001, Hebei Province, People's Republic of China b Department of Endocrinology, Cangzhou Central Hospital, Cangzhou 061001, Hebei Province, People's Republic of China c Department of Otolaryngology, Peking University Health Science Center, Beijing 100191, People's Republic of China

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Objectives: To explore surgical timing of facial paralysis after temporal bone trauma. Methods: The clinical data of the patients with facial paralysis after temporal bone trauma who underwent sub- total facial nerve decompression were retrospectively collected, and 80 cases followed-up for one year were en- rolled in the study. They were divided into different subgroups according to the age, onset, and interval between facial paralysis and surgery, and the outcomes of facial nerve between different subgroups were compared. Results: The number of patients who achieved good recovery of HB Grade I or II was 52 of 80 (65.0%). 43 of 66 cases (65.2%) in the younger group had good recovery of facial nerve in contrast to 9 of 14 cases (64.3%) in the elderly group, without signi fi cant difference ( p N 0.05). 9 of 13 cases (69.2%) in the delayed onset group had good recovery, while 43 of 67 cases (64.2%) in the immediate onset group had good recovery, without signi fi cant difference ( p N 0.05). The good recovery rate of the b 1 month group was statistically higher compared to the 3 – 6 months group or the N 6 months group ( P b 0.05), while the good recovery rate of the b 1 month group was not statistically higher than that of the 1 – 2 months group or the 2 – 3 months group ( P N 0.05). Conclusion: This study demonstrated that the good recovery rate of facial paralysis after temporal bone trauma was uncorrelated with age and onset. It was better to perform surgical decompression within 3 months after fa- cial paralysis. © 2017 Elsevier Inc. All rights reserved.

Article history: Received 20 April 2016

Keywords: Temporal bone trauma Facial paralysis Facial nerve decompression

1. Introduction

2. Materials and methods

Traumatic facial paralysis is not infrequent, and accounts for around 17% of peripheral facial paralysis [1] . About 7% – 10% temporal bone frac- tures lead to facial paralysis [2] . When temporal bone trauma occurs, fa- cial nerve may be pressed by hematoma or bony spicules, or may even be transected. Because those patients often have fatal head trauma, sur- gical management of facial paralysis is usually delayed. Currently, the surgical timing of traumatic facial paralysis is still controversial, al- though it has been discussed for many years. The most studies just in- volved b 30 cases of traumatic facial paralysis which were treated by surgical management [3 – 6] . However, we analyzed outcomes of the largest series of patients with traumatic facial paralysis who underwent subtotal facial nerve decompression to our knowledge. ☆ Copyright Transfer Statement: In consideration of the American Journal of Otolaryngology — Head and Neck Medicine and Surgery's reviewing and editing my submission, “ Surgical timing for facial paralysis after temporal bone trauma ” , the author(s) undersigned transfers, assigns and otherwise conveys all copyright ownership to Elsevier Inc. in the event that such work is published in the American Journal of Otolaryngology — Head and Neck Medicine and Surgery. Signed by Peng Xu, Aiyan Jin, Baoqiang Dai, Ruijie Li, Yefeng Li. ⁎ Corresponding author. E-mail address: xupeng201408@126.com (P. Xu).

2.1. Subjects

The clinical data of patients with unilateral traumatic facial paralysis after temporal bone trauma who underwent subtotal facial nerve de- compression in our hospital from Feb., 1998 to Feb., 2013 were retro- spectively collected, and only those who were followed up for one year were enrolled in the study.

2.2. Grouping

The patients were divided into different groups according to the age, onset, and interval between facial paralysis and surgery. Theywas divid- ed into younger group ( ≤ 45 years) and elderly group ( N 45 years), im- mediate onset group (facial paralysis onset within 48 h of trauma) and delayed onset group (facial paralysis onset after 48 h of trauma) ac- cording to the age and onset of facial paralysis, respectively. The cases were also divided into subgroups of b 1 month (surgery was performed within 1 month of facial paralysis onset), 1 – 2 months (surgical time ranged from 1 to 2 months after paralysis onset), 2 – 3 months (surgical time ranged from2 to 3months after paralysis onset), 3 – 6months (sur- gical time ranged from 3 to 6 months after paralysis onset), and

http://dx.doi.org/10.1016/j.amjoto.2017.01.002 0196-0709/© 2017 Elsevier Inc. All rights reserved.

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