2017-18 HSC Section 3 Green Book

P. Xu et al. / American Journal of Otolaryngology – Head and Neck Medicine and Surgery 38 (2017) 269 – 271

References

surgical decompression on 7 cases with facial paralysis over 6 months, and only 28.6% of them achieved good recovery. However, there was no signi fi cant difference in the good recovery rate when the patients who underwent surgical decompression over 3 months after temporal trauma were compared to those who did not undergo surgical decom- pression ( p N 0.05). Thereby, given its limited bene fi ts, surgeons should reconsider facial nerve decompression if facial paralysis duration had exceeded 3 months. Facial paralysis usually occurred immediately after temporal bone trauma, but delayed onset may affect few cases. The main causes of de- layed onset of facial paralysis included nerve edema, delayed arterial spasm or compression by hematoma [18,19] . In our study, onset of facial paralysis after temporal bone trauma was delayed in 13 of 80 cases (16.3%). 69.2% of patients with delayed onset of facial paralysis had good recovery, while 64.2% of patients with immediate onset of facial paralysis had good recovery, without signi fi cant difference ( P N 0.05), indicating that delayed onset was not a poor prognostic factor for facial paralysis after temporal bone trauma. Moreover, our study also found that outcomes of facial paralysis after temporal bone trauma were un- correlated with the patients' age. Interestingly, there were 9 of 80 cases (11.3%) showing visible frac- tures of fallopian canal during surgery, while preoperative high-resolu- tion CT of temporal bone did not detect the fractures before surgery, demonstrating high-resolution CT of temporal bone was not always re- liable for fallopian canal fracture. Similarly, micro-bony spicules were also reported in few cases during surgery, while no gross temporal bone fractures were identi fi ed by high-resolution CT of temporal bone before surgery [20] . Nevertheless, high-resolution CT of temporal bone is still the most accurate choice to detect temporal bone fractures at present [21 – 23] . In conclusion, our results suggested that any patients with facial pa- ralysis after temporal bone trauma who meet the surgical indication should receive facial nerve exploration and decompression as soon as possible, and the outcomes of facial nerve would be better if the surgery was performed within 3 months. Moreover, outcomes of facial nerve were uncorrelated with patients' age and onset of facial paralysis.

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Con fl ict of interests

None.

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