Facial Paralysis after Trauma: A Simplified Method to Find and Repair the Facial Nerve
Keywords:
Facial nerve, Wound and injury, Hypoglossal-facial nerve anastomosis (HFNA)Abstract
Objective
This study aims to identify the digastric nerve as an alternative to access the facial nerve in case of post-traumatic facial nerve paralysis.
Study design
Retrospective study.
Setting
Tertiary care hospital.
Subjects and Methods
Eleven peripheric facial paralysis cases between 2005-2016 following trauma to the parotid gland are presented. Initial emergency treatments were done elsewhere but all returned back to treat facial paralysis after 11-18 months to our institute. The digastric nerve was identified and a facial-hypoglossal nerve anastomosis was performed.
Results
Pre-operative House-Brackmann scores were 6 for all cases. Post-operative scores were between 3 and 4. Pre-operative needle electromyography revealed no motor unit action potentials; after 7 months post-operatively, we had motor unit action potentials in every case.
Conclusion
In cases of trauma and secondary approaches of the parotid gland, a safe step for finding the facial nerve is to find the digastric nerve and follow it through the main trunk.
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