Facial Paralysis after Trauma: A Simplified Method to Find and Repair the Facial Nerve

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.