Evaluation And Management Of Immediate Posttraumatic Facial Nerve Palsy At Sir T Hospital, Tertiary Care Centre In Bhavnagar

Evaluation And Management of Immediate Posttraumatic Facial Nerve Palsy

Abstract

Background: Facial nerve palsy following trauma, is an uncommon condition which occurs in 1.5%
patients of skull base fractures, majority of them due to road traffic accidents causing temporal bone
fractures. Indication and timing of facial nerve decompression for facial paralysis and anatomical extent of
decompression has been a subject of controversy for years. The aim of this study is to present prospective
review of 10 patients with immediate facial paralysis after trauma that underwent either surgical
decompression of facial nerve via trans mastoid approach or conservative management. Objectives-To know
age and sex wise distribution of immediate posttraumatic facial nerve palsy and to know most common grade
of presentation according to H-B scale and most common type of temporal bone fractures and segment of
facial nerve involved. To study outcome (within 1 month) of various modes of management of immediate
posttraumatic facial nerve palsy. Material And Methods: After approval from ethics committee, this
prospective cross-sectional study was carried out in 10 patients presented with immediate facial nerve palsy
due to trauma at ENT department of Sir T Hospital, Bhavnagar over a period of 1 year from July 2022 to June
2023. After taking consent, proper history was taken and time of RTA and time of presentation at ENT OPD
was separately noted. Patients were examined and graded using House and Brackman grading system. All
the patients were evaluated and treated either by conservative management (Injectable steroids with facial
physiotherapy) or surgical decompression via trans mastoid approach. Results: Most common age group
involved was the young adolescents (20-30years) who are more prone to RTA and traumatic injuries.
Numbers of males affected were more than females in our study. Tympanic segment of facial nerve was
found to be involved in maximum number of patients. Patients with transverse fracture of temporal bone
causing immediate posttraumatic facial palsy were found to have better prognosis with surgical
decompression. Patients with longitudinal fracture of temporal bone can go for either conservative
management or if no improvement found within 7days were taken for surgical decompression of facial nerve
via trans mastoid approach. Most of the patients who were managed surgically were found to have better
prognosis according to this study. Conclusion: We draw the conclusion from our study that early diagnosis
and surgical intervention significantly improved prognosis for immediate facial palsy following trauma. The
trans mastoid approach for facial nerve decompression can be utilized when trauma is clearly localized to the
tympanic or mastoid segment of facial nerve. Transverse fracture of temporal bone should be always treated
with immediate surgical decompression and in longitudinal fractures both conservative and surgical
management plays an important role. Appropriate post-operative management with oral steroids and
physiotherapy plays an important role in traumatic facial nerve palsy. [K A Natl J Integr Res Med, 2026; 17(1):
22-26, Published on Dated: 07/07/2026]