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Endoscopic vs microscopic facial nerve decompression for traumatic facial nerve palsy: a randomized controlled trial

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To explore a minimally invasive trans-canal endoscopic facial nerve decompression for traumatic facial nerve palsy and compare it with microscopic facial nerve decompression.

Methods

35 and 38 patients underwent endoscopic and microscopic facial nerve decompression, respectively, for traumatic facial nerve palsy. Onset of symptoms, type of temporal bone fracture, day of surgical intervention following trauma, ossicular chain status and nature of insult to facial nerve were observed. Time period for recovery (House Brackmann grade ≤ 3), long term recovery rates, pre- and post-operative hearing status, surgical time and post-operative pain were compared between groups.

Results

Maximum patients in endoscopic and microscopic groups (77.1% and 76.3%, respectively) had acute onset of symptoms. 57.1% (20/35) had longitudinal, 17.1% (6/35) had transverse and 25.7% (9/35) had mixed fractures in endoscopic group. In the microscopic group, 57.9% (22/38) had longitudinal, 18.4% (7/38) had transverse and 23.7% (9/38) had mixed fractures. The mean (± S.D.) post-operative air–bone gap in endoscopic and microscopic group were 16.47 ± 4.5 dB and 19.4 ± 5.2 dB, respectively, which was statistically significant. The mean (± S.D.) time period for recovery of endoscopic and microscopic groups were 14.4 ± 5 days and 22.5 ± 7 days, respectively (p value < 0.05). The difference in post-operative pain between the two groups was also statistically significant. The difference in long term recovery rates was not statistically significant (p > 0.05).

Conclusions

Endoscopic facial nerve decompression results in early recovery, less post-operative pain and better post-operative air–bone gap closure when compared to conventional microscopic technique.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We acknowledge the contribution of Ms. Debatri Ghosh, M.Sc, Research Assistant, Institute of Otorhinolaryngology and Head and Neck Surgery, for her inputs regarding statistical analysis.

Funding

Nil.

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Authors and Affiliations

  1. Institute of Otorhinolaryngology and Head and Neck Surgery, Institute of Post Graduate Medical Education and Research and SSKM Hospital, 244 AJC Bose Road, Kolkata, 700020, India

    Arindam Das, Mridul Janweja, Sayan Hazra & Arunabha Sengupta

  2. All India Institute of Medical Sciences, New Delhi, India

    Sandipta Mitra

Authors
  1. Arindam Das
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  2. Mridul Janweja
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  3. Sandipta Mitra
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  4. Sayan Hazra
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  5. Arunabha Sengupta
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Correspondence to Mridul Janweja.

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Das, A., Janweja, M., Mitra, S. et al. Endoscopic vs microscopic facial nerve decompression for traumatic facial nerve palsy: a randomized controlled trial. Eur Arch Otorhinolaryngol 280, 3187–3194 (2023). https://doi.org/10.1007/s00405-023-07836-x

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  • DOI: https://doi.org/10.1007/s00405-023-07836-x

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