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Surgical and nonsurgical treatment outcomes in traumatic facial nerve palsy

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

Abstract

Purpose

Facial nerve decompression surgery is performed on patients with immediate, complete traumatic facial palsy. However, the clinical advantage of the surgical treatment has weak evidence because of lack of control groups in previous studies. Therefore, this study compared facial function outcomes between the patients who underwent surgery and those who did not. Furthermore, in cases of bilateral traumatic facial palsy, the outcomes of the surgical and nonsurgical sides were also discussed.

Methods

A retrospective medical chart review of immediate and severe (House–Brackman [HB] grade V and VI) traumatic facial palsy was conducted. Twenty-five ears from the surgical group and eight ears from the conservative treatment group were enrolled. Among the patients, three with immediate and severe bilateral facial palsy underwent unilateral surgery.

Results

The average HB grade after 1-year follow-up was 1.7 in the surgical group and 1.5 in the nonsurgical group. Four patients who have definite facial canal disruption in the imaging study have recovered to HB grades I–III without surgical intervention. In patients with bilateral facial palsy, the nonsurgical side showed the same or better facial functions than the surgical side.

Conclusions

Compared with nonsurgical conservative treatment, facial nerve decompression surgery did not show superior outcomes in immediate HB grade V–VI traumatic facial palsy. The clinical advantage of facial nerve decompression is questionable and should be re-evaluated in a prospectively designed study.

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The data underlying this article cannot be shared publicly due to the policy of the institutional review board. The data will be shared on reasonable request to the corresponding author.

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Funding

This study was supported by a faculty research grant of Yonsei University College of Medicine (6-2018-0177 to I.S.Moon).

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Seong Hoon Bae, Ju Ha Park, Jinsei Jung & In Seok Moon

Authors
  1. Seong Hoon Bae
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  2. Ju Ha Park
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  3. Jinsei Jung
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  4. In Seok Moon
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Contributions

SHB: design, analysis, and manuscript draft. JHP: acquisition, analysis. JJ: acquisition, supervision. ISM: acquisition, supervision, funding, and manuscript draft.

Corresponding author

Correspondence to In Seok Moon.

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Conflict of interest

All authors declare that there is no potential conflict of interest.

Ethics approval and consent to participate

This study was approved by the Severance hospital (Seoul, Korea) institutional review board (project number 4-2022-0479) and was performed in accordance with the Declaration of Helsinki.

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Not applicable.

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Bae, S.H., Park, J.H., Jung, J. et al. Surgical and nonsurgical treatment outcomes in traumatic facial nerve palsy. Eur Arch Otorhinolaryngol 280, 3203–3208 (2023). https://doi.org/10.1007/s00405-023-07839-8

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  • DOI: https://doi.org/10.1007/s00405-023-07839-8

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