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Endoscopic facial nerve decompression in post-traumatic facial palsies: pilot clinical experience

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

Abstract

Purpose

Post-traumatic facial nerve (FN) paralysis might need surgical decompression in selected patients. Different microscope-based surgical techniques are described in the literature such as the transmastoid, the middle cranial fossa and the translabyrinthine approach. The effectiveness of the transcanal endoscopic approach (TEA) in managing such condition has never been described and its possible indications has to be defined.

Methods

Retrospective multi-centric case series of patients with post-traumatic FN paralysis surgically treated with TEA. From July 2013 to July 2017, 6 patients underwent TEA for post-traumatic FN paralysis with involvement of the second genu and/or the tympanic segment of the nerve. The surgical technique is described step by step, with focus on anatomic landmarks. Post-operative outcomes are specified in terms of FN postoperative function and audiologic results.

Results

The TEA showed to recover a House–Brackmann grade I–II FN function in 83.2% of the patient. Post-operative air–bone gap significantly improved; whereas, the pure-tone average bone conduction did not differ significantly.

Conclusions

TEA represents a viable option for the treatment of post-traumatic facial palsy in patients with radiologic evidence of tympanic segment and/or perigeniculate region involvement with no involvement of the mastoid segment of the FN. Transcanal endoscopic facial nerve decompression is a safe and effective approach in highly selected cases.

Level of evidence

4

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Funding

No funding is reported for the present study.

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Authors and Affiliations

  1. Otorhinolaryngology Head and Neck Surgery Department, University Hospital of Modena, Largo del Pozzo 71, 41100, Modena, Italy

    Matteo Alicandri-Ciufelli, Matteo Fermi & Livio Presutti

  2. Otorhinolaryngology Head and Neck Surgery Department, University Hospital of Verona, Piazzale Aristide Stefani 1, 37126, Verona, Italy

    Flavia Di Maro, Davide Soloperto & Daniele Marchioni

Authors
  1. Matteo Alicandri-Ciufelli
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  2. Matteo Fermi
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  3. Flavia Di Maro
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  4. Davide Soloperto
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  5. Daniele Marchioni
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  6. Livio Presutti
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Corresponding author

Correspondence to Matteo Fermi.

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The authors declare no conflict of interest.

Ethical Standards

All the procedures performed in the study were in accordance with the ethical standards of the institutions at which the study was conducted.

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Cite this article

Alicandri-Ciufelli, M., Fermi, M., Di Maro, F. et al. Endoscopic facial nerve decompression in post-traumatic facial palsies: pilot clinical experience. Eur Arch Otorhinolaryngol 277, 2701–2707 (2020). https://doi.org/10.1007/s00405-020-05997-7

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  • DOI: https://doi.org/10.1007/s00405-020-05997-7

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