Management of the Intratemporal Facial Nerve Injury

Kadir Serkan ORHANa, Levent AYDEMİRa, Said SÖNMEZa
aİstanbul University İstanbul Faculty of Medicine, Department of Otorhinolaryngology, İstanbul, Türkiye

Orhan KS, Aydemir L, Sönmez S. Management of the intratemporal facial nerve injury. In: Sanus GZ, Batıoğlu Karaaltın A, eds. Surgical Management of Facial Nerve Paralysis. 1st ed. Ankara: Türkiye Klinikleri; 2022. p.115-22.

Article Language: EN

ABSTRACT
The facial nerve runs within the fallopian canal of the temporal bone. Facial nerve injury most commonly develops after blunt head trauma. During otologic surgery, facial nerve can also be damaged iatrogenically. The management of intratemporal facial nerve palsy should be with the team work. Electrophysiological examinations electroneurography and electromyography, evaluate whether there is axonal damage. Temporal bone and intracranial pathologies are evaluated with temporal bone computed tomography and cranial magnetic resonance imaging. Surgical approaches to intratemporal facial nerve injuries include trans-temporal, middle fossa, trans-labyrinthine ways. Facial nerve decompression is benefical in cases of the nerve integrity is normal. If there is a nerve damage, end-to-end coaptation, cable graft or hypoglosso-facial anastomosis can be done. In iatrogenic injuries, if surgeon is sure of the integrity of the nerve, it can be followed, but mostly the nerve is damaged without being noticed. Therefore, early surgical decompression is beneficial in cases of total facial paralysis. Management of facial nerve damage can be with knowledge, experience and teamwork. If the process is well managed, the results can be satisfactory.

Keywords: Facial paralysis; facial nerve injuries; temporal bone

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