Facial reanimation after temporal bone fracture.

Fracture of the temporal bone is usually associated with skull injury and the patient is initially seen in the emergency room. As a result the diagnosis of facial paralysis may be delayed. The aim of this study is to emphasize the importance of early diagnosis and treatment of facial paralysis in such cases. Between 1990 and 1996, sixteen patients with facial paralysis due to temporal bone fracture were operated on within one month of trauma. The surgical technique was selected on the basis of the location of fallopian canal involvement and the patients hearing status. Six patients had grade VI, 7 had grade V and 3 had grade IV facial weakness preoperatively. Twelve patients had serviceable hearing. 9 of them underwent facial decompression through the transmastoid approach and 3 were operated on via the middle fossa approach. Four patients with unserviceable hearing had the operation through the translabyrinthine route. Postoperatively, 15 out of sixteen patients gained normal facial function while one had grade III facial weakness. Severe grade and sudden onset facial paralysis after temporal bone fracture should be surgically corrected as early as possible. The site of involvement of the facial canal and patient's hearing status should be considered in deciding the type of surgery to be applied.