[Prognosis of facial paralysis caused by fracture of the petrous bone].

The final outcome of 33 facial palsies (4 bilateral, 25 unilateral) after temporal bone fracture is reviewed. 11 immediate and 22 delayed paralysis were found. Out of the 22 delayed palsies 20 did heal spontaneously. The remaining two patients underwent tympanotomy because of CSF otorrhea. Simultaneously decompression of the facial nerve was performed. 17 of 22 delayed palsies showed complete and 5 incomplete recovery with slight functional defects only. 7 of 11 facial palsies with immediate onsets after injury were treated surgically (6 cases by transmastoid approach, 1 case by transmastoid as well as trans-middle-cranial-fossa approach); in 2 of these patients neural function did not recover. The remaining 4 immediate facial palsies healed spontaneously but showed incomplete recovery. Because it has not been proven yet that the prognosis of traumatic facial palsy can be improved by immediate surgical treatment early surgical intervention should be indicated restrictively. If necessary, reconstruction of the nerve can be done even 6 months after trauma with unchanged prognosis.