Traumatic Bilateral Facial Nerve Palsy: A 10-Year Retrospective Study.

BACKGROUND AND OBJECTIVES

Simultaneous bilateral facial nerve palsy (FNP) is rare. Traumatic and nontraumatic causes have been demonstrated. This study was performed to determine the prevalence and outcomes of bilateral traumatic FNP.

SUBJECTS AND METHODS

We retrospectively reviewed temporal bone fracture (TBF) cases from 2010 to 2019. Number of patients and each patient's characteristics were obtained using the hospital coding system.

RESULTS

A total of 336 TBF cases were identified, among which 316 (94%) were unilateral and 20 (6%) were bilateral. Among these 20 cases, five (25%) developed bilateral FNP, all resulting from bilateral TBF and accounting for 1.5% of all TBF cases. Four of these five patients experienced delayedonset bilateral FNP, and one patient experienced immediate onset on one side and delayed onset on the other. All five patients developed incomplete FNP, with the most severe case scored House-Brackmann grade IV. Longitudinal TBF was the cause in all but one case, which resulted from mixed fractures on one side. All five patients were treated conservatively with oral steroids and physiotherapy.

CONCLUSIONS

Although bilateral traumatic FNP is rare, it should be suspected in all cases of bilateral TBF, and close follow-up is required to achieve rapid diagnosis and enhance management. Because bilateral TBF strongly tends to be longitudinal, incomplete FNP is typical.