Ehdam Vshakri, Daud Mohd Khairi Md
Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kelantan, Malaysia.
Hospital Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia.
J Audiol Otol. 2025 Jul;29(3):214-218. doi: 10.7874/jao.2025.00150. Epub 2025 Jul 18.
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.
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.
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.
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.
双侧同时性面神经麻痹（FNP）较为罕见。已证实其存在创伤性和非创伤性病因。本研究旨在确定双侧创伤性FNP的患病率及预后情况。
我们回顾性分析了2010年至2019年的颞骨骨折（TBF）病例。通过医院编码系统获取患者数量及每位患者的特征。
共确定336例TBF病例，其中316例（94%）为单侧骨折，20例（6%）为双侧骨折。在这20例双侧骨折病例中，5例（25%）发生了双侧FNP，均由双侧TBF引起，占所有TBF病例的1.5%。这5例患者中有4例出现延迟性双侧FNP，1例患者一侧为即刻发病，另一侧为延迟发病。所有5例患者均为不完全性FNP，最严重的病例评分为House-Brackmann IV级。除1例由一侧混合性骨折导致外，其余4例均由纵向TBF引起。所有5例患者均接受口服类固醇和物理治疗的保守治疗。
尽管双侧创伤性FNP罕见，但在所有双侧TBF病例中均应怀疑该病，需要密切随访以实现快速诊断并加强管理。由于双侧TBF强烈倾向于纵向骨折，不完全性FNP较为典型。
