[Intratemporal surgery of the facial nerve. Apropos of 34 cases].

The results of facial nerve surgery in the temporal bone have been evaluated in a review of 34 cases (19 decompressions and 15 reparations). Decompressions of immediate and complete facial paralysis by fracture of the temporal bone that have achieved a good motor recovery resulted from early surgery before the 21st day (50% of grades I and II, 50% of grades III). After this delay, facial recovery did not reach grades I and II any longer. In case of nervous interruption of traumatic origin or after tumoral ablation, direct restoration of continuity by an intermediary grafting fixed with fibrin glue enabled the recovery of a facial function of grade III in 87.5% of the cases. These results point out the importance of an early exploration of traumatic facial paralysis before the end of the third week, and the interest of using a cable graft fixed with fibrin glue to repair directly the facial nerve.