Role of topodiagnostic tests in evaluation of facial nerve palsy in head injury
Keywords:Head injury, Facial palsy, Topodiagnosis, Schirmer’s test, Acoustic reflex
Background: Head injury with temporal bone trauma manifests with facial nerve palsy. The site of lesion can be assessed by various tests.
Methods: A retrospective study of 500 cases of head injury was undertaken to study the role of topodiagnostic tests in localising the site of lesion in 48 patients of facial palsy. The study was undertaken by the otology services of Dayanand medical college and hospital, Ludhiana during a period of one year.
Cases: 500 cases admitted with head injury were screened. The cases with facial nerve paralysis were then enrolled in the study.
Results: In 48 patients of facial palsy, taste sensation was diminished in 67% (21 cases); acoustic reflex absent in 86.8% (33 cases) and Schirmer’s test showed reduced lacrimation in 29.1% (14 cases).
Conclusions: The topodiagnostic tests do not always localise the site of lesion in head injury.
Bento RE, Vellutini EA, Pahl FH. Topodiagnóstico na paralisia facial periférica (Topodiagnosis in peripheral facial paralysis). Arq Neuropsiquiatr. 1985;43(3):275-80.
Gates GA. Facial paralysis. Otolaryngologic Clinics of North America. 1987;20(1):113.
Dobie RA. Electrical and topognostic tests of the facial nerve. In: CW, Cummings, JM Fredrickson eds. Otolaryngology Head and Neck Surgery. 2nd ed. New Jersy: Wiley;1986:2821-7.
Tschiassny K. Eight syndromes of facial paralysis and their significance in locating the lesion. Annals of Otology. Rhinology & Laryngology. 1953;62(3): 677-91.
Lambert PR, Brackmann DE. Facial paralysis in longitudinal temporal bone fractures: A review of 26 cases. The Laryngoscope. 1984;94(8):1022-6.
Gantz BJ, Gmür A, Fisch U. Intraoperative evoked electromyography in Bell's palsy. American journal of otolaryngology. 1982;3(4):273-8.
Renou G, Psaume T. Diagnostic topographique de la paralysie faciale a frigore topographical diagnosis of facial paralysis (Bell's palsy) (author's transl). Ann Otolaryngol Chir Cervicofac. 1978;95(12):769-75.
Hara A, Kusakari J, Kawamoto K, Hara S.Topographic diagnosis of facial paralysis by the assay of lysozyme concentration in tears. Acta Oto-Laryngologica. 1987;104(sup435):130-5.
Faleiros MC. L'importance du réflexe stapédien dans le diagnostic de plusieurs pathologies (Importance of the stapedial reflex in the diagnosis of several pathologies). Rev Laryngol Otol Rhinol (Bord). 2000;121(5):345-8.
Ide M, Morimitsu T, Ushisako Y, Makino K, Fukiyama M, Hayashi A. The significance of stapedial reflex test in facial nerve paralysis. Acta Otolaryngol Suppl. 1988;446:57-63.