Surgical management of facial nerve palsy: our experience

Devang P. Gupta, Shreya Rai, K. S. Dinesh


Background: Facial nerve palsy is a challenging task to deal with in patients as it has medical as well as social implications. The aim of this study was to examine the efficacy of different surgeries for facial palsy according to pathology and the ideal time for surgery.

Methods: This prospective study was conducted with the help of a structured proforma for history and examination. Defined diagnostic tests were performed and depending on complexities of cases, different surgical approaches were done.  

Results: A total of 50 patients with secondary facial nerve palsies were included in our study and after thorough evaluation surgical management was planned. Ninety two percent were treated with facial nerve decompression, 4% with neurorrhaphy of the nerve and another 4% with cable graft.

Conclusions: High prevalence of facial nerve palsy in today’s era necessitates early diagnosis and management in order to prevent complications and thereby reducing the risk of permanent disfigurement.


Facial nerve palsy, Facial nerve decompression

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Glasscock M, Shambaugh G. Facial nerve surgery. In: Surgery of the ear, Glasscock M, Sham- baugh G, editors. Philadelphia: W.B. Saunders; 1990: 434-465.

Melvin TA, Limb CJ. Overview of facial paralysis: current concepts. Facial Plast Surg. 2008;24(2):155–63.

Hadlock TA, Greenfield LJ, Wernick-Robinson M, Cheney ML. Multimodality approach to management of the paralyzed face. Laryngoscope. 2006;116(8):1385–9.

Bruno R. Pinna, José RG. Testa and Yotaka Fukuda, Brazilian J Otorhinolaryngol. 2004;70(4):3069.

Junior NA, Junior JJJ, Gignon VF, KiticeAT, Prado LSA, Santos VGW, et al. Facial Nerve Palsy: Incidence of Different Ethiologies in a Tertiary Ambulatory. Int Arch Otorhinolaryngol. 2009;13(2):167-71.

Rajati M, Rad MP, Irani S, Khorsandi MT, Zarandy MM. Accuracy of high-resolution computed tomography in locating facial nerve injury sites in temporal bone trauma. Eur Arch Oto-Rhino-Laryngol. 2014;271(8):2185–9.

Popović D, Stanković M, Popović Z, Milisavljević D. Factaiversitatis Series. Medicine and Biology. 2003;10(3):145–7.

Chang CY, Cass SP. Management of facial nerve injury due to temporal bone trauma. Am J Otol. 1999;20:96-114.

Xie S, Wu X, Zhang Y, Xu Z, Yang T, Sun H. The timing of surgical treatment of traumatic facial paralysis: a systematic review. Acta Oto-Laryngologica. 2016;136(12):1197-200.

Darrouzet V, Duclos JY, Liguoro D, Truilhe Y, De Bonfils C, Bebear JP. Management of facial paralysis resulting from temporal bone fractures: our experience in 115 cases. Otolaryngol Head Neck Surg. 2001;125:77-84.