2019 Volume 62 Issue 6 Pages 267-272
Facial nerve decompression is often indicated in cases of traumatic immediate facial palsy, because of the low cure rate of traumatic immediate facial palsy. Although there is no clear standard regarding the timing of treatment, it has been reported that for treating immediate paralysis, it is desirable to perform facial nerve decompression within 2 weeks. However, traumatic facial palsy is often accompanied by disturbance of consciousness and delayed diagnosis of paralysis or otologic examinations, and it is often difficult to actually perform surgery within two weeks.
We encountered 2 cases of traumatic immediate facial paralysis. Both cases showed complete paralysis of the nerve, and because of early consultation with the otolaryngologist, surgery could be performed within two weeks after the injury. As a result, the facial nerve score in the first case improved from 8 to 36, meeting the healing criteria, and that in the second improved from 6 to 28.
In facial nerve decompression, it is common to consider the indications for surgery after conducting prediction tests, such as ENoG, within 1 week to 10 days of onset. However, in order to further improve the cure rate, in the case of complete paralysis in cases of immediate paralysis, correspondence that is different from that for late paralysis and other causes of facial nerve paralysis is required. Also, in order to perform surgery early, collaboration with other departments and regional collaboration are also important.
