POST MASTOIDECTOMY IATROGENIC FACIAL NERVE

PALSY – Injury Profile and Treatment Results

DR MADAN GUPTA

DR ALOK THAKAR

COHORT OF 6 CONSECUTIVE IATROGENIC FACIAL

NERVE PALSY PATIENTS REFERRED TOTREATED AT

OUR CENTRE ( ENT II)

2 YEAR DURATION

2010-2011

DR MADAN GUPTA

DR ALOK THAKAR

Face is a part of beauty!!!!!!!!

A perfectly beautiful face needed both symmetry and ‘averageness’!

Osaka University Japan 2009

“Losing face is as important to people as losing bark is to a tree”Chinese Proverb

Specific Impairment of Smiling Increases the Severity of DepressiveSymptoms in Patients with Facial Neuromuscular Disorders !

JessieM.VanSwearingenet al

Aestheticplasticsurgery vol 23 no 6

patient Duration injury

To presentationOnset of

paralysis

Improvement

sinceH & B Grading

20/m 2 wk immediate No Vl

19/f 1 wk immediate No Vl

25/m 6 month immediate No Vl

13/f 2 month immediate No Vl

45/f 1 wk immediate NO Vl

32/m 2wk immediate yes V

Evaluation by ENoG ,EMG and HRCT Temporal

bone

patient Duration

Injury to

presentation

grade Electrical Testing HRCT management

ENoG EMG labyrinthine Tympanic vertical

20/m 2 wk Vl NR silent N x N surgical

19/f 1 wk Vl NR silent N x N surgical

25/m 6 month Vl NR silent N X N surgical

13/f 2 month Vl NR silent X X N surgical

45/f 1 wk Vl NR silent N X N surgical

32/m 2wk V Reduced

CMAP

N X N medical

patient Duration

Injury to

presentat

ion

grade Electrical

TestingHRCT managemen

tSurgical

finding

extent procedure

ENoG EMG labyrinthine Tympanic vertical

20/m 2 wk Vl NR silent N x N surgical As per

radiology

<50%

thickness

decompressi

on

19/f 1 wk Vl silent N x N surgical As per

radiology

Full

thickness

Greater

auricular

cable graft

25/m 6

month

Vl NR silent N X N surgical As per

radiology

Full

thickness

Greater

auricular

cable graft

13/f 2

month

Vl NR silent X X N surgical As per

radiology

Full

thickness

Xll-Vllanastomosis

45/f 1 wk Vl NR silent N X N surgical As per

radiology

>50%

thickness

End to end anastomosis

32/m 2wk V Re

duc

ed

CM

AP

N X N medical

Conclusion

THANK YOU