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January 1950

PERIPHERAL FACIAL PARALYSIS IN FRACTURES OF THE TEMPORAL BONE: Indications for Surgical Repair of the Nerve; Report of Cases in Which the Ballance and Duel Operation Was Used

Author Affiliations


Arch Otolaryngol. 1950;51(1):25-41. doi:10.1001/archotol.1950.00700020044002

THE TREATMENT of facial paralysis in fractures of the temporal bone has been purely conservative until recently; first, because prognosis with conservative therapy has been considered favorable and, second, because before the introduction of surgery of the facial nerve by Ballance and Duel1 the proper treatment could not be instituted.

Recent investigations, however, have shown that even if prognosis is good in most cases, there is, nevertheless, a limited number of cases in which the nerve ought to be repaired, and reports are available indicating that this has been done with success. The aim of this paper is to outline the indications for surgical intervention on the facial nerve.

According to most authors, a fracture of the temporal bone is present in practically all cases of closed head injuries which are accompanied with facial paralysis even if the fracture may be difficult or impossible to demonstrate in roentgenographic studies; and