RECENT advances in otology are changing the outlook of permanent facial paralysis in patients suffering facial nerve injuries following temporal bone fracture. Although the general prognosis for recovery from facial paralysis in skull fracture is favorable, the threat of permanent facial disfigurement is present in 10%-15% of cases; and it is in this group that the role of the otologic surgeon is most important.
The dismal prospect of permanent facial deformity following skull fracture is brightened by three significant advances in otology. First, polytomography has given the roentgenologist a better method of identifying fractures anywhere along the course of the facial canal. Secondly, the nerve excitability test appears to provide the surgeon with a simple accurate means of assessing the degree of facial nerve damage at an early stage of the paralysis. Lastly, the microsurgical techniques now used in otology allow exploration of the entire length of the fallopian canal.
McGovern FH. Facial Nerve Injuries in Skull Fractures: Recent Advances in Management. Arch Otolaryngol. 1968;88(5):536–542. doi:10.1001/archotol.1968.00770010538015
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