POST-TRAUMATIC FACIAL PARALYSIS: OUTCOMES OF TRANSCANAL ENDOSCOPIC FACIAL NERVE DECOMPRESSION: A RETROSPECTIVE ANALYSIS

Abstract

Abstract

Background: Microscopic or endoscopic techniques allow for facial nerve decompression (FND) in cases of traumatic facial palsy involving the denticulate ganglion and tympanic segment, offering an alternative to procedures requiring mastoidectomy.

Objective: Focusing on facial nerve (FN) function and hearing in lesions limited to the perigeniculate and tympanic segments, this study analyzes the outcomes of the Transcanal endoscopic approach (TEA) for FND.

Material and Methods: A review of post-traumatic facial nerve (FN) paralysis cases treated with the transcanal endoscopic approach (TEA) at KGN Teaching Hospital, Bannu-KP, from January 2018 to December 2022 was performed retrospectively. Twelve patients with immediate post-traumatic FN paralysis, no response to 14 days of systemic corticosteroids, a “House-Brackmann grade (HBG) of IV–VI”, and lesions limited to the perigeniculate ganglion and tympanic segment of the FN were selected for surgical intervention. Postoperative changes in FN function and hearing following TEA for FND were then analyzed.

Results: The transcanal endoscopic approach (TEA) resulted in post-surgical enhancement of facial nerve (FN) function (HBG I/II) in 80.0% of patients within a 6-month follow-up.No significant further improvement in FN function was observed between the 6th and 10th months. Postoperative hearing improved in ten cases, while one patient with pre-existing sensor neural hearing loss showed no improvement.

Conclusion: In conclusion, the transcanal endoscopic approach (TEA) provides direct access for facial nerve decompression (FND) of lesions confined to the perigeniculate ganglion area and tympanic segment, avoiding the need to address the mastoid segment. TEA is characterized by minimal bone removal, good visualization, and precise surgical site evaluation. Importantly, our findings suggest that even patients presenting for surgery at a later stage may experience positive results.