Clinical Study of Intratemporal Facial Nerve Palsy - The Causes and Outcome

Abstract

Paralysis of the seventh cranial nerve, the facial nerve, is usually immediately obvious. It results in weakness of the musculature of the face, impacting verbal communication, social interaction with respect to facial expression, oral competence, taste and most importantly, protection of the cornea, ocular globe and vision. Palsy of the facial nerve in its intratemporal course leads to ipsilateral lower motor neuron facial palsy. Objectives: 1. To study 100 cases of facial nerve palsy due to pathology in the intratemporal course of the nerve. 2. To identify the frequent causes, course of palsy, treatment modality and recovery during a period of 3 months follow-up. Materials & Methods: 100 patents with facial nerve palsy with an intratemporal pathology were analysed. Detailed history was taken. Patients were subjected to complete clinical evaluation of ear and cranial nerves, radiological evaluation was also done to confirm the diagnosis. Patients were treated appropriately. The facial nerve function was graded again during follow up after 3 months. Results: 46% patients were diagnosed with Bells palsy, 26% with chronic suppurative otitis media/cholesteatoma, 17% with trauma leading to palsy and 4% patients had tumours that lead to the palsy. Males were more affected (58%) than females. 39% patients were in the age bracket of 21 to 30 years. 25% of cases had Grade 3 palsy at presentation, 40% of cases had Grade 4, 13% had grade 5 and 8% had grade 6 palsy. After 3 months 82% cases showed complete recovery following appropriate treatment.