Combined Traumatic Facial Nerve Repair and Maxillofacial Fractures: Long Term Follow-Up

Abstract

Maxillofacial fractures management is considered a greatchallenge to facial plastic and reconstructive surgeons. Theyinquire adequate and systematic patient assessment to excludeinvolvement of facial neurovascular structures and the airwayinjuries. Types of fixation differ whether rigid or semi rigidfixation is used according to the degree of comminusion, siteand shape of the fracture. The etiology of facial nerve palsyinclude: Idiopathic, post traumatic, neoplastic, etc... Thetraumatic injuries are the second most common, caused bypersonnel assaults, accidental at work or due to road trafficaccidents.Searching in the English written literature it is not mentionedthe outcome of primary traumatic facial nerve repaircombined with complex maxillofacial injuries. The aim ofthe study is to investigate the long term functional outcomeof traumatic facial nerve and maxillofacial fractures reconstruction.The study reviewed 16 patients with nerve injury andvaries types of maxillofacial fractures, at El Demerdash AinShams University Hospital between June 2015 and October2019. Only patients diagnosed with facial nerve main trunkor its branches after examination were included in the study.Only patients with followed-up data for at least 18 monthswere included. All patients was examined in the post-operativeperiod and assessment was done using the House-Brackmannclassification 11 and CT facial bone Patients demographic,history, physical and clinical examination, clinical photographsand surgical procedures (number and type) and complicationswere collected.This study revealed that the long term follow-up forpatients with repaired facial nerve and varies maxillofacialfractures had promising esthetic and functional with a meanthe post-operative objective House-Brackmann score analysiswas 2.56 (±0.51). Further multi centric study is suggested toinvestigate the relation between the type of trauma, resultsand different nerves involved and this could be achieved byincreasing the number of patients to be included in the futurestudy.