Abstract
Facial paralysis can result from a variety of etiologies; the most common is the idiopathic type. Evaluation and treatment are particularly complex. The treatment of acute facial paralysis may require facial nerve decompression surgery. Any structure near the path of the facial nerve is at risk during transmastoid decompression surgery. AimThis is a retrospective study, carried out in order to evaluate hearing loss after transmastoid decompression and how idiopathic cases evolved in terms of their degree of paralysis in the last 15 years. Materials and MethodsWe selected the charts from 33 patients submitted to transmastoid facial nerve decompression in the past 15 years and we assessed their hearing loss and facial paralysis. ResultsThere was a high percentage (61%) of patients with some degree of hearing loss after the procedure and in all cases there was improvement in the paralysis. DiscussionThe values obtained are similar to those reported in the literature. One possible explanation for this hearing loss is the vibration transmission by drilling near the ossicular chain. ConclusionThe surgical procedure is not risk free; indications, risks and benefits should be explained to patients through an informed consent form.
Highlights
Aim: This is a retrospective study, carried out in order to evaluate hearing loss after transmastoid decompression and how idiopathic cases evolved in terms of their degree of paralysis in the last 15 years
Materials and Methods: We selected the charts from 33 patients submitted to transmastoid facial nerve decompression in the past 15 years and we assessed their hearing loss and facial paralysis
Facial paralysis can be the result of a large variety of etiologies, including infections, neurologic, congenital, neoplastic, traumatic, systemic and iatrogenic[1]
Summary
Facial paralysis can be the result of a large variety of etiologies, including infections, neurologic, congenital, neoplastic, traumatic, systemic and iatrogenic[1]. The most common among paralyses is Bell’s, or idiopathic, which incidence is estimated to be 2,025 cases per 100,000 inhabitants per year. Facial palsy assessment and treatment are complex, because of the large variation in regeneration potential and the lack of reliable prognostic indicators for spontaneous recovery[3]. The current treatment for facial paralysis is based on a combination of medication, facial physical therapy and surgical intervention in selected cases[4]. The different means of intervention are broken down into acute paralysis (up to 8 weeks), intermediate duration paralysis (8 weeks to 2 years) and chronic paralysis (longer than 2 years), each with their different indications and possible complications. Treatment for the acute facial paralysis may involve facial nerve decompression surgery, primary grafting or repair in cases of resection or transection[4]. May & Klein[5] reported that hearing impairment was the most frequent complication (air-bone gap, sensorineural hearing loss and lower hearing acuity)
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