A Clinical Study of Facial Nerve Paralysis

Park, Chul Won; Ahn, Kyung Sung; Choi, Suk Joo; Muhn, Dong Suk

Abstract

BACKGROUND AND OBJECTIVES: Since Sir Charles Bell (1829) demonstrated that motor innervation of the muscles of facial expression is by cranial nerve VII, many more research have contributed to the diagnosis and treatment of facial nerve paralysis. We attempted to evaluate the causes, arrive at accurate diagnosis and determine the treatment for facial nerve paralysis.
MATERIALS AND METHODS
The authors analyzed 65 cases of facial nerve paralysis diagnosed at the Department of Otolaryngology, Hanyang University Hospital from January 1993 to December 1995.
RESULTS
1) The most common age group was the twenties. 2) The most common cause was trauma (23 cases, 35.4%). 3) The degree of facial nerve paralysis that were most common on first visits was Grade IV, based on the House-Brackmann grading method. 4) 38 cases (58.5%) were treated with chemotherapy and 27 cases (41.5%) were treated with surgical therapy. 5) Surgical techniques used were facial nerve decompression in 11 cases (40.8%), end to end anastomosis in 4 cases (14.8%), myringotomy with v-tube insertion in 4 cases (14.8%), tumor resection in 3 cases (11.1%), nerve graft in 2 cases (7.4%), mastoidectomy only in 2 cases (7.4%), and muscle transposition in one case (3.7%).
CONCLUSION
In our review, the the most common degree of facial nerve paralysis on patients' first visits was Grade IV according to the House-Brackmann grading method. Statistically, there was no sexual difference in the incidences of facial nerve pals. The causes of facial nerve palsy due to trauma are recently on the rise because of increased traffic accident. However, iatrogenic incidents are decreasing because of the advance in the technical and instrumental development.