Arch Craniofac Surg.  2017 Mar;18(1):65-70. 10.7181/acfs.2017.18.1.65.

New Treatment in Facial Nerve Palsy Caused by Sagittal Split Ramus Osteotomy of Mandible

• Lee JH
• Lee KA

• KMID: 2375227
• DOI: http://doi.org/10.7181/acfs.2017.18.1.65

Abstract

A 25-years-old woman with mandibular prognathism underwent a mandibular setback by way of mandibular sagittal split ramus osteotomy (MSSRO). After 2 days of operation, she developed difficulty of closing her right eye. The blink reflex test and motor nerve conduction study of the right orbicularis oris muscle were revealed right facial neuropathy of unknown origin and House-Brackmann facial nerve grading system (HBFNGS) grade V. For treatment, we initially prescribed oral prednisolone and nimodipine including physical therapy. The samples consisted of 11 facial nerve palsy patients caused by MSSRO and were analysed about onset of facial nerve palsy, postoperative HBFNGS, final HBFNGS, treatment method and recovery time. At 10 weeks of treatment of nimodipine, she had completely regained normal function (HBFNGS grade I) of the right facial nerve. The clinical results lead to assume a fast recovery of facial nerve function by the nimodipine medication, whereas average time of recovery is 16.32 weeks in references. Despite of the limited one patient treated, the result was very promising with respect to a faster recovery of the facial nerve function. Considering the use of nimodipine treatment for peripheral facial nerve palsy following a surgical approach with an anatomically preserved nerve can be recommended.

Keyword

Osteotomy, sagittal split ramus; Facial paralysis; Nimodipine

MeSH Terms

Blinking
Facial Nerve Diseases
Facial Nerve*
Facial Paralysis
Female
Humans
Mandible*
Methods
Neural Conduction
Nimodipine
Osteotomy, Sagittal Split Ramus*
Paralysis*
Prednisolone
Prognathism
Nimodipine
Prednisolone