[Surgical treatment of traumatic facial paralysis].
Facial paralysis caused by cranial traumatism often needs surgical treatment / 28 operations were carried out on a group of 47 paralysed patients. Direct lesion of the facial nerve was in fact common / 10 compressions or contusions, 4 sections. Associated kophosis was frequent (15 cases). Conductive deafness was not uncommon (11 cases). Transverse fractures (5 cases) and complicated fractures (4 cases), true to their reputation for seriousness, all needed surgery and span the four nerve sections observed. Surgery is often delayed due to extensive cranio-cerebral lesions requiring prolonged neuro-surgical nursing care / 16 patients were operated on between the 4th and 8th weeks, 9 patients after the 8th week. The operation was usually carried out through the mastoid. Posteiror lympanotomy enabled the bend and the second portion to be reached and later enabled the ossicular chain to be reconstructed. In two cases involving kophosis, the three portions of the nerve were tackled through the labyrinth. The choice depends on the audiometric, radiological and operative findings. Surgical indications depend on clinical, elecromyographic, audiometric and radiological results. A check was carried out by means of muscular tests in 23 out of 28 cases: --20 decompressions / 15 recuperations of more than 50 p. 100 of which 7 were above 75 p. 100; --3 grafts or sutures / 3 recuperations of 30 p. 100.
D000293:Adolescent; D000328:Adult; D005158:Facial Paralysis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012886:Skull / Q000293:injuries
Le traitement chirurgical des paralysies faciales traumatiques