title: Management of traumatic facial nerve paralysis with carotid artery cavernous sinus fistula.
abstract: Massive skull base injuries require detailed preoperative neurological and neurovascular assessment prior to undertaking surgical repair of isolated cranial nerve deficits. We present the management of a patient with traumatic facial paralysis, cerebrospinal fluid leak, and carotid artery cavernous sinus fistula as the result of a gunshot wound to the skull base. The carotid artery cavernous sinus fistula was ultimately controlled with super-selective embolization via the vertebral artery. The facial nerve injury was then safely treated with mobilization of the labyrinthine and vertical segments to allow a primary anastomosis.
authors.affiliation: Department of Otolaryngology, New York University School of Medicine, NY 10016.
authors.forename: J T
authors.initials: JT
authors.lastname: Roland
authors.forename: P E
authors.initials: PE
authors.lastname: Hammerschlag
authors.forename: W S
authors.initials: WS
authors.lastname: Lewis
authors.forename: I
authors.initials: I
authors.lastname: Choi
authors.forename: A
authors.initials: A
authors.lastname: Berenstein
mesh_terms: D000328:Adult; D001164:Arteriovenous Fistula / Q000209:etiology* / Q000628:therapy*; D020212:Carotid Artery Injuries; D002426:Cavernous Sinus / Q000293:injuries*; D002558:Cerebrospinal Fluid Otorrhea / Q000209:etiology / Q000601:surgery; D004621:Embolization, Therapeutic; D005154:Facial Nerve / Q000601:surgery; D020220:Facial Nerve Injuries; D005158:Facial Paralysis / Q000209:etiology* / Q000601:surgery*; D005830:Geniculate Ganglion / Q000601:surgery; D006801:Humans; D008297:Male; D016067:Nerve Transfer; D012886:Skull / Q000293:injuries*; D014948:Wounds, Gunshot / Q000150:complications*