title: [Facial paralysis after temporal bone trauma].
abstract: OBJECTIVE
  To evaluate functional outcome in 64 cases of facial paralysis following temporal bone fracture and discuss decisive arguments leading either to medical treatment or surgical management.
  
  
  METHODS
  Sixty-four patients suffering from post-traumatic facial paralysis were managed between 1995 and 2003: 38 (59%) were given medical treatment and 26 (41%) underwent surgery. A combined middle fossa and transmastoid approach was mostly used (58%). Electrophysiological testing and CT scan results were the main points of the decision algorithm.
  
  
  RESULTS
  Electroneuromyography seems to be the most accurate exploration for guiding treatment. Good results (grades I to II on the House and Brackmann scale) were obtained in 63% of cases after medical management and in 39% of cases after surgical treatment. Grades III or IV were obtained in 13% of medically-treated patients and 42% of surgically-treated patients.
  
  
  CONCLUSIONS
  Management of facial paralysis following temporal bone fracture in accordance with electrophysiological testing (evoked EMG) together with CT scan findings enabled accurate indications for surgical treatment. A good grade I or II result can be expected after medical management. A grade III is at best reached after nerve anastomosis.
authors.affiliation: Service d'ORL et de Chirurgie Cervico-faciale, Centre Hospitalier Universitaire, Place A. Reba Léon, 33076 Bordeaux. camille.bodenez@wanadoo.fr
authors.forename: C
authors.initials: C
authors.lastname: Bodenez
authors.forename: V
authors.initials: V
authors.lastname: Darrouzet
authors.forename: M
authors.initials: M
authors.lastname: Rouanet-Larriviere
authors.forename: X
authors.initials: X
authors.lastname: Barreau
authors.forename: D
authors.initials: D
authors.lastname: Liguoro
authors.forename: J-P
authors.initials: JP
authors.lastname: Bebear
authors.forename: V
authors.initials: V
authors.lastname: Franco-Vidal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001299:Audiometry / Q000379:methods; D002648:Child; D003131:Combined Modality Therapy; D004576:Electromyography; D005158:Facial Paralysis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D013701:Temporal Bone / Q000293:injuries* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014947:Wounds and Injuries / Q000150:complications / Q000628:therapy
chemical_list: D000893:Anti-Inflammatory Agents; D011241:Prednisone; D008775:Methylprednisolone