title: Facial nerve decompression surgery in patients with temporal bone trauma: analysis of 66 cases.
abstract: BACKGROUND
  In the treatment of facial nerve paralysis after temporal bone trauma, it is important to appropriately determine whether nerve decompression surgery is indicated. The aim of this study was to examine the efficacy of facial nerve decompression surgery according to fracture location and the ideal time for surgery after trauma by analyzing the therapeutic outcome of traumatic facial nerve paralysis.
  
  
  METHODS
  In total, 66 patients with facial nerve paralysis after temporal bone trauma who were treated at our institution between 1979 and 2009 were studied retrospectively. The patients were divided into five subgroups, according to the fracture location and the period of time between trauma and surgery.
  
  
  RESULTS
  The number of patients who achieved complete recovery of House-Brackmann (H-B) grade 1 was 31 of 66 (47.0%). There was no difference in therapeutic outcomes among the subgroups classified by fracture location. The rate of good recovery to H-B grade 1 or 2 in patients undergoing decompression surgery within 2 weeks after trauma reached 92.9%, resulting in a significantly better outcome than that of patients undergoing later decompression surgery (p < 0.01).
  
  
  CONCLUSIONS
  The results of this study demonstrated that the ideal time for decompression surgery for facial nerve paralysis after temporal bone fracture was the first 2 weeks after trauma in patients with severe, immediate-onset paralysis. Our study also showed that surgery should be performed within 2 months at the latest. These findings provide useful information for patients and help to determine the priority of treatment when concomitant disease exists.
authors.affiliation: Department of Otolaryngology, Ehime University School of Medicine, Ehime, Japan. nhato@m.ehime-u.ac.jp
authors.forename: Naohito
authors.initials: N
authors.lastname: Hato
authors.forename: Junpei
authors.initials: J
authors.lastname: Nota
authors.forename: Nobumitsu
authors.initials: N
authors.lastname: Hakuba
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Gyo
authors.forename: Naoaki
authors.initials: N
authors.lastname: Yanagihara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000379:methods*; D005158:Facial Paralysis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009416:Nerve Regeneration / Q000502:physiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012887:Skull Fractures / Q000150:complications* / Q000175:diagnosis; D013701:Temporal Bone / Q000293:injuries*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult