title: Middle cranial fossa facial nerve decompression before two years of age.
abstract: We present a case report of a 17-month old patient who underwent serial bilateral total facial nerve decompression procedures for complete bilateral facial paralysis in the setting of craniometaphyseal dysplasia via combined middle cranial fossa and transmastoid approaches. The surgical decision-making process and procedures were reviewed. The patient recovered without complications from the staged surgical procedures, and developed partial return of function of both facial nerves postoperatively, with symmetric House-Brackmann grades of II-III. Despite its technical difficulty in the setting of this particular disorder, facial nerve decompression may be appropriate in the setting of acute facial palsy in craniometaphyseal dysplasia, with the potential for return of function. Given the extremely rare nature of the disease process, variable surgical experience and the clinical condition of the patient remain our best guides for management.
authors.affiliation: City of Hope National Medical Center, Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, 1500 East Duarte Road, Duarte, CA 91010-3000, United States. rskang.md@gmail.com
authors.forename: Robert S
authors.initials: RS
authors.lastname: Kang
authors.forename: Jay T
authors.initials: JT
authors.lastname: Rubinstein
mesh_terms: D001848:Bone Diseases, Developmental / Q000601:surgery*; D035301:Cranial Fossa, Middle / Q000601:surgery*; D019465:Craniofacial Abnormalities / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005154:Facial Nerve / Q000601:surgery*; D005158:Facial Paralysis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D015576:Hyperostosis / Q000601:surgery*; D006972:Hypertelorism / Q000601:surgery*; D007223:Infant; D016896:Treatment Outcome