Objectives: In this study, our surgical approaches in temporal
bone transvers fracture cases with facial paralysis and their
results were evaluated.
Patients and Methods: Five temporal bone transverse fracture
cases (2 females, 3 males; mean age 32.8 years; range 4 to
62 years) with facial paralysis which were treated in our clinic
between July 1998 and July 2008 were included in this study.
Radiologic, audiologic, topographic and electrodiagnostic investigations
were made preoperatively. The evaluation of facial
nerve function was performed by using House-Brackmann (HB)
classification. Tympanic segment, ganglion geniculi and labyrinthine
segment were exposed by translabyrinthine approach
in all cases. Integrity of the facial nerve was achieved via
re-routing and end-to-end anastomosis or n. auricularis major
interpositional graft. The cases were evaluated regarding complications
and facial nerve function postoperatively.
Results: In the audiologic investigation ipsilateral total neurosensorial
hearing loss was determined in all cases. In four
cases facial paralysis was recognized immediately and in one
patient it was recognized when the patient was discharged from
the intensive care unit. Facial nerve function was HB stage V
in all cases. Surgery was performed in the first six weeks and it
was observed that integrity of the labyrinthine segment was distorted
in all cases. Reconstruction was performed by re-routing
and end-to-end anastomosis in three cases and n. auricularis
major interpositional graft in two cases. There were no postoperative
complications. Facial nerve function was HB stage II in
three cases (re-routing) and HB stage III in two cases (graft).
Conclusion: In temporal bone fracture cases with neurosensorial
hearing loss and facial paralysis, we achieved good exposure
via translabyrintine approach. Better functional results
were obtained in re-routing and end-to-end anastomosis technique
when compared to interpositional grafting.
FREE FULL TEXTAnahtar Kelimeler: Temporal kemik; translabirentin yaklaşım; transverskırık.