Facial Nerve Decompression

In case of trauma or accidents, patients can have temporal bone fracture resulting in facial nerve palsy. Temporal bone fractures, blunt or penetrating head and neck trauma, and iatrogenic surgical injury are all common causes for facial nerve injury. Immediate paralysis is suggestive of nerve disruption or severe compression, such as bone fragment. Temporal bone fractures are classified as longitudinal or transverse or mixed. It is described as nerve swelling within the bony canal. The odema and inability to expand beyond the bony confines creates a conduction block which prevents the axoplasmic flow. In case of temporal bone fracture, the treatment for facial nerve palsy depends on the fracture location and the ideal time for surgery following trauma. In our OPD, a patient came with alleged history of trauma following which he had facial nerve palsy. We performed facial nerve decompression and patient had a good prognosis, postoperatively. Facial nerve decompression is a surgery recommended for complete facial nerve palsy in which patients get benefitted by regaining the facial nerve functions. Surgical decompression of all nerve segments affected by temporal bone fracture should be performed using middle cranial fossa approach or transmastoidal approach or translabyrinthine approach.