When is decompression surgery indicated in the treatment of congenital facial paralysis?

Updated: Jan 07, 2019
  • Author: Alan D Bruns, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

A general preoperative guideline for decompression surgery of the temporal bone after a traumatic injury is to determine if clinical and electrophysiologic tests reveal (1) complete unilateral paralysis (H-B grade VI), (2) evidence of temporal bone trauma based upon CT scanning and physical examination, (3) complete loss of function of the facial nerve at age 3-5 days, and (4) absence of improvement by age 5 weeks. As a reminder, after the nerve had been decompressed, and if Wallerian degeneration has occurred, the nerve regenerates at a rate of approximately 1 mm per day.


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