A Case of Complete Neurotmesis of the Facial Nerve Caused by a Temporal Bone Fracture

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  • Nakae Susumu
    Department of Otolaryngology, BellLand General Hospital
  • Inoue Mami
    Department of Otolaryngology, Kyoto Kuramaguchi Medical Center
  • Tadaki Nobuhisa
    Department of Otolaryngology, Saiseikai Shigaken Hospital

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Other Title
  • 側頭骨骨折による顔面神経完全断裂例
  • 臨床 側頭骨骨折による顔面神経完全断裂例
  • リンショウ ソクトウコツ コッセツ ニ ヨル ガンメン シンケイ カンゼンダンレツレイ

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<p>An 8-year-old girl was brought to the emergency room of our hospital with a right temporal bone fracture sustained when she received a strong blow to the right side of her head in a traffic accident.</p><p>She was found to have total right facial palsy on the following day, and was referred to the otolaryngological department 3 days after the injury. Decompression surgery of the right facial nerve was attempted 5 days after the injury, however, at surgery, the patient was found to have developed complete neurotmesis of the facial nerve in the horizontal portion, with a defect about 20 mm in length, caused by the impact of the temporal bone fragments. This was a very rare case of traumatic facial palsy caused by a temporal bone fracture.</p><p>The great auricular nerve was used to reconstruct the facial nerve. The nerves were not sutured to each other, but stuck to each other with fibrin glue.</p><p>Approximately a year after the operation, the paralysis grade had improved from grade IV to grade III (House-Brackmann grade), and the Yanagihara score from 0 to incision 24.</p><p>In a case presenting with severe temporal bone fracture, it is necessary to recognize the possibility of neurotmesis of the facial nerve and prepare to reconstruct the facial nerve. Various methods of reconstruction of the facial nerve have been discussed in the literature.</p><p>Transplantation of the great auricular nerve in the present case was very simple and resulted in a good outcome.</p>

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