AAHS ASPN ASRM - 2013 Annual Meeting - American Association ...

ASRM Concurrent Scientific Paper Presentations B-1
Long-term Subjective and Objective Outcome after Primary Repair of Traumatic Facial Nerve Injuries
Institution where the work was prepared: Erasmus Medical Center Rotterdam, Rotterdam, Netherlands
Marc A.M. Mureau; Erik Frijters; Stefan O.P. Hofer; Erasmus University Medical Center Rotterdam
Background:
Traumatic facial nerve injury can lead to varying degrees of facial paralysis. Although it has been generally accepted that primary nerve repair leads to optimal
results, there are no follow-up studies evaluating subjective and objective outcome after primary repair of traumatic facial nerve injuries. The aims of the present
study were to assess long-term: subjective facial functioning and satisfaction; objective facial functioning; and physical and mental health.
Methods:
From May 1988 to August 2005, 28 patients were operated for traumatic facial nerve lesions. All patients were invited to our outpatient clinic for a standardized
questionnaire (Facial Disability Index, SF-36), physical examination (Sunnybrook Facial Grading System), and clinical photographs.
Results:
There were 21 male and 7 female patients (mean age, 28 years; 9 to 63 years). There were 22 sharp and six crush facial nerve injuries. Left and right side were
equally affected. The main facial nerve trunk was severed four times, the temporal branch 10 times, zygomatic branches 12 times, buccal branches 13 times,
and the marginal mandibular branch nine times. In four patients all branches were involved, in one case four, in five subjects three, in seven patients two, and
in 11 cases one. Concomitant injuries consisted of Stenson's duct transection (7), facial fractures (4), parotid gland injury (9), major neck vessel injury (3), and
facial muscle injury (10). End-to-end facial nerve repair was performed within 24 hours in 23 cases (82%) and within one week in the remaining five cases.
Concomitant injuries were always repaired as well. Eighteen patients were eligible for follow-up (mean, 6.5 years). Mean Sunnybrook FGS score was 70.4 indicating
reasonably good facial functioning (100 means perfect), which was better compared to recovered Bell's palsy patients after mime therapy (54.9; p