215 / 264
prognosis, MF decompression offers good long-term
facial nerve outcomes. In cases with irreversible facial
nerve injury, nerve grafting offers beneficial results when
performed with MF decompression. Surgery should
ideally be performed within 14 days of the onset of
traumatic facial nerve paralysis, however, patients who
present after this time frame and meet surgical criteria,
may still benefit from decompression. Decompression in
patients over 60 years should be performed to identify
those patients with irreversible injuries, but these patients
may not improve as much as their younger counterparts.
In summary, MF decompression and repair is safe,
effective, and provides good long-term facial nerve out-
comes in patients with traumatic facial nerve paralysis
and poor prognosis on electrical testing.
CONCLUSION
In this series, all patients with traumatic complete
paralysis and poor facial prognosis on electrical testing
achieved a long-term outcome of HB III or better after MF
approach for decompression and repair of the facial nerve.
Surgical criteria for decompression includes immediate-
onset, complete paralysis (HBVI),
>
90%degeneration on
ENoG, and absent voluntary EMG potentials. When a
patient is stable after trauma, surgery is ideally performed
within 14 days of trauma, with earlier decompression
showing the best results. The current study further supports
the safety and efficacy of the MF approach, demonstrating
long-term facial nerve outcomes of HB III or better and
minimal morbidity in these high-risk trauma patients with
facial paralysis.
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