A case of patient who underwent ossicular reconstruction with facial nerve decompression after temporal bone fracture

Abstract

Skull fracture to the temporal bone is responsible for 5%-10% of facial paralysis. It happens because the facial nerve travels through a small bony channel where the nerve can get crushed either by a blow to the head, or the swelling afterwards. This can result in temporary or permanent damage to one or both of the facial nerves. In the case of facial paralysis caused by trauma, conservative treat-ment or surgical treatment can be considered depending on the time of onset and severity of facial paralysis. Conductive hearing loss due to temporal bone fracture could be observed because it is mainly caused by a middle ear hematoma. However, if the ossicle is disrupted by a fracture, it must be corrected surgically. Here we present a case in which surgical facial nerve decompression was per-formed on a patient with facial paralysis after trauma. After a 2.5 m fall, he developed left-sided facial paralysis of House-Brackmann grade IV. The facial nerve decompression with ossicular reconstruc-tion surgery was completed. Reporting this case, we want to discuss about the importance of ideal time for surgical intervention and the appropriate surgical approach for patients with facial paralysis with ossicular disruption after temporal bone fractures.