Factors Contributing to the Facial Paralysis after Temporal Petrous Fractures

ABSTRACT

One of the common serious consequences of trauma to the temporal bone is facial nerve paralysis. Several attempts have been made to evaluate the relationship between the radiological findings and traumatic facial paralysis. These works have demonstrated the usefulness of high-resolution computed tomogrphy in assessment of facial nerve pathway. The authors tried to clarify the significant factors contributing to the facial nerve paralysis due to temporal petrous fractures clinically and radiologically including the high resolution CT findings. Fifty eight patients with 66 petrous fractures were reviewed in this context. Various clinical factors including hearing disturbance, CSF otorrhea demonstrating the objective traumatic evidences were reviewed. Plain X-ray findings and CT findings were reviewed as radiologic evidences. The radiologic factors were fracture evidence and wide fracture gap(more than 1mm) in plain film. Among CT findings, evidence for blood in middle ear, blood in mastoid air cells, ossicular disruption, fracture line compromising the facial nerve pathway from internal acoustic canal to mastoid portion and multiplicity of fracture lines were reviewed. These factors were analyzed statistically. In this study, it was found that traumatic bony involvement in facial nerve pathway did not necessarily mean facial paralysis. The most relavent factor contributing to the traumatic facial paralysis was multiple petrous fractures.