Publication: Relationship between site of facial nerve injury and percentage of denervation in electroneuronography: A retrospective study
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Date
2022
Authors
Rajoo, Tamil Selvi
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Abstract
Objective Traumatic facial nerve injury is very devastating functionally and aesthetically for a patient. It is crucial for an Otorhinolaryngology surgeon to be vigilant in diagnosing facial nerve injury and intervene at a right time . Hence, we aimed to study the clinical outcome of patients with temporal bone fracture (TBF) and traumatic facial nerve injury. In addition, the association between site of facial nerve injury and percentage of denervation in electroneuronography(ENOG) was studied. Methodology This a retrospective study (observational) which done in tertiary university hospital between 1st January 2010 to 31st January 2020. A total 82 patients who had TBF and traumatic facial nerve injury who fulfilled inclusion and exclusion criteria have been recruited. The inclusion criteria are all the patients who involved with trauma with complete documentation of facial nerve function with House Brackmann (HB) grading, Electroneuronography (ENOG) result and post trauma High Resolution Computer Tomography (HRCT) of Temporal bone. The data on demography of patients, clinical findings, Pure Tone Audiometry, HB grading, ENOG and HRCT Temporal result were collected and analysed. Results The mean age of patients involved in trauma were 27.5 years old. Motor Vehicle Accidents (MVA) constituted 92.7% of the cause for trauma. Most of the motorcyclists who involved were without helmet (83.3%). Delayed facial paralysis was found in 87.8% cases. Half of the patients with facial nerve injury had severity of HB grade IV (50%). The conductive hearing loss was commonly seen among our patients. The prevalence of patients with longitudinal TBF were the highest (60.5%). Based on the new classification of TBF, majority of our cases were otic capsule sparing (84.4%). Based on the old classification, we found the tympanic segment of facial nerve (28%) commonly injured followed by the first genu (24.4%). There was no significant difference between the percentage of denervation (ENOG) and the sites of facial canal fracture (p value<0.075). Conclusion There is no association between sites of facial nerve injury and ENOG result. The selection of patients for surgery should not solely rely on HRCT but also clinical grading (time of onset) and serial ENOG monitoring
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