A review of 22 patients who had sustained an iatrogenic facial nerve injury was conducted. Although the most common procedure being performed during the injury was mastoidectomy (55%), a surprising number of patients had injury during tympanoplasty (14%) or during removal of exostoses (14%).
of time from the facial nerve injury to the surgical repair was days (range, 1 to days). A single patienthad surgical repairmore than 8months after a facial nerve injury, and this patient was excluded from thiscalculation. The most common location for injury of the facial nerve was the lower tympanic segment. This region was injured in.
Surgical management of an iatrogenic facial nerve injury represents a significant challenge for the otologic surgeon. The decision to perform facial nerve grafting is a difficult one and is based.
Managing iatrogenic trigeminal nerve injury 3 YIJOM; No of Pages 9 Please cite this article in press as: Renton T, Yilmaz Z. Managing iatrogenic trigeminal nerve injury: a case series and review of the literature, 10 20 of.
Facial Nerve Center patient records from to were reviewed for cases of iatrogenic facial nerve injury. These were analyzed by type of inciting procedure, injury location, patient demographics, and referral pattern. Results. Out of 1, patient records, were identified that involved iatrogenic facial nerve injury.
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One of these patients had concomitant facial nerve palsy and labyrinthine fistula. There were two cases of complete facial nerve palsy (House Brackmann grade VI) and two cases of incomplete palsy (House Brackmann grades IV and V). The second genu was the site of injury in three of the four cases. Iatrogenic injury to the facial nerve is one of the most devastating complications of ear surgery. Some authors have found the incidence of facial nerve injury in primary otologic procedures to be as high as 1% and 4%.
Facial nerve paralysis is a devastating injury and doubtless makes a compelling sight in court. Awards and settlements can be large, and at least in this study occurred frequently (12 [63%] of 19 cases), and the verdict seemed to be primarily influenced by a bad outcome (facial nerve paralysis). Traumatic or Iatrogenic facial nerve paralysis is either partial (paresis) or complete paralysis of the facial nerve from trauma, surgical misadventure, or planned surgical resection of the nerve. The vast majority of these cases involve one side of the face. The facial nerve can be damaged intracranially, or within, or external to the temporal.
The course of the facial nerve may be aberrant due to congenital abnormalities unanticipated by the surgeon. A thorough knowledge of facial nerve anatomy and meticulous attention to surgical technique can reduce the risk of injury, but every surgeon must be prepared to manage such iatrogenic facial nerve injuries.