1. POST MASTOIDECTOMY IATROGENIC FACIAL NERVE
PALSY – Injury Profile and Treatment Results
 DR MADAN GUPTA
 DR ALOK THAKAR

2. COHORT OF 6 CONSECUTIVE IATROGENIC FACIAL
NERVE PALSY PATIENTS REFERRED TOTREATED AT
OUR CENTRE ( ENT II)
2 YEAR DURATION
2010-2011
 DR MADAN GUPTA
 DR ALOK THAKAR

3. Face is a part of beauty!!!!!!!!
A perfectly beautiful face needed both symmetry and ‘averageness’!
Osaka University Japan 2009
“Losing face is as important to people as losing bark is to a tree”
Chinese Proverb
Specific Impairment of Smiling Increases the Severity of Depressive
Symptoms in Patients with Facial Neuromuscular Disorders !
JessieM.VanSwearingenet al
Aestheticplasticsurgery vol 23 no 6

4. patient Duration injury
To presentation
Onset of
paralysis
Improvement
since
H & B Grading
20/m 2 wk immediate No Vl
19/f 1 wk immediate No Vl
25/m 6 month immediate No Vl
13/f 2 month immediate No Vl
45/f 1 wk immediate NO Vl
32/m 2wk immediate yes V

5. Evaluation by ENoG ,EMG and HRCT Temporal
bone

6. patient Duration
Injury to
presentation
grade Electrical Testing HRCT management
ENoG EMG labyrinthine Tympanic vertical
20/m 2 wk Vl NR silent N x N surgical
19/f 1 wk Vl NR silent N x N surgical
25/m 6 month Vl NR silent N X N surgical
13/f 2 month Vl NR silent X X N surgical
45/f 1 wk Vl NR silent N X N surgical
32/m 2wk V Reduced
CMAP
N X N medical

7. patient Duration
Injury to
presentat
ion
grade
Electrical
Testing
HRCT managemen
t
Surgical
finding
extent procedure
ENoG
EMG labyrinthine Tympanic vertical
20/m 2 wk Vl NR silent N x N surgical As per
radiology
<50%
thickness
decompressi
on
19/f 1 wk Vl silent N x N surgical As per
radiology
Full
thickness
Greater
auricular
cable graft
25/m 6
month
Vl NR silent N X N surgical As per
radiology
Full
thickness
Greater
auricular
cable graft
13/f 2
month
Vl NR silent X X N surgical As per
radiology
Full
thickness
Xll-Vll
anastomosis
45/f 1 wk Vl NR silent N X N surgical As per
radiology
>50%
thickness
End to end
anastomosis
32/m 2wk V Re
duc
ed
CM
AP
N X N medical

9. Conclusion

10. THANK YOU