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Purpose <p>To assess the potential of Transcanal Microscopic Approach of Facial Nerve Decompression in managing traumatic facial nerve palsy of House Brackmann (HB) grade <b>≥</b> 5.</p> Methods <p>The study involved 31 patients of traumatic facial nerve palsy of HB grade <b>≥</b> 5, not improving with conservative management for 21 days, who underwent transcanal microscopic nerve decompression. The ease in identifying the site of lesion, ease in exposure of different segments, challenges faced during surgery, the advantages and disadvantages of the technique, postoperative hearing and complications of the procedure were assessed.</p> Results <p>Most commonly injured part was the horizontal segment (60.5%) followed by the geniculate ganglion or area proximal to it (26.3%). These segments of nerve could be adequately exposed and accessed by minimal bone drilling through this approach. Mean duration of surgery was 169.5&#xa0;min and ossicular disruption was found in 61.3% patients. Mean preoperative House Brackmann Grade was 5.5 ± 0.5 which reduced post operatively to 2.2 ± 0.4 (<i>p</i> &lt; 0.05). Mean air bone gap reduced from 32 ± 7.6 dB to 20.7 ± 3.6 dB (<i>p</i> &lt; 0.05).</p> Conclusion <p>Transcanal microscopic approach has considerable ability to single handedly provide access to the entire intratemporal course of the facial nerve via a less invasive manner with satisfactory postoperative results. A meticulous surgical approach and sound anatomical knowledge is recommended.</p>

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Potential of Transcanal Microscopic Approach in Management of Post-Traumatic Facial Nerve Palsy (House Brackmann Grade ≥ 5) - An Observational Study

  • 期刊论文

  • 发表日期：

    2025年7月29日

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  • Sayan Hazra,
  • Aysha Shirin K,
  • Arindam Das,
  • Pooja Goyal

摘要

Purpose

To assess the potential of Transcanal Microscopic Approach of Facial Nerve Decompression in managing traumatic facial nerve palsy of House Brackmann (HB) grade ≥ 5.

Methods

The study involved 31 patients of traumatic facial nerve palsy of HB grade ≥ 5, not improving with conservative management for 21 days, who underwent transcanal microscopic nerve decompression. The ease in identifying the site of lesion, ease in exposure of different segments, challenges faced during surgery, the advantages and disadvantages of the technique, postoperative hearing and complications of the procedure were assessed.

Results

Most commonly injured part was the horizontal segment (60.5%) followed by the geniculate ganglion or area proximal to it (26.3%). These segments of nerve could be adequately exposed and accessed by minimal bone drilling through this approach. Mean duration of surgery was 169.5 min and ossicular disruption was found in 61.3% patients. Mean preoperative House Brackmann Grade was 5.5 ± 0.5 which reduced post operatively to 2.2 ± 0.4 (p < 0.05). Mean air bone gap reduced from 32 ± 7.6 dB to 20.7 ± 3.6 dB (p < 0.05).

Conclusion

Transcanal microscopic approach has considerable ability to single handedly provide access to the entire intratemporal course of the facial nerve via a less invasive manner with satisfactory postoperative results. A meticulous surgical approach and sound anatomical knowledge is recommended.