NGHIÊN CỨU ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ ĐÁNH GIÁ KẾT QUẢ ĐIỀU TRỊ LIỆT DÂY THẦN KINH VII NGOẠI BIÊN DO CHẤN THƯƠNG XƯƠNG THÁI DƯƠNG TẠI BỆNH VIỆN TAI MŨI HỌNG CẦN THƠ VÀ BỆNH VIỆN ĐA KHOA TRUNG ƯƠNG CẦN THƠ NĂM 2022-2024

Abstract

Background: Peripheral facial paralysis exhibits a diverse etiology, with temporal bone trauma ranking as the second most prevalent contributing factor. However, due to the frequent cooccurrence of intracranial injuries, lesions within the temporal bone are susceptible to underdiagnosed. Objectives: To describe the clinical, subclinical features and to evaluate the treatment outcomes of facial paralysis following temporal bone fractures. Materials and methods: A prospective cross-sectional descriptive study was conducted on 31 patients that diagnosed with posttemporal bone fracture facial paralysis. These patients received treatment at Can Tho Ear Nose Throat Hospital and Can Tho Central General Hospital  from July 2022 to March 2024. Results: Among the 31 patients enrolled, 83.9% were male. The mean age was 31.8 years. Traffic accidents constituted the primary cause of trauma (83.9%). Facial paralysis developed immediately in 8 of the 31 cases, with most patients presenting with House-Brackmann grades IV. Longitudinal fractures were observed in 17 cases (54.8%). Conservative treatment was employed in 16 cases, while 15 patients underwent facial nerve decompression surgery. Following a 3-month treatment period, 77.4% of patients achieved a good recovery (House-Brackmann grades I-II). Patients underwent facial nerve decompression surgery within 1 month after temporal bone trauma better than patients underwent later decompression surgery. Conclusion: Detecting severity and timing of facial nerve palsy onset contribute to select treatment as well as prognostic clinical recovery for patients. Treatment guidelines for conservation of late paralysis of the face, mild paralysis, surgery indicated for patients with severe facial paralysis, sudden facial paralysis after an injury. Patients underwent facial nerve decompression surgery within 1 month after temporal bone trauma better than patients underwent later decompression surgery.