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Nes

  1. 1. POST MASTOIDECTOMY IATROGENIC FACIAL NERVE PALSY – Injury Profile and Treatment Results  DR MADAN GUPTA  DR ALOK THAKAR
  2. 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. 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. 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. 5. Evaluation by ENoG ,EMG and HRCT Temporal bone
  6. 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. 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
  8. 8. Conclusion
  9. 9. THANK YOU

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