Facial Nerve Trauma

Excerpt

Facial nerve palsy is a common presenting complaint in primary care offices, emergency departments, otolaryngology, and neurology clinics. Trauma accounts for 6-27% of all facial nerve palsies, depending upon whether anticipated iatrogenic injuries (such as radical parotidectomy for oncological resection) are considered "trauma" or not. The most common traumatic causes of facial paralysis are resection of tumors, temporal bone fractures, and penetrating trauma to the facial nerve, including iatrogenic injury. Facial paralysis has implications for patients' quality of life due to the facial nerve's role in myriad activities of daily living.

Alongside the emotional impact of impaired facial expression, facial nerve palsy can produce ophthalmological, otological, rhinological, gustatory, and articulation sequelae. Ophthalmological consequences from impaired lacrimation, ectropion, and epiphora include exposure to keratopathy, which can ultimately lead to blindness if not recognized and addressed promptly. Otological consequences include hyperacusis and numbness of a portion of the external auditory canal. Impaired muscular support to the nasal valve can lead to nasal obstruction. Impact on the perioral musculature can result in altered speech and oral incompetence, while damage to the chorda tympani branch of the facial nerve can lead to dysgeusia.