Etiopathological factors and management of facial palsy

Abstract

lie within the temporal bone. Evaluation of these cases includes complete head and neck examination with special emphasis on otological workup. While many cases are managed conservatively a small but significant number will require surgical intervention. Objectives: To study the various etiopathological factors responsible for facial nerve paralysis and its clinical course and to analyze the outcome of medical and surgical management policy adopted. Methodology: Descriptive time bound study conducted at Department of ENT,Mysore Medical College and Research Institute, Mysore from 1st November 2009 to 30thApril 2011.Patients with LMN facial nerve palsy were included in the study. They were investigated and treated as per the cause and their facial nerve function after treatment was assessed. Results: A total of 50 patients with facial nerve paralysis due to various causes were seen during the study period. The Bells palsy 21(42%) was the most common cause followed by Accidental trauma 13 (26%). LMN facial palsy was found more common in males than in females (1.5:1) and more in the adult age group(20-40 years). Bell’s palsy was more in 20-40 years age group with male to female ratio of 0.75:1. About 76% patients with Bells palsy had complete recovery with steroids, while 77% of patients with trauma had complete recovery. All patients of CSOM with facial palsy had complete recovery. Conclusion: Most cases of Bell’s palsy can be managed conservatively. Cases due to iatrogenic trauma and accidental injury require careful evaluation and early intervention. CSOM cases fair well withmodified radical mastoidectomy and decompression of the nerve. The causes for facial paralysis are similar compared to other studies in many cases. Little dissimilarity are observed depending on the geographical landmarks, health consciousness and type of center where the study was done.