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madan gupta
madan gupta

This document summarizes the results of treating 6 patients who experienced iatrogenic facial nerve palsy after mastoidectomy surgery over a 2-year period from 2010-2011. It describes each patient's injury details, evaluation findings, management approach, surgical details if applicable, and outcomes. The majority of patients had complete paralysis and underwent surgical intervention like cable grafting or anastomosis to repair the injured nerve. One patient had some recovery of function and was managed medically. The document concludes the study of treating these facial nerve injury cases following mastoidectomy.

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POST MASTOIDECTOMY IATROGENIC FACIAL NERVE PALSY Injury Profile and Treatment Results DR MADAN GUPTA DR ALOK THAKAR
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
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
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
Evaluation by ENoG ,EMG and HRCT Temporal bone
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
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
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  • 1. POST MASTOIDECTOMY IATROGENIC FACIAL NERVE PALSY Injury Profile and Treatment Results DR MADAN GUPTA DR ALOK THAKAR
  • 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. 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. 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. Evaluation by ENoG ,EMG and HRCT Temporal bone
  • 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. 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
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