Etiology, evaluation, and management of facial nerve trauma

A typical presenting concern in general practitioners' offices, emergency rooms, otolaryngology, and neurology departments are facial nerve paralysis. Penetrating injury to the facial nerve, especially iatrogenic damage, is one of the most frequent traumatic reasons of facial paralysis. The facial paralysis that results from blunt trauma that crushes the nerve frequently appears as an incomplete or delayed paralysis. The affected part of the nerve will determine how the injury manifests clinically. For adequate patient counseling with respect to prognosis and management, accurate diagnosis of facial nerve palsy must be achieved. The most often employed standardized instrument for determining the level of facial weakness is the House-Brackmann 6-grade instrument for facial nerve activity. The greatest success chances for reanimation occur in cases of a recent, sudden nerve transection i.e., less than 72 hours, where the nerve is quickly identified and repaired using direct coaptation or interposition grafts. The primary strategy of care is surveillance in situations with facial nerve paralysis where it is known that the nerve is physically intact such as blunt force trauma with incomplete or delayed complete paralysis. Neurological, muscular, static, and facial plastic treatments are some examples of facial reanimation approaches.