Management of Non-Surgical Traumatic Facial Nerve Injuries

INTRODUCTION: Traumatic facial nerve injuries present a unique challenge to clinicians and surgeons because of the intricate facial nerve anatomy and profound impact on the psychological well-being and social interactions of patients. In this study, we aimed to shed light on the multifaceted nature of non-iatrogenic traumatic facial nerve injuries through an in-depth analysis of 12 distinctive cases.
METHODS: Between March 2019 and June 2022, at Ankara City Hospital and Akdeniz University Hospital, we conducted a retrospective analysis of 12 patients who presented with traumatic facial nerve injuries without surgery-related complications. To better understand the particularities of traumatic injuries to the facial nerve outside the context of surgical interventions, all cases selected for this study were of nonsurgical origin.
RESULTS: Twelve patients (eight males and four females) were included in the study. The average age of the patients was 29 years (range, 5–53 years). The causes of injury varied from dog bites in one patient, work-related injuries with a jigsaw in one patient, traffic accidents in two patients, sharp penetrating injuries in four patients, and temporal bone trauma in four patients. Five patients underwent a direct nerve repair. Three patients had nerve grafting. Three patients underwent reconstruction using a free functional gracilis flap. One patient underwent masseter nerve transfer. Considering the diverse treatment modalities applied and the subsequent outcomes observed, an algorithm was formulated.
DISCUSSION AND CONCLUSION: By sharing these experiences, we aspire to contribute a nuanced perspective to the existing body of knowledge on traumatic facial nerve injuries, further supporting clinical decision-making in such rare and challenging scenarios.