Facial paralysis can be congenital or acquired. Congenital variety consists of Mobius syndrome, Hemifacial microsomia and osteopetrosis. All conditions are rare and not seen in day to day clinical practice. Acquired: Trauma to the skull causing longitudinal or transverse fracture of the temporal bone leading to facial paralysis. HR temporal CT scan should be done to access the extent of the damage.
For incomplete paralysis, such as neuropraxia, initial treatment is with steroids. If there is incomplete recovery, the temporal bone should be surgically explored and the facial canal decompressed, starting from the labyrinthine segment up to the stylomastoid foramen. For grade IV - VI House-Brackman facial nerve paralysis or when a fracture is detected on CT scan, the nerve should be decompressed and end to end anastomosis is done. If a section of the facial nerve is missing in such a…
