[The results of surgical treatment of the facial nerve paralysis].

UNLABELLED: Paralysis of the facial nerve reveales some symptoms which are very unfavourable for esthetic point of view (deformity of the face with incompetence of the palpebal function). It is recognized as the one of the most invalidity for humane life. There are many surgical techniques to reconstructive facial nerve such as: decompression, end to end or side to end anastomosis with hypoglosal, glosopharyngeal, axesorius or mandibular nerves. Reconstruction technique depends upon the extent of injury, the availability of the proximal stump and time since injury and duration of muscle denervation. In the presence of facial paralysis electrodiagnostic tests should be performed before surgery and every 3 mounts after, during rehabilitation, which play also the most important role in recovery.

MATERIAL AND METHODS: The authors present the outcome of the surgical treatment of the facial nerve paresis in 31 patients cured in the Silesian Department of Laryngology in Katowice from 1991 to 2002. The reasons of the paresis were otitis media with cholesteatoma and granuloma in 18 cases, head trauma in 2 patients and iatrogenic impairment after ear operations in 11 cases. The decompression of the facial nerve was done in 20 patients, anastomosis end to end in 3, crossover anastomoses between the facial nerve and the hypoglossal nerve was done in 1 case, and transplantation of auricular major nerve in 7 cases.

RESULTS: The outcome was good in 20 patients (64.5%), satisfactory in 10 patients (32.3%) and non satisfactory in one case (3.2%).

CONCLUSION: In our material the most of cases was caused by otitis media with cholesteatoma. The best outcome was obtained after decompression of the facial nerve. The rehabilitation before and after surgery play the very important role in the recovery.