The timing of surgical treatment of traumatic facial paralysis: a systematic review.

CONCLUSIONS

Surgical decompression performed within 2 weeks yields the best clinical prognosis for patients with TFP. This study also demonstrated that surgical exploration performed within 2 months results in acceptable outcomes.

OBJECTIVES

The ideal timing for surgical intervention of traumatic facial paralysis (TFP) is still controversial. A systematic review was performed to appropriately determine the timing of surgical decompression.

METHODS

Related studies were identified by searching Pubmed, EMBASE, and Cochrane and reviewing the relevant reference lists until 1 March 2016. Surgical timing was classified into four sub-groups: <2 weeks, 2 weeks-1 month, 1-2 months, and >2 months.

RESULTS

Six studies including 119 patients (119 cases) fulfilled the study requirements. The number of patients who achieved perfect recovery of House-Brackmanm (H-B) grade 1 was 40 of 119 patients (33.6%). Good results were demonstrated in 94.4% (17/18) of patients managed with surgical decompression within 2 weeks vs 63.4% (64/101) of patients undergoing surgical intervention at >2 weeks (p = 0.009).