Muhammad Farooq Khan, Muhammad Amjad, Javaid Iqbal, Bushra Anjum.
Iatrogenic Facial Nerve Palsy in Mastoid Surgery.
Esculapio J Services Inst Med Sci Jan ;13(4):227-9.

Introduction: The aim of this study is to see the incidence of facial nerve injury in mastoid surgery for chronic suppurative Otitis media active epithelial type and how can we reduce this incidence. Methods: We operated upon 165 patients for chronic suppurative otitis media active epithelial type and saw the facial nerve palsy intraoperatively and postoperatively. A total of 165 mastoid explorations were performed out of which Modified radical mastoidectomy was done in 155 cases. Radical mastoidectomy was done in 7 patients and combined approach tympanoplasty done in 3 patients . Results: In our series, only three patients got facial weakness 24 hours postoperatively which was grade 3 according to HB (House Brackman). Complete facial nerve recovery was achieved in all three cases with conservative treatment alone. Two patients developed labyrinthine fistula which was managed conservatively. In ten patients, facial nerve was exposed in tympanic segment of the middle ear cavity. Conclusion: Mistake that most likely occurred during mastoid surgery were drilling towards the antrum and going inferiorly. Short process of incus is good landmark to avoid facial nerve injury.

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