Temporal Bone Fracture Requiring Facial Nerve Decompression or Repair

Facial nerve paralysis is one of the complications with temporal bone fractures. While the majority of these are treated medically with observation and steroids, we review the indications and surgical approaches to the facial nerve along its course within the temporal bone. It is important to get an exam as early as possible to determine immediate vs delayed, and complete vs incomplete paralysis. Patients with immediate onset, complete facial nerve paralysis should receive electrodiagnostic testing 3–7 days after onset, to allow for Wallerian degeneration.

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