Evaluation of facial nerve function following surgical approaches for maxillofacial trauma

PURPOSE: The aim of this study was to report facial nerve injury following extraoral surgical approaches for the treatment of maxillofacial trauma, using the House–Brackmann facial nerve grading system (HBFNGS) as a means of classifying and measuring the degree and type of injury. MATERIALS AND METHODS: The sample comprised 100 consecutive cases of various maxillofacial trauma in which extraoral surgical approaches were used. Variety of surgical approaches such as coronal, preauricular, endaural, retromandibular, and submandibular approach and its modifications were used based on the anatomic location of the fracture and the accessibility required for its reduction and fixation. Facial nerve function of all patients was evaluated preoperatively and 24 hours after surgery. Patients who presented postoperative facial nerve injury were likewise examined using the HBFNGS at 24 hours, 1 week, 1 month, 3 months, and 6 months. RESULTS: Of the 100 patients, temporofacial branch involvement was seen in 11 cases, whereas cervicofacial branch involvement was seen in 6 cases. Complete recovery of the temporofacial branches was seen in a period of 3–4 months; whereas cervicofacial branches recovered in 5–6 months postoperatively. CONCLUSION: The frequency of facial nerve injury was related to various surgical approaches in maxillofacial trauma. Facial nerve impairment was found to be temporary in all cases, although the recovery of cervicofacial branches took a longer time. Moreover, there is a need to standardize the reporting of facial nerve recovery.