Facial paralysis in fractures of the petrous bone

Abstract Recording of the summation potential of the facial muscles with surface electrodes from a representative population of motor units after maximal stimulation of the facial nerve trunk (electroneuronography) has been found essential for selecting patients requiring surgery because of facial paralysis associated with a fracture of the petrous bone. The most common site of injury to the facial nerve in 10 transverse and 30 longitudinal fractures of the temporal bone has been found within the labyrinthine segment of the Fallopian canal. The problems encountered in the surgical repair of the facial nerve lesions are reviewed. In order to repair facial nerve injuries associated with fractures of the temporal bone the surgeon must be prepared to use the middle cranial fossa or the translabyrinthine approach in more than 90 percent of the cases.